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Home My WebLink AboutPermit Electrical 2006-11-15 CD.o. sP~~ (Y)~~irl(( "/ls/~ ,;' ;.. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERltIIT APPLICATION City Job Number c.o-m~~ -O/~"1 ,. . . ... .. 1. LOCATION()F INSTALLATION :;~::;!,';. 2Aoo ~-1YY\4r\ Lane.. Date 3.c6]ifpLE:TEFEiFscjjitJjULE'lJELOW . ~,_ ., d, .., _. ~ - "', _..._. "'".,.' '. ,__ _.." _ "-", A. Ne~R~sidenii,~lj:Sij,.~le~l: i\I~lti-F~iHWYc'p~:~,~~~it'li~g~njt Service Included LEGAL DESCRIPTION \1 03 '2-2- !::.7, 00600 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 JOB DESCRIPTION 2- e>>r4wJ, ciAr.J.Uk $ 19.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . cONikAC1'OR'mSTALIA'J'lON ONI_Y . - . - ",'-'- ,,- , ""';,'.:"j; $50.00 B. 'S.er,\'j~rs or Feede.rs:;-:'"',1,ns.t<:tllan~I~, .Aller~tions o~ ~eloclltion: . -. ,~. . 2. Electrical Coi'tr,artgrN-:-:::?CP~'J~~::F:~!,:C:~R,LC..52,o,.v" ,... 200 Amps or less NOTICE: $ 63.00 '''11'111\1 rL,I"", "Idooted by tho'Orcgon Utili+lOI Amps to 400 Amp~H _ $ 75.00 Address ~;.?;::~.?!.:.:.~?~5_:::~:. -:-:-.;:;;:;':' ;;::;:;;:; .:.;:; set fCliA01 Amps to 600 Ampi IS PERMII SHAlsl:BXlIlIRF IF TI1I' LVORK , in OAR 952-001-C010 throug!l OAR 952-00?01 Amps to 1000 AmWTHORIZED UNDr~6HI9S PFRMIT IS NOT City ~'r'~'::,nll~:. ~:,l~eR~in nli;RhcRhh?cg rules 19ver 1000 AmpsNoitCOMMENCEO OR ItH%iW.JQ.0'Jm f9R cal~I7,~q.~e cenler. (Note: the telephone Reconnect Only ANY 180 [)..'\'( r::~ldD?'oo numberfnrthe Oregon Utility NotificattQ.c!J -T'. .,..... S""~' - 'F'd" Supervisor License Numberer:_ 42188 'v..,,,,' nn A.., . -::..!;.ry.~p~r~r:)':-__,~,ry~~~~ HL..~~e~rs,."~ \"tHIl ..... .....~,~ ...._ _ , .... '" 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 "13" above. D. '~~~.r.an~~j";CH:c~Ji~i!:i;,:;",-r~:-"',-, ~->~~ . New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with I Service or Feeder Permit 10/01/2007 Expiration Date $ 50.00 $ 69.00 $100.00 Constr.C onlT. Number 38702 12/21/09 Expiration Date '2~"?~M . Owners Name .Dx.t../Ar:iYt tLtn ~U Jttsf: Address I \ ~D r~ (J'y, I City ~ Phone *3- Cfz.ro OWNER INSTALLATION 43.00 d.DO $ 43.00 $ 3.00 E. ': iMis(;~I-ijineolls (Se-r\'icetf~~eder'not iiu:hided).~Each InstnHntion , ::' ._,,:. ,I., ", '., -~ ' : . ,'_ Y,' . . ,. ,_ -,'" '.'-:" ., ';. -' .. ... ..' """:. '-...,.." "'. .., '.. . Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 The installation is being made on property I oWn which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is 545.00 + Surcharges ~.OC> 3.b~ 4-.hO ~.~D ~.~~ 4. SUhTOTALOFABPVE Owners Signature: 8% State Surcharge 10% Administrative Fee T~7':.L~ ~ Inspection Request: 726-3769. Shared Drive(f;)lBuilding FormslElectrical Pennie Application 1-06.doc 225 Fifth' Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-0 1267 COM2006-0 1267 COM2006-0 1267 COM2006-0 1267 COM2006-0 1267 'payments: Type of Payment CreditCard cReceintl RECEIPT #: . 