HomeMy WebLinkAboutPermit Electrical 2005-11-01Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
S4l-726-3676Fax
541 -7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01543ISSUED: lll0ll2005APPLIED: 11/0112005EXPIRES: 05/0112006
VALUE:
SITE ADDRESS: 1196 38TH ST
ASSESSOR'S PARCEL NO.: 1702304303202
PROJECT DESCRIPTION:
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition Residential
ATTENTION: Oregon law requi
Owner:
Address:
LARELLE G GRAIIT TRUST
455 ALEXANDERLP #149
EUGENE OR 97401-6580 llow rules adopted by th
o
e Ore
res you to
rgon Utility
001 -0010 through OAR 9S2-OO1-
y obtain copies of the rules byllintheCContractor Type
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Contractor
EUGENE ELECTRIC SERVICE INC
Phone
541-34'l-3561
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
nla
Sidewalk Type:
Downspouts/Drains:
IS
ruNUIRED PARKING
Total:
Handicapped
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
] INFORMATION
PUBLIC IMPROVEMENTS
Description Type of Construction
Pase I of2
Value Date Calculated
EI
\
Overlay
# Street
Paved DAY
o/o of Lot
fib[
Valuation Description
FIELD
Building/Combination Permit
PERMIT NO: COM2005-01543ISSUED: tll0tl2005APPLIED: 11/0112005
EXPIRES: 05/0112006
VALUE:
F
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Fee Description
+ l0Yo Administrative Fee
+ 7o/o Stzte Surcharge
Service Reconnect
Total Amount Paid
Amount Paid
$5.00
$3.s0
$s0.00
$58.50
Total Value of Project
Date Paid
11ill05
11/1/05
tuU05
Receipt Number
2200s00000000001524
2200s00000000001s24
2200500000000001524
Fees Paid
Plan Reviews
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Electric Service: Approval required prior to utility company energizing service.
Reouired Insnections
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Pase2 of2
Date
\
'225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
evelopment Services Department-- Public Works Department
RECEIPT #: 2200500000000001524 Date: lll0ll2005 8:48:35AM
Job/Journal Number
coM2005-01543
coM2005-01s43
coM2005-01543
Description
Service Reconnect
+ 7Yo State Surcharge
+ ljoh Administrative Fee
Amount Due
50.00
3.s0
s.00
Item Total:$s8.s0
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
CreditCard RUSS ROBBINS nJm 001600 Phone $58.50
Payment Totat:
-S55,:Sd-
$.
t
j
;
JC
',!
I.
l
i
I
11/1/2005
Page 1 of 1
*FnallaFlry $
prolect as
ing
Date
Date \ t - (3Ntno'el$ffiture
3. CONIPLETE FEESCHEDTJLE BELOI'Y
Service Included
1000 sq. ft or less
Each additional500 sq. ft. or
portion thereof
uires you to
regg_!_U_tljly. $s0.00
N 0,--C gn"tq r,, Ih psq.rqlqs- ?tg,s.e!- fp r!11
Permits are non-transferable and expire if work is
' not started within 180 days of issuance or if work is
Suspended for 180 daYs.
^ COA'rIRACTOR INSTALLATION ONLYL.
Electrical Contractor
Address i, O { l\, l):\A
Phone.3q{-}5tol
Supervisor License Number
Expiration Date
Constr. Contr. Number Q6.X nn
Expiration Date
Signaure of Supervising Electrician
tollowing
use
225 FIFTII STREET o SPRINGFIELD, OP.97477 . PH:(541)726-3753 'FAX: (Sqr
PERMIT APPLICATION
Ciry Job \
1.
.:
LACATION
LEGAI
JOB DESCRIPTION
DESCRIPTION3o +? <> 3ao)-A. New Residential - Single or lVlulti-Family per drvelling unit.
$106.00
or Relocation:
Ciry
., t.egodiA$fibofles$er. (Note: the telephone$ 63.00
r[Un hf#gidhggQ[figp n U t i I i tV Not r f r cati o S zs.oo
40 I tu$Silffi ddiljo s32'2344L- $125-00
601 Amps to 1000 AmPs $163.00
Over 1@0 AmPs/Volts $375.00
ReconnectOnly }1 $50.00 V
C. Temporary Sen-ices or Feetlers
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
Ownen
Address \s+-
Each
Service UNDER IHSrEntmcE ilol--. C0I,IMEUCEO 0B lS f8$D0llE0f0f,, , ,,, "
E.I\{is c eft fftotts W ffi 0q: I includ Installation
New
One
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
mmrttro&onr--
Phone
OWNER ALLATION
The insallation is being made on properfy I own which
is not intended for sale, lease or rent.
Owners Signature:
Limited Energy/Commercial $ 45'00
Minimum Electric Permit Inspection Fee is $45.00 * Surcharges
SWTOTALOFABOW
7%o Stzte Surcharge
10% Administrative Fee
3.So
TOTAL 5
$ 50.00
$ 50.00
$ 25.00
Inspection Request: 726-37 69 \y
Shared Driv{T:)/Building Fonns/Electrical Pennit Application I -03.doc
so
$ 19.00
€ttd r u o
6
232\ F \
Per Panel
"s