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Home My WebLink AboutPermit Electrical 2004-3-17 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APP. 'LIGATION 10 The following project as su~mitted has the following ..' / ~ 1 zonmg, and does not reqUire speCIfic land use City Job Number ('LJWI.7.oott -002. Cf Date }/7 0 "/ipprovaL (I 1. fitiOeATION!o.EffNsl'Aim1.:loNif~.~l 3. 'e-roviP-'j"":"EfFiW~~HEi:f~i!6,I;y'(B4Y':''':a\rif.'iJ''~~i~ ~""""'''''''''''''''''''''''''''''''"""",:,:~"",""""""",_,k1lr~~'os,,,,,, ts:...",.,,,..,'f5I}];~,,,,, '.,~.~.."......>..,-......,..,,- '0 .J . "!JiU.J12rM'lI',,,.~~,.~ 71.00 H~RTMAN T.ANF A. ~'N"-;,.'r~~~it.i.l~~ITf,i1i~~TJi1~w[i~~iflW~~mW:l:~ffii'H$~~J LEGAL DESCRIPTION ~\i'''~''''.'''''-'''~'''''''''''~'-''~n~.;;.i4~..~~~'1iI~~~..~li.~i;1..B.n:;1'1J:i!f~I..!~..l'i:.~t.:Jo'\~ t 7 t) '\ Z- 2-'33. 00 bOO Service Included 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Expiration Date 12-21-05 Over 600 Amps or 1000 Volts.see "B" above'''\N re.,res vou to R'" ~'~~JnPJ~~"'~~'I~".'!'~I~"l\l@t';;..(i,~:H!',~;~~fC'U~~~l>,~r.'f$"~ ~. r:"~%'{!"\'~- "~"~~ D B'" ~"l~'-;'"'~" ...." ...~,...t")J~r.~u":f:!'NJm.~.I-'"lil.ht:~m~m~"~. <;;'.!a' ~"~!;:l Signature ofSupervism' g Electricl'an . ,! rllnc 1""'":CIII""~,,tf,>!(""''f,,.i,J~' "'~k~;'W-.. H' r " ',J;8..!;:d'"'~"" -.,'.._1., "~~~~$a- ~~ ~,,=...,.., ~ are' se' rtl,il> A7 //~ / /J//.7 /J .v~/ Jllrw Alteration 9.!i:~~!~!lsion'Rer.'PaiiejrhOS: ,r::le AR 952-00 //MAIb/ /' ~~/Jf.,f~~ . ~neCircuit .OAR952-001.0010thr$143t~" _ ....__ I V - - .. Each Additionall,Circuitor)withlay obtam (;Oples 0 ...~ .-.-- . Service or Feeder P~;';itng' the Cr'ntor INc$e-3.00e telephone Owners Name OREGON UROLOGY """: .-...J.h ('\, ;\ID UYJjtv Notification E. ~~~~1lr,W~\f{iW"m'~W~1i'~~\fMt5difa'~'E1iii1BtU'1ltWt1'g~1tl Address 1180' PATTERSON ~~'f,:~"""""'~~"-~"'.';'~~~'\'l:se.~W!lii:lV-"'P'~!o't1~.l'1"").)~~.t!~,~",.!!'F;:f')I{J'~~!Jll JOB DESCRIPTION TEMPORARY SERVICE FOR DE-HUMIDIFIER Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. !l~:\Cf.1!7.'''~'''j(~rn-:tjr3?::R"~~::r.-)i~~;J~!~,~?i\.;''ffil:'1;~'~!;~~ r,t(iJONT-RAC'FOR;INSTlNJEAT-IOMONJ:iYr'\1 2. ~~.'.~f\~~e!~J,~,',"!i""'^~~I~_i-tt~"''\im~'i'."",..-~:.,,;o~;j;iJ.~o,~,.,-~t.1-:tI.~I~ Electrical Contractor SCOFIELD ELECTRIC CO, Address PO BOX 2765 City Fnt::FNE. nR Q7J&2 Phone .bAn-An 12 Supervisor License Number <;nR-~ Expiration Date 10-1-04 Constr. Contr. Number 38702 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 "...........~=..,.-"""""'='"""~e;="'<""."';'~.illl\,,_.V.,~....."""""'''~:!\~''''''''',.'''"'''l~ B ~'):"S' ~''>l'.i;.~?:;!i+~ S!~,;l\"';n"'~~'~d ' .i't"~m'Ii;iVt ""f>.J.'I"I;\1it!:~ ".t,;;,""..,~ t~'l,,', '~\t>;~'!lf"s..;:,~l!,~"~rR"~":" I ~.,f>~",~; ~~:~~~('" i, ' . -''I el,;,:\'lcesrOI;",l\ee eI'S,j'-)' IS a a IOn-:"1\.Jtera IOns:Ol"..:~ e ocahon:,'~~; ~._~: :~1:l.f'.i'!,'.1f"~'t.l;S'{!;l,;~'~'~~.,':'!l!i!1."'''::;'~-ill?':r''i~''~:~:14~~_m>:-t.T';'~~j',"''!~:.~i'~.t.;:;:.~~1I1l;u;:.; 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ~~'X'i~.lnr-.s.~xit~5~w!!,~~y...."'t.'~!'~il:(i~~U~'t1S:~~"~"'7-l~:t~ltlrr'J\?-J.l~W~~"'~fJl c. ,kTem orarv:,Ser;:\'IcesiOr.'FeederSl\" .~~~'~\ti. ;.{ '. ~ltV~1:;.~.lbV''!:'~H~1 "'{' , ", :~"__-"",, P~.-..,~."" ~ ,,'!.. "'.'..','H ".' ".';',,~,_.,,',' '- ";'~""'~"'_. '". .,~fin,.",--..:t:,f::'~"';~l '. .. ,t";,~.":~!~~.,-,~",, .',,:tfir..~q';l 61 ,I' ,~,,,............,-- "''''............,==>..........'~..'.~- ....~""_""""_,,~ '-l:iUlll;~~...'-,,"".>\ A..