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Home My WebLink AboutPermit Electrical 2004-5-6 .','~f.l(;:7 ,:'" >'" ~""C'l'"'' aLp' s"'-' ~'''FtE''.. 1)' tJ1tE'a" b'" ""' \, <,- .. '.' 'I ,... TY .. I G LN." " :it" ., 1 J_~r_ . it, .. .; , . , f..~'l.~::'ti~. - ':":1 ,:,".~_, _ J...~ ........:~ -'~<~~" ......._;':) l:' .->:., .:. . ~.. .._';;: , ;... \!J..-_.. . "... " .:..... ......L,s... ' 'I 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PII:(541)726-3753 . ~1~fuI.l~~'As submitted has the following .. II ELECTRICAL PERMIT APPLICATION zoning, and doas not raquire spacific land usa . . . lr7L./ j / approval. /1 ~ City Job Number COllVl 1-o0Lf-oO..;) ~-',j)ate c:;;-/6/iJ 'f Zoning l, '1. l;fL6~Ti6M'OjfiNSt;4'i'\T)'ATiON/ij\~'ilY.;m 3. ~CbMP11E:iB.i&tl!)Sdi"-"':' fP:.;".~,:'f.!o.{ . "~li!1l G=.....,..,',.~'\!:""''''"'''.......~ilfillM1lm~ . ~,'-"'~,~"'~,.\ ,......!!J,'!.~j!(d}_ ~~ ' ~~~ '2-0 ? S- L/h-'I. (t..1fl- ~ t- Authorizad Signature New A1terallon or Extension Per Panel One Circuit J $ 43,00 Each Additional Circuit or with '5 Owne", Name' ~ D ~ .....: -&0;"/ ~ Service or Feeder Permit $ 3,00 Add ''''00 '~---, bb ~~' -' J ,....1. E. 1'Mffi:~mm~~'~s~;iir~fil~tt!L3'1~ -, ress -'> "~ 11:cc:.~:,L.N., ,,"-- i!''''''''''ll.::='-'\'_.'''''''''''''''rw' City &-uG6V€:.- Phone 'glf 7 -090) ~\<U'I~"t\~ a!'OS\\~llt'f-\'~\,r-p.tA\1\S~50,OO, ~,,~ytbIIe~ ~twt.\'.1\\~"OQ~t.\) t~\\ 50,00 OWNER INSTALLATION L~,",'lllM ec~h'ii~~ $ 25,00 The installation is being made on property I own which . Llle~!) 'P~~' $ 45,00 . , is not intended for sale, lease or rent. Mlnlmu~~c'~c Permit Inspection Fee Is $45.00 + Surcharges 4. I/!SUBroTm(JE't4BQVE>>W.i1Mm~~fWf,'I rJ~y',t!M.:t:~I~l.~:llu"'~lj!j'M"(_ LEGAL DESCRIPTION /7032.7/0 OZ.l(7 JOB DESCRIPTION ~ ~r~~~;::e:: an: L~!>wor~:~CrS not started within 180 days of issuance or If work Is Suspended for 180 days, ~if9~RAifiOR!iNS'TAil'iUrrON/oMrlf . 2.,,..,<.....-~-m.ofl1:!1.:.~U!.L,.~H~Ift..'t~t~WJ.~It::\"'.1!r ,. li . - f . t Electrical Contractor G ~ s flfl~1r)C ,III\C . Address r. [l. BDi IL'~L City Sf<1 l;:fit' I d. Phone J Lj 1-2 231. Supervisor License Number Lj~ g L\ S I D-OI-OY. :) R L/ (1 9-/-r7</ Expiration Date Constr, Contr, Number Expiration Date ):a~:o:p;g~ Owne", Signature: Inspection Request: 726-3769 . ~ A. il'N~'\;"R~~id1!iit.iai1!?-sjjjlli~:\lVM~itil~~\1iiJlf;\l~!d;::~iiill'~n'~ilim~l 1'~~"Uii.\UiU.~i;,.uun;"~t~'l..:-.g'~'L'."'~" v "l;.>:'i~",M<;' ':l.m... g.'f'.?n.... " Service Included 1000 sq, ft, or less Each additional 500 sq, ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19,00 $50.00 , 1~'\ffi6li'ialjl;R~I~g(ii'~11l'" . ..... 200 Amps or less 201 Amps to 400 Amps ...... Over 600 Amps or 1000 Volts see "B" above, D. "'Biilni:11@lrtiJl~;~''';~"h~~_JlF_~/ij~;$i~~~ Ii~.".u."'..n"'" ~."'UH.~'", t~ ~ . _ \ ." '. f~ LI3 0;' .~ hv..\....-:'~"'l'"'' _ ,~cn~~'l~t'!.ua lo,! 7% State Surcharge 10% Administrative Fee ~z 36'1 52.0 t,o~ TOTAL " .,' SIwcd Driv<(T:)IBuilding FonnsIEleclrical Permit Applicatioo 1.o3,doe . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00534 ISSUED: 05/0612004 APPLIED: 05/0612004 EXPIRES: 11/06/2004 VALUE: Status ISsued 225 Firth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2095 LAURA ST ASSESSOR'S PARCEL NO.: 1703271002117 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Alteration to lights and plugs Owner: CROWDER JOHN W & NATALIE G Address: 300 DIBBLEE LN EUGENE OR 97404 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION I Expiration Date 09/01/2004 Phone 541-741-2236 # ofUllits: I)rimary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I ~ .....TION. n.....on law requj PARKING /o.Ti P"" . vow.. the fj5 II Overlay Dist: \lOW rules adOpted by N ~ torth # Street Tree ~,Catlon Center. '1l\O89 It .yc~. Paved Drive ~~AR 952.001.0010 It\roug ~3 by tffl~ ay obtain copies % of Lot Cov~{jg.o. You m (Note: the 18Iephon8 , \~~\~~~.~^~ :~~llon Utll~:ca1iOR I PUBLIC IMPROVEMENl'-s ICenter Is 1-8U~ Sidewalk Type: Front yard Sethack: Side I Setback: Side 2 Setback: Rearyard Setback: Soh.r Setbacks: Slrecllmprovcments: Slorm Sewer Available!M01\CE: fl.LL EXPIRE IF lHE WORK Speciallnslr"ction: lHIS PERMll S~DER lHIS PERM\1 IS NOl fl.1J1HOR\IED lJon IS fl.Bfl.NDONED FOR Notes: COMMENCED n ;..:;'[ < on nAY PERIOD. I Valuation Descriotion I DownspoutslDrains: Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . o . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00534 ISSUED: 05/06/2004 APPLIED: 05/06/2004 EXPIRES: 11/06/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~~ paidJ Fcc Deserilltion + 1 WXI Administrative Fee + 7':1" State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Cire Ea Add Amount Paid Date Paid Receipt Number $5.20 $3.64 $43.00 $9.00 5/6/04 5/6/04 5/6/04 5/6/04 2200400000000000488 2200400000000000488 2200400000000000488 2200400000000000488 Total Amount Paid $60.84 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouired Insoe~ti?n~ I I Rough Electric: Prior to Cover 2 Finnl Electric: When all electrical work is complete. By signnture, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all infnrmation hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and thnt NO OCCUPANCY wlll be made of any structure without permission of the Community Services Division, Building Safety. I furthcr ce.'tify that only contractors and employees who are in compliance with ORS 701.005 wlll be used on this project. I further agree to ensure that all required Inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans wlll remain on the site at all times during construction. Owner or Contractors Signature Date Pa!!e 2 of2 225 FIfth Street Springfield, Oregon 97477 541-726-3759 Phone . ~~ liE' of Springfield Official Receipt _elopment Services Department Public Works Department RECEIPT #: 2200400000000000488 Date: 05/06/2004 1:32:S9PM Job/Journal Number COM2004-00534 COM2004-00534 COM2004-00534 COM2004-00534 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee P3ymcnts: Type of P:I)'mcnt Paid By Item Total: Check Number AuthoriZation Received By Batch Number Number How Received Amount Due 43,00 9,00 3,64 5,20 $60.84 Amount Paid CrcditCard MELISSA GEHRKE djb 000376 006360 In Person Payment Total: $60,84 $60.84 5/6/2004 Page I of 1