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Home My WebLink AboutPermit Electrical 2008-7-1 ZON 1:1') INITIALS rJ ~ DATE/-~-OK SOURCE m.o~/ 22S FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726.3753 . FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number ~ VIA. ,;;LEo f?'- Co I D " SupervIsor License Number 37S (.., 5 C i T~~rlIry Se!"lces or Feeders- .' 'i\'" j! / p 2~"11i''' ExpITatlOn Date /0 (") j ~ 10, "0 : B',. 'U'''d J ,lnslalla/,lIlH' AlteratIon or RelocatIOn 'I/('AH9 "lIiFr Th lJ300,,, )l~.to ODIi(b .02-001 0 oScru/~an t:1f1l1ty_ Constr Contr Number ./ "/ CJ / cf&.i7l" YOU m"y ~~~IO throt1BA ~@1tlelll!lI'/ljHPS ~ I1Umbe~ ~~~ Center. (Nc,~PIt1SIJ\m~1\mps ExpiratIon Date ----.S: ~"., / (\ _ the n'e e g"", ....~.Aro es ""1000 V It "B" b Vf:lflle 90n Uti tVer...."PEOus tw 0 s see a ove 1~1~0 '~~~{j& - Slgnatnre ofSupervlSlng ElectrIcian O-JQ2~1..:-.-,:,lliffllts _ _ . .: _~ . _ _~_. __ r\ cp JJ, New Aiterallon or ExtenSIOn Per Panel ~ ,.vIVO '----- One CrrcUlt $ 48 00 -- Each Add1l10nal CIrcUIt or WIth -? c:' ,I 1:> _ ServIce or Feeder PeTmlt '- $ 4 00 Owners Name ~~r... 'll-C>YS. Address 4 '3 s-S S fa........... 1J /... d. City &.G.- C:1V~ 'lffff/Pt . Pump or rrngatlon $ 55 00 THIS p"c. SIgn/Outlme Llghtmg $ 55 00 OWNER INST ALLA TIO~UTHO ERMIT SHALL EX LUnIted Euergy/Resldentml $ 28 00 The mstallatlOn IS bemg ma<@&~R.j~lVdY/rJ(Jffl;"f//RE IFi'FPI!fr ICommercml $ 50 00 IS not mtended for sale, leasAwe NeED OR IS A ISrRliIii4ff'P ~fl.I; PermIt InspectIOn Fee IS $50 00 + Surcharges 80 DAYp BANDnNE" ..ICi,y" -. - -- , Owners SIgnature tRlOD. 'lI J}rPa1l0T. OF ABOVE " - IS ~ ~ '"--~~- - , ) . "6 1(:50 'fO / 0 !.fL ,- -~~-- I LOCATION OF INSTALLATION: ~M ""M__ ~'"'_~_ _ _ _ = __~ / 8'. ~ C-, s:..,. /J? c:. '7' LEGAL DESCRIPTION 17D>>b>I 67700 JpB DESCRIPTION . ~ ch~ *- t ~k..C LJYf!.p ~{J tc:yr /'/ /",,~/.7'" - J Permits are non-transferable an~xPJre Ifwork IS not started wlthlD 180 days of ISsuance or If work IS Suspended for 180 days CONTRACr()R INSTALLATION ONLY 2 Electncal co:tractor (1;: {;,~ ~ J , Address I~ 3 c.. City _;.ap. /1,,---1 ~\'"I1.P- ;4...,k ..., Phone 9cS-\I'. ?stf' J InspectIOn Request 726-3769 Date -1~O/~o'6 "----,,,~,~ ~, ~ ~-"'~ - ---- 3 tCO~PLETE F1!E:.~C!fEDULE ~EWW ~~-- , - A i New Residenbal::Single or MultI-Family per d"elllDg UUlt 1 ~-'~ ~~~ ___""_~,,~_~~~~="" ~~~~""-,, ,,,;;) ~ ServIce Included 1000 sq It or less Each additIOnal 500 sq It or portIon thereof Each Manufact'd Home or Modular Dwellmg ServIce or Feeder $11700 $2100 $55 00 r-"~~ ~ '" ',~T""""",- "'r~ B . Services or FeederS - InstallatIOn, AlteratIOns or RelocatIon. ~~ j 0 _~ _ _ ~- L;;_ _ /,',- 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 70 00 $ 83 00 $13800 $18000 $413 00 $ 55 00 $ 55 00 $ 76 00 $11000 g r~ ~ - . E . M,scellaneous (Servlce/feeder not lDeluded) -Each InstallatIOn '-~~~ -~-~--.;;~-~~-- ~-j -~~~-"'-*- - 12% State Snrcharge 10% AdJOIDlstratlve Fee 5% Technology Fee TOTAL Shared Dnve(T )/BUlldmg FormslElcctncal Pennlt ApplicatIOn 1-08 doc 225 Fifth Street Spnngfield, Oregon 97477 541-726-3759 Phone . ~~ CIty of SprIngfield OfficIal ReceIpt Development Services Department PublIc Works Department Job/Journal Number COM2008-00 I 06 COM2008-00 I 06 COM2008-00 I 06 COM2008-00 I 06 Pdyments 1 vpe of Payment Check cRecelOtl RECEIPT #. Date: 07/0112008 1200800000000000718 Description Add, Alter, Extend ClfC Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmmlStratlve Fee PaId By DARRELL ROSIN Item Tot.1 Check Number AuthorizatIOn RCl-clved By Batch Number Number How Received dJb 1135 In Person Payment Total Page I of I 917 lOAM Amount Due 800 040 096 080 $IU 16 Amount Paid $1016 $1016 711/2008 ::/ fa: Status Issued 225 FlIth Street, Sprmgfield, OR 54]-726-3753 Phone 541-726-3676 Fdx 541-726-3769 InspectIOn Lme CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO' COM2008-00106 ISSUED. 