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Home My WebLink AboutPermit Electrical 2004-6-10 225 FIFTH STREET - . SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION 449 Harrlow Rd. LEGAL DESCRIPTION Minds In Motion JOB DESCRIPTION Temp power for building Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2, CONTRACTOR 1NST ALLA TION ONL Y Electrical Contractor JB ELECTRIC. INC. Address 4685 Isabelle 81. City Euaene. OR 97402 Phone 541.687.5770 Supervisor License Number 38728 E"piration Date 1 0/1/04 Constr Contr. Number 37587C ceB 104929 Expiration Date 1 0/1104 3/14/08 Signature of Supervising Electrician ~~,o~ Address City 8orinafield. OR Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: JBJob# ) 1~ ELECTRICAL PERMIWLlCATION City Job Number ~rn ;) OD 2-;" - ~() C:6' .d J'W..lpl\Ql'(ipjj lit'qj,~ \lMpbmilled has the following 3. COMPLETE FE!ZofI\rIgfMlo/\lli1Slflbt..Irtjuire specific land use approval. A. New Residential-Single OIZoning Multi-F~}.Y per dwelling unit. Service Included: Authorized SignatureIt....lII.... UL (,-IO~tOl/J I 9SvJ ......Vj< 3_u 1000 sq. ft.. orless $106.00 $ Each additional 500 sq. ftorportion thereof . $'1900 $ Each M;;;JJfdlT1~t.U)regon .~.. . ~....ctlfes you.!O ModUlafDWell\\\'g: adopted by the Oregon Utility Servici;\ijfti't!&i& Center. Those rules are s~t1OOtl $ in OAR 952-001-0010 tllluu\jl, ~ 95'1.'tlli~. B. Services &EiF.lfedl(fsu may obtain copies of the rules by Installatioiljr.l\ltCl1lli6rilnll3r. (Note: the telephone Relocatilllllber for the Oregon Utility Notification Center is 1-600-332-2344). 200 amps or less $63.00 $ 201 amps to 400 amps $75.00 $ 401 amps to 600 amps $125,00 $ 6lNQtpOEjOOO amps $163.00 $ ofl:tlYJlXP;Pffiffl"~ $375.00 $ AAtPliPffi~D UN~iL EXPIRE IF Tlit w6rlWO $ COMMI.~~Q~THIS PERMIT IS NOT c. TernI.WrffiD-DAY PERJOD.8ANDONED FOR 200 amps or less $50,00 $ 50,00 201 amps to 400 amps $69.00 $ Over 40 I to 600 amps $100.00 $ Over 600 amps or 1000 volts see B above $ D, Branch Circuits New, Alteration or Extension Per Panel One Circuit $43.00 $ Each Additional Circuit or with Service or Feeder Permit $3.00 $ E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $50,00 $ Sign/Outline Lighting _ $50.00 $ Limited EnergylRes $25.00 $ Limited Energy/Comm $45.00 $ 5. SUBTOTAL OF ABOVE MINIMUM $45,00 $ 50.00 7% State Surcharge $ 3.50 10% Administrative F ec $ 5.00 TOTAL $ 5850 o 0 CITY 01' 1JINCiFIEI.D. ORLCiON 0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number Date 1. I LOCATION OF INSTALLATION LEGAL DESCRIPTION JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CONl'RAeroR INSTALLATION ONLY I Electrical Contractor ~ .J:"\.p ,,+ri ( _ Address 4u,9;'S I5.C\6eJ \t<> g Phone ilL<)(l~S\"'O City E"" 6 ~n<=> Supervisor License Number '2> "ZS', ~ - 'S Expiration Date I CI-I..o'-f Constr, Contr. Number I (J I..j q:J q Expiration Date 3- I Y - GY Signature of Supervising Electrician Owners Name Address City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: Inspection Request: 726-3769 3. I COMPLETE FEE SCHEDULE BELOW ElPRINQI?'IELD . fL^~ i~~~ A. I New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft, or portion thereof $106,00 $ 19,00 Each Manufact'd Home or Modular Dwelling Service or Feeder B. I Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only c. I Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. I Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $50.00 $ 63.00 $ 75,00 $125,00 $163.00 $375.00 $ 50,00 $ 50.00 $ 69.00 $100.00 $ 43,00 $ 3.00 E. I Miscellaneous (Service/feeder not included) -Each Installation I Pump or irrigation Sign/Outline Lighting Limited EnergyfResidential Limited Energy/Commercial $ 50,00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee TOTAL . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3~~?1!!~p~~~0~ g,'!.~,;C'n low requires you to, IUIlU.V II..m:. '" a.....utJlCU U'j lilt:: \,...1 CtJUl1 UtilItY SITE ADm'S~~'on venJ4' Ii rm;orw~'lre set lortn ASSESS~~I:Ii! ~t-GE~~,tlf\'703il~4'o7~~0952-001- UO!lIl. 'You may o~ialn copies of the rules by PROJECTCOiJ~\>lrIil>'N!lr. t~~JMl!f~Fe'one number_for the Oregon Utility Notification ..,IQIII.91 tQ 'V\,l"'."''''4~...V*''t'''J' Owner: RLS HOLDINGS LLC Address: 2525 CAL YOUNG RD EUGENE OR 97401 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00683 ISSUED: 06/10/2004 APPLIED: 06/10/2004 EXPIRES: 12/10/2004 VALUE: Springfield TYPE OF WORK: Electrical Work Only NOTifuPE OF USE: Addition Commercial THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNOER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor JB ELECTRIC License 104929 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Expiration Date 03/14/2008 Phone 541-687-5770 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer A vanable: Special Instruction: Notes: Sidewalk Type: DownspoutslDrains: I Valuation DescriDtion I Description $ Per Sq Ft or multiplier Type of Construction Square Footage or Bid Amount Value Date Calculated Total Value of Project Pal!e I of2 . . CITY OF ~rK1j'luFIELD ' Status Issued Building/Combination Permit PERMIT NO: COM2004-00683 ISSUED: 06/10/2004 APPLIED: 06/10/2004 EXPIRES: 12/10/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line IF..... tlWU Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 6/10/04 6/10/04 6/10/04 2200400000000000738 2200400000000000738 2200400000000000738 Total Amount Paid $58.50 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. l.R..onir..d u..dinnLl Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that I have carefully examined the completed application and 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 perfl it card is located at the front of the property, and the approved~et of lans will remain on the site at all ::;;:::~r ~ actio ~ /0 /01 c-"V\ \ /, / ( ow~r.t~ure 'Date Paee 2 of2 225 Fifth Street Springfil!ld, Oregon 97477 541-726-3759 Phone . .P'~.A,I~q~~ .____. ;, ~' , . ',,-. - ',. ! ,~ I ~' . M.ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 2200400000000000738 Date: 06/10/2004 1I:41:43AM Job/Journal Number COM2004-00683 COM2004-00683 COM2004-00683 Description Temp Power 200 amps or less + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 50.00 3.50 5.00 $58.50 Amount Paid Check JB ELECTRIC njm 01433 In Person Payment Total: $58.50 $58.50 6/10/2004 Page 1 of 1