8Pj:~~ ~- Ci_f Springfield Official Receipt D.opment Services Department Puhlic Works Department 2200600000000001587 Date: 11/15/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By SCOFIELD ELECTRIC Item Total: <":heck Number Authorization Received By Batch Number Number How Received ddk 21535 In Person Payment Total: Page I of 1 10:55:39AM Amount Due 43.00 3.00 2.30 3.68 4.60 $56.58 Amount Paid $56.58 $56.58 11/15/2006 . ecITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01267 ISSUED: 10/10/2006 APPLIED: 10/04/2006 EXPIRES: 04/10/2007 VALUE: $ 20,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2400 Hartman Ln ASSESSOR'S PARCEL NO.: 1703223300600 Springfield TYPE OF WORK: Interior TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Change waiting room into office Owner: OREGON UROLOGY INSTITUTE Address:, 1180 PATTERSTON STREET EUGENE OR 97401 Phone Number: 541-343-9250 I CONTRACTOR INFORMATION I Contractor Type Contractor License Gene~aJ_~. ,_''''''.r\.MJ!j:I\F;RF;Y,J,;rA YLORw 158664 f~'li~;r~les adopted by \l~,: (jIlini' 1,';BUILDING INFORMATIlpi IE" Notification Canter. Those r11lr.': ',f'; ,',' '"' \~U'.l., " # of.pnj!.s':1952-001-001 0 tilrou('h U/\,: ",:f)(J# of Stories: THIS PERMIT SHAloiSiWIRE IF THE WORK Prill'~'.fu?ff,'I.!'~,'1~~ g!:.'!~p':, copizs oB11I rljl~[; ,Height of Structure AUTHORIZED UN~!I~t"P~i~lil6flMIT IS NOT seCOndary,OCCUl'anCY1GrOU, I',:J Ie' Ih"l '(;I,'.;;'~,r;~ Type of Heat: COMMENCED ORlfj" ~nd'''lnn'''D FOR r.a""lu H.~ l.C:. ~.....lo \ " . . ',W .' ::'i'b I"\I'4UUTi"L. Primary Construction ;I:ype,nn IJ"tY1hr ~"t;jt. <lonWater Type: ~ asement: "'lm~l':\rf(lllIl....,-.-I~'1 '. ../.1.1 ~ ANY180DAYPE Secondary Construction1Type:.. . 'j.';iH/A', Range Type: 'Garage/Carport t ,onler I~ ....,J.~ ~ ~ - -'-' ~ ./- # of Bedrooms: ~ Energy Path: Sq Ft Other: Sprinkled Building: Yes Occupant Load: Expiration Date 0211112008 Phone 541-990-0905 I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descrintion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . ecITY OF ~rtOl~l:."lf,LD Building/Combination Permit PERMIT NO: COM2006-01267 ISSUED: 10/10/2006 APPLIED: 10/04/2006 EXPIRES: 04/10/2007 VALUE: $ 20,000.00 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Estimate Estimate $1.00 20,000.00 $20,000.00 $20,000.00 10/04/2006 Total Value of Project F.....~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Amount Paid Date Paid $18.54 $9.27 $14.83 $185.40 10/10/06 10/1 0/06 10/1 0/06 10/10/06 Receipt Number 2200600000000001420 2200600000000001420 2200600000000001420 2200600000000001420 Total Amount Paid $228.04 Plan Reviews I Fire Department Review Structural Review 10/10/2006 10/04/2006 10/10/2006 10/04/2006 APP GRG APP DJB approved per JMP 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. ~..d In.n~ Framing Inspection: Prior to cover and after all rough in inspections have been approved. Firewall: Located and constructed according to plans. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that I have carefully examined the completed application and do herehy 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 he used on this project. 1 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. 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