03124/2008 APPLIED' 01125/2008 EXPIRES. 09124/2008 VALUE' SITE ADDRESS 1836 S A ST ASSESSOR'S PARCEL NO 1703363]07300 PROJECT DESCRIPTION Electrical only Owner ROSSI SANDRA L Address 4355 SPRING BLVD EUGENE OR 97405 Contractor Type Electrical Contractor CRAFTSMAN # ofUllIts Primary Occupdncy Group Secolldary Occupancy Group Plllnary Coustl uctlOn Type SeconddrY ConstructIOn Type # of Bedr ooms Front yard Setbdck SIde I Sethdck S,de 2 Setback RearYdrd Setback Solar Setbdcks Street Impl ovement!t Storm Sewer AVdlldble Speclallnstrulhon Notes De~cnptlOn Tvpe of Con~tructlOn Sprmgfield TYPE OF WORK Electrical Work Only TYPE OF USE CommercIal I CONTRACTOR INFORMATION I LIcense 170]83 BUILDING INFORMATION' ExpIratIon Date 05/30/2010 Phone 541-954-7589 B # of Stories Lot Size ..fii'lght ot Structure Sq Ft 1st Floor NOTIq;pe of UfI\lll EXPIRE IF THE WOR~ Ft 2nd Floor THIS PMlM.lTr~ 5 PERMIT 15 NOJq Ft Bdsement AUTHOOli!i{)'UWtlER THINOONEO FOR Sq Ft GaragelCarport COM~OW'OR IS ABA Sq Ft Other AN'l1m5'DWf~~I~l)g nla Occupant Load I DEVELOPMENT INFORMATION I VN REQUIRED PARKING OverldY DI>t # Street Tree; Rqd Paved Drive Rqd % of Lot Coverage Total Handlcdpped Compact I PUBLIC IMPROVEMENTS I ~rmtm>&IIW requIres yoU to ^TTE IA . do ted by the Oregon Utility follow rUrr,\t~~'tiW$la'nJles are set forth Notlficatlon~~1'()010 through OAR 952.()01. In OAR 952 btaln copies of the rules by 0090. You may 0 (N le' the telephone calling the center. 0 utllohl Notification _..~..... th,\ O{egon ", . .._.11'- - Center Is 1-80U""""........./. I ValuatIOn DescrmtlOn l $ Per Sq Ft or mulhpher Square Footage or Bid Amount Value Ddte Calculated Pdgelof2 __R'NR"~ ~ J,1. ... , JIIi: CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO ISSUED. APPLIED' EXPIRES VALUE' COM2008-00106 03/2412008 01125/2008 09124/2008 225 Filth Street, SprlngIield, OR 541-726-3753 Pholle 541-726-3676 Fax 541-726-3769 InspectIOn Lme Tot,ll V dine of Project Fees Paul I Fee DescllPtlOn + 10% Admllllstratlve Fee + 12% State Snrchdrge + 5% Technology Fee Add, Alter, Extend Ore Add, Alter, Extend Orc Ed Add Pendlty Fee - BWOP Electrical + 10% AdmmlStratlve Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend CII c Ed Add Amount PaId Date P dId RecClpt Number $1040 $624 $520 $48 00 $400 $52 00 $080 $096 $040 $800 3/24/08 3/24/08 3/24/08 3/24/08 3/24/08 3/24/08 7/1/08 7/1/08 7/1/08 7/1/08 1200800000000000270 1200800000000000270 1200800000000000270 1200800000000000270 1200800000000000270 1200800000000000270 1200800000000000718 1200800000000000718 1200800000000000718 1200800000000000718 Total Amount P dId $ 136 00 I Plan ReVIews I To Request an InspectIOn call the 24 hour recordIng at 726-3769 All InspectIOns 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 ReoulI ed Insnectlons I Rough Electr IC Prior to Cover Fmdl Electric When dll electrlcdl WOI k IS complete By SIgnature, I stdte and dgree, that I have carefully exammed the completed applicatIOn and do hereby certJfy that all mformatlOn hereon IS true and correct, and I further cerllfy that dny and all wor k performed shall be done ID dccordance With the Ordmdnces ot the CIty of SprlngIield and the Laws of the State of Oregon pertallllllg to the WOI k described herem, and that NO OCCUPANCY Will be made 01 any StruCtUl e Without permISsIOn of the Commulllty Sel vIces DIVISIOn, BUlldmg Safety I turther certlly that only contractors and employees who are m compliance With ORS 701 005 WIll be used on thIS project I further agree to ensure thdt all reqUIred IDspectlOns are requested dt the proper t.me, that each address IS readable trom the ,treet, that the permit card IS located at the front of the property, and the approved set of plans WIll remam on the SIte at all times dunng constructIOn Owner or Contractors Signature Date Paee 2 01 2