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Home My WebLink AboutPermit Electrical 2006-6-30 L.fY\:r- -+- c.. c..... ~1'&JI~fo ,:,Fb,!",tf.-ECD '. '. -5 I NiV'JJn$.ah!l> .L-_I~_'~r \7..-_ . ~-~(. ", '- I . .. '. ~ '" bhG>"Io b "Il ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COoM'Z-O,,6- 00 <tZ \ Date I. ! I,OCATION-oiiNSTAiiATIO;t-~ ~.-~ l__ u, _ _ '. " _ ~... ,_ _,___~__ 2-D 9.\ f.A-v.rA S r- 'K . 3_ l!?~~jErii.F~E_~C!f.ED_l!LEjJEI:O"i~ ~ LEGAL DESCRIPTION 170~ Z7lD JOB DESCRIPTION !ref J l{ OZl17 A, FN;; R~~id;nti.l=-Sin~i; 0; M;,I;i:;"-;;;-i!;p:; d~c1li;lg ~nit~'--~ -~- ----......-___.__1 Service Included (..lr~: h 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 Permits are non-transferable and expire if work is not starled wilhin 180 days of issuance or if work is Suspended for 180 days, $50,00 Supervisor License Number ~ Ol q ~ 1/) fOl I 4)f Expiration Date l II) 7 { Si~a7JYfW? (/ '( Owners Name '1:>it........ C.roo-ldK.- Address 300 -:J>,-I>~IEe- L~..I , City f::1A..6-E?V~~ Phone. 51{ ~ -0' '0 ~ Pump or inigation $ 50,00 NOTIC.SignlOutline Lighting $ 50,00 ~I~~ited En . . . lResi(ieh'ti~IIF THe WUKl\ $ 25,00 THIS t"L11"'" vmy-- .. The installation is being made on property I own which AUTH(,~il!!':~gl@~ygy!(;o1i\'\\&di.f1RMI1I~ I~U I $ 45,00 is not intended for sale, lease or rent. C~M!\i!1iii)fl~ctri'j!, P~r~a~~~~c~~~te~U $45.00 + Surcharges ANY r'''' II ;-,;';;.?Ef\188',., I 4. :SUBTOTAL OF ABOVE ", '. .-:., ..""... - . ~. .' ,-., Expiration Date 2. r 'c;ONrRACTOR INSTALLATION ONLY; B, t.Services 0'- Feeders -In.stall.lion, Alteralions or Relnealion: Electrical Contractor C" h rLb I JI-(l5,1fYJ {;jt2.G nt.L.L '200 Amps or less $ 63,00 I: 201 Amps to 400 Amps $ 75,00 Address .;:;/)D S. D I'll eb 0 V\v.L 40tA.mp~,t?I~Q9ft'11l?~res you tc $125,00 , d, I 601' ~mpsto\IOo.Q:AJI1p.lJon Utilit,! $163,00 City {81.i.)-vfl- . Phone J" llY 'G,J.L1.l'l COver; I OOOAmps/YoJl!i are set forth $375,00 - -- J .d !J::2-0RecOJ!11eft,Q11!Y.Jgh OAR 952-0('1 $ 50,00 G090, You ma\t8~t?;n ""'riesof thlH~r call i ng tr,G'cleT:~mpo.",~\'YL~,':II~'llillWI~,~!I,gs number for the Oregon Utility Notification Centtn.s~llatjl1.nJ~~J:'=~t!'?,n-t7'" Relocalion 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, D. ~!l;:"nch .Circuits .." ",0 .f,c.."." ,;~ ,(-.'. .. .", New Alteration or Extension Per Panel I One Circuit $ 43,00 Each Additional Circuit or with Service or Feeder Permit $ 50,00 $ 69,00 $100,00 Constr, Contr, Number -:", 'J $ 3,00 LlJ 1 E. ~M)~,c~i~~:~eo~~(~,e.~icelfee~~.~; ~~~_ .i~~IUd~~~j'~'~~C_~-'I~~lIp tion,"J OWNER INSTALLATION Owners Si~ature: ~- '. 8% State Surcharge 10% Administrative Fee 52 '1'& SZo b(lb Inspection Request: 72~ ~t(b SU?\ l-()O' <0 0l 0\ TOTAL Shared Drive(T:)lBuilding FormslElecbical Permit Application 1..Q6.doc . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-0082I ISSUED: 06/30/2006 APPLIED: 06/30/2006 EXPIRES: 12/30/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2095 Laura St B ASSESSOR'S PARCEL NO.: 1703271002117 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 4 circuits Owner: JOHN CROWDER Address: 300 DlBBLEE LN EUGENE OR 97404 I Phone Numher: 541-349-0905 Contractor Type Electrical r"'" -. ~ ",..".",nn \aW re4Ull"'''' U~ f\iftI I CONTffi\GTOR'INFORMATlONlJ'egon 'trth 10\10'1'1 \u<v" -- , Those rUlt:lS are set ~ 1- Contractor Notilication center'1 cK!\l~e' OA\E~IWra~lln Date CHRISTENSON ELECT~'QINd52-001-~~.~~?~ooies 01 the r~b~19.lho07 -...." V"., '.1....... "e' tOl:' u;;aut"".- BUIIJDlNG INFORMAmI~'l' "\'t Notilicat\On V_'" - h ureyJ.. Uti I Y -mber tor t e 0 332-2344). # oflSlOneshenter is 1-80 - Lot Size: Height of Srructure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Phone 541-688-6121 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: Q . # Street Trees Rqd: ~1'.,!!Ch'P'pe~: Paved Drive ~q~i1\C~:. \\f>.\.\. ~'!..?\?E 'RwP~~t~Q\ % of Lot Cov~~:s ?E?\'JI\I '5 DE? ,,\\\\'5?r. ED fO\', \~:'n-\OR\lE~~\l~u IS f>.\)f>.~\)O~ I PUBLIC IMPROVEM~'S"I~Df>.; ?E?\OD. ~\'il ,;;I Sidewalk Type: .. Frontyard Setback: Side 1 Sethack: Side 2 Sethack: Rearyard Sethack: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: DownspoutslDrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Aniount Value Date Calculated Paee 1 of2 . . CITY OF SPRINGFIJ!.LV Building/Combination Permit PERMIT NO: COM2006-00821 ISSUED: 06/30/2006 APPLIED: 06/30/2006 EXPIRES: 12/30/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project Fee~ ~ Fee Description + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $5.20 $4.16 $43.00 $9.00 6/30/06 6/30/06 6/30/06 6/30/06 Receipt Number 1200600000000000999 1200600000000000999 1200600000000000999 1200600000000000999 Total Amount Paid $61.36 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspeclion 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, By signature, I state and agree, that I have carefully examined the completed application aud do hereby certify that all information 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 that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will 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 will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-,V6-3759 Phone . 'iniii"" "...... , Wii- o_:'~.._."" .' -' ".. J" " l' .. ,- ...., - -,..,...,,",. -'" , <;IIi of Springfield Official Receipt .elopment Services Department Public Works Department RECEIPT #: 1200600000000000999 Date: 06/30/2006 9:23:36AM Job/Journal Number COM2006-0082I COM2006-0082I COM2006-00821 COM2006-00821 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee' Payments: Type of Payment CreditCard Paid By CHRISTENSON ELECTRIC Item Total: (;heck Number Authorization Received By Batch Number Number How Received djb 030759 In Person Payment Total: Amount Due 43,00 9,00 4,16 5,20 $61.36 Amount Paid $61.36 $61.36 cReceinll Page I of I 6/30/2006