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Home My WebLink AboutPermit Electrical 2004-6-23 cl as submitted has the following not reqUire specific land use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(541)726-J75J . FAX~r!iJW'26-J68Q L D v<-- ELECTRICAL PERMITAPPUCA 110N Zonin~ City Job Number CPMzooy.-007L( I.{ Date b~L5 -O~( Date (riJ.S-ofJ. Authorized Signature 9'S 3. .. COMl'LElE FEE SCHEDULE BELOlV . 200 Amp< or legg 20 I Amp< In 400 Amp< 401 Amp< In 600 Amp< \NOQI{ ,mn.:t\C~'. 60 I Amps ~~qo.V\'Ol\f; "I"i \S \'In1 4 ~S- 07~~?t.I'\Cim~lw\fO\. o'V~~R~"'~\ ~QR ,,\\\1'5 QI'\fi.~m\~ - 1~~I'.~\)Q~t.Q , 11-\\"\\'\ ~t.Q QR \S CQ~~~\) ~P!l'~9~hvices or Feeders II-~'i \0 Installation, Alteration or Relocntion '.' ",,""~.' . 1. ; LOCA110N OFiNS1'ALLA110N ..:'...<......,... . , .. "' I. I . 'r Nend€-1~() V\ /'/Olo LEGAL DESCRIPTION 1703"3 ~(3L{ DIQoo JOB DESCRIPTION YV\lI(P r,ron5~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. -rlt......!.,.:.;"';....... :.' . . . . .CONTRACTORINS1'ALLA110N ONLY 2. ~ _.....?;j.I;'.t;,"";~..J,.< '_,.".. .j" '.' . ..~'.. ,.... '.; ,1_," Electrical Contractor R! lI'ldp(S . Uec+rr '<:. ,,)C Address IClC) MClC/,,~()r\ City !S'1)3 {' n (' Phone Supervisor License Number 3:190'. S Expiration Date I D' 1- 04. C~nstr. Contr. Number 4 ';:lq ( 0 Expiration Dale \'J - 10- 01 Supervising Electrician tJ'b A-N((::L is /.l (L,Q;\f Owners Name 0 "'n 'S. t I' \ IeVI') Addre.. 170 G ~clc-5-,,^-- City i::;:vL C:r-rrtv g Phone OWNER INSTALLATION The installation is being made on property 1 own which is nol intended for saie, lease or rent. Owners Signature: Inspection Request: 726-3769 A. .Ne,\ Resideutial- Single or Multi-Famil)' per dwelling ullit. Service Inclllded 1000 sq. ft. or les< Each additional 500 <q. ft. or portion thereof Eaeh ManufacCd Home or Modular Dwclling Service or Feeder $106.00 $ 19.00 $50.00 B. ,Srn"icrs or Feeders - Install fit ion. AIt("r~tion~ or Relocntion: I $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 &~- 200 Amps or legs 201 Amps to 400 Amp< 40 I Amps to 600 Amp< $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volt< sce "D': abo,'e. D. Branch Circuits ' New Alleration or Extension Per PMU'e& yClll.Ul One Circujt ,tol:,Ote90n \a'tol .,~ ~llQ Each ~l\~~91~~>cipwdJ+t\\ \tI6 tu\8S ate se\ ~ servi\iS\\O'IIf<l~ceRllit, 'thOSe o;.&\g!tl-tlM- ~ot\\\catIOn 1.(lO10 \hfO\1on \)\9, cu\8S \rf E. IVW,ee/llilAlilHl?er80tfLffCI!JilIAA ~~~~Ch IlIslallalloll 0090, 'lou ma'i ~et O'lote~ \tI6 No\i~ Pump or~\l.'Ik;I~ :Ot~~3M).$ 50.00 Signlout\~nilfl~~\lI' $ 50.00 Limited Euergy/~'dential $ 25.00 Limiled Energy/Commercial $ 45.00 Minimllm Electric Permit Inspectinn Fee is $45.00 + SlIrcharges . 4. SUBTOTAL OF ABOVE' (0 -=<, - Lf Ij( bJO 7"3 ?l- 7~~ State Surcharge 10% Admini<lralh'e ree TOTAL Sh:ued Dlive(T:VBuilding. Fonn~/E'eclrit:nl Pcnnil Arplicntion I.OJ,doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00744 ISSUED: 06/23/2004 APPLIED: 06/23/2004 EXPIRES: 12/23/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1706 HENDERSON AVE ASSESSOR'S PARCEL NO.: 1703343401400 Eugene TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service change Owner: BARTON DANIEL A Address: 1706 HENDERSON AVE EUGENE OR 97403 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor BUILDERS ELECTRIC INC License 4296 Expiration Date 1211012007 Phone 541-485-0922 I BUILDING INFORMATION I # of Units: # of Stories: Primary Occupancy Group: R-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VN Water Type: Secondary Construction Type: Range Type: # of Bedrooms: Ene~l~ "O't\C~:. , ."'PIRl:. IfS~\:IIik'i B,ilding: '" " ,_ "u~\ \. ~" __.n,. tc, D 1\\IS ~troI~O U~OEP.1i\~~~~Lij~NT INFORMATION' " "'\l1\\~Et~CEO 01\ IS p.\/.., Froutyard SetbackCOWl < a\) O"'~ ~~P.IOO. Overlay Dist: Side 1 Setback: M~~'''' # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla REQUIRED PARKING Street Improvements: Storm Sewer Available: Special'Instruction: Total: Handicapped: iompact: . _".a6~ ~ :-~t<<\\~~~o1\~~ I PUBLI'- ll>IP~Ml~i~~,u\99;;9Si.oo; ~\\~=ce~\~~~~9~~ ~o\i~~.o\)\ ~~~&,p '" O"'~ ~~.-t. ~~;;tio\"'- fi:J9\)' tl6CU"":......-t\u.. ~. ~\flQ \o'~~ ~ CI)~\S Notes: I Valuation Descriotion I Description Tvpe 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: COM2004-00744 ISSUED: 06/23/2004 APPLIED: 06/23/2004 EXPIRES: 12/23/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F....s Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 6/23/04 6/23/04 6/23/04 Receipt Numher 2200400000000000833 2200400000000000833 2200400000000000833 Total Amount Paid $73.71 I Plan Reviews , . 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 R..ouir..d InsoedionsJ Electric Service: Approval required prior to utility company energizing service. 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 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 Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~~.IlEY?,.'."._..._"". ~ ~fj\ ~ of Springfield Official Receipt _elopment Services Department Public Works Department RECEIPT #: 2200400000000000833 Date: 06/23/2004 9:06:13AM Job/Journal Number COM2004-00744 COM2004-00744 COM2004-00744 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard BUILDERS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 000418 025120 In Person Payment Total: Amount Due 63.00 4.41 6.30 $73.71 Amount Paid $73.71 $73.71 6/23/2004 Page 1 of I