~'~1l.:~"1A:o Installation, Alteration or Relocation $ 50.00 $ 69.00 $100.00 'iO.OO City ..El1t::F>JF Q7L.n1 Phone 141-Q?<;n Pumporimgation $50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION, Limited EnergylResidential $ 25.00 The instailation is being ma~Qn~l~fJl(i ~'Rl\Y1:i@<PIRE IF 'J1li\ii~rgy/Commercial $ 45.00 15 not mtended for sale, leas,nl-\~Jl. 10 UNDER 1HIS ~I.Tn\iltll!Mc Permit Inspection Fee is $45.00 + Surcharges AU1HORIZE OR IS ABANDONil:)",!i:Q~!m!ijj\'fl1.;,;m;"",".",,,,r,lili1!l-!.', . Owners Signature: COMMENCED 4. ~{)SUB[fO[f,~~~,,~VE.4!f!': 'j 50 00 AN't' 180 DA't' PERIOD. ~'i>1l\1!lt'l'.", " .""', .,';""" ''!;?'d'''.L ,.' 7% State Surcharge 1. 'in 10% Administrative Fee 5.00 Inspection Request: 726-3769 TOTAL 'iR.'in Shared Drive(T:}lBuilding FormslElectrical Permit Application 1"()3 .doc . . CITY OF ~rKlr~t.I<lJ'.,L1J Building/Combination Permit PERMIT NO: COM2004-00291 ISSUED: 03/17/2004 APPLIED: 03/17/2004 EXPIRES: 09/1712004 VALUE: 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: Electrical Work Only TYPE OF USE: New Commercial -:"..;" PROJECT DESCRIPTION: Temp service for dehumidifier Owner: HARLOW UROLOGY CENTER LLC Address: 1180 PATIERSON ST EUGENE OR 97401 I CONTRACTOR INFORMATION 1 Contractor Type Electrical Contractor SCOFIELD ELECTRIC License 38702 Expiration Date 12/2112005 Phone 541-686-8612 BUILDING INFORMATION 1 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carp'or-!JU to ATTENTION:OreS' 'Ft'DthW;.l" " 0 " 1 .. d t ~~ h\l 'ne nrenon Utility follow rules a op Impervlous\Surface Areabrtl ._. ,,__ r",......+n.r Tnn~e ru es i:utJ ::Jt:lL I I DEVELOPMENT INFORMATION} 1)01-001 0 through OAH \io;O:-UV . .' _ _ _6. ........ ,,"Ioc:: ~ 0090 You may obtain CO~REQUlRED Pi\RKING . . r (NotA: the telephone Overlay Dist: calling the cente . IT,~II~!i Notification # Street Trees Rqd:number for the. Oregon ,l!~ndicap.lled: P dD' R d ~_,,'__,~1_pnn-'C"-"""t';)' ave rive q: ompac : # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: ~~ Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I ~~~~~i6 ~~~~~ ;X~~~~~~~{I~~~~ COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: DownspoutslDrains: " Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00291 ISSUED: 03/1712004 APPLIED: 03/17/2004 EXPIRES: 09/17/2004 VALUE: Status Issued ''t~ 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees tiWU 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 3/17/04 3/17/04 3/17/04 1200400000000000336 1200400000000000336 1200400000000000336 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. I ~el'uired Insnection\! 1 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 certiry 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. 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. Owner or Contractors Signature Date ',- Paee 2 of2 225 Fifth Street ~y Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0029I COM2004-0029I COM2004-0029I Payments: Type of Payment Check -1iQ~;. 1I!7. ....,".,' .."-~ ""..'--'."i .. I , ., ~A!.:' I '., J ~' " ,- '" ,- '.".,'~". ',.'.' Receipt #: 1200400000000000336 Description + 7% State Surcharge + 10% Administrati ve Fee Temp Power 200 amps or less Paid By SCOFIELD ELECTRIC Received By djb Check Number Batch Number Authorization Number 28212 ;' City of Springfield Official Receipt .# Development Services Department Public Works Department Date: 03/17/2004 1:43:43PM .',' Amount Paid 3.50 5,00 50.00 $58.5U Item Total: How Received In Person Payment Total: Amount Paid $58.50 $58.50 . .'