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Home My WebLink AboutPermit Electrical 2005-8-5 . ,-..,..... .,.....,~" ;\' CITY OF 'sPRINGFIELD, OREGON ~ . . T~Q~~ tI\i sa;::.. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 . ELECTRICAL 1?~N't'fICATION CityJobNumber \'_,U. \\9"'] Date 1.:.,(F"Qi!i .._L_. rg,(jN.l:~S.b.li.i!.ui2iEjjEiJ6 . "",. - --.;.,.... ',:t;"1,.o.,":,'" -. LEGAL DES~T10fi) f"'\ . A. ~wr~~~~~~,irte~f:i,:"'IiII!~"Dirf \0 ~. Service Included ~o DESCt' ~IO~ n!ri~~r ~~BLIOoOSq.ft.orless M I~ f\ r. _ tV\ \) Each additional 500 sq. ft. or r LA , \U 1\ \ \' portion thereof Permits are non-tra rable and ~Ire ifw~rk is Each Manufact'd Home or not started within 18 ays of issnanee or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 2 if€0':'W;)~crORi1Ns.~T:~lr'J'fA;::;VMUNiiy;Jl . ~~r':'~'~A-:';''''l~~'''f\4~\ll-l'''~ $106.00 $19.00 $50.00 Electrical Contractor La nt;z EJe.cil1'c.. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Address 3J-I~31 -\-\ WI..{ S n ~ City ~W\~.rft.. Phone -=r 21P(x,'5 '1 Supervisor License Number 3 t.J 9 J ~ Expiration Date lof 112ex:)':::+- , , Constr. Contr. Number ,.:;) (j - .3';;;>.~_ Expiration Date =1-1 \ I WOtp 1i't~._'''''''-'''":!lI:!''''''""''''''"'';'\ 4 '''''':1i''''''''''~'''--'''''''':ifl1 c. : .e~,:,~nrry:~eru-c~.,9r1F.,~ede~~!:.~~;;..~~~w~'6.t~a~~~;~ ~ !~ Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. i'BriifiiN3i~cuj&~D"'i"i~~~~~~~ ~..__.....~........ . ~'lli.. .. '. ,." l $ 50.00 $ 69.00 $100.00 .EJ.rP The installation is being made on property I own which is not intended for sale, lease or rent. New Alteratiou or Extension Per Panel , One Circuit S ' " Each Additional Circuit or with () ~ 9}J~ 1efrt:.:~~~e.~::",:~:,c.","",...~~~.~:<~~:0",,,,,,~~,,~>,::! ~l , iJ _t E. ~ii~~~~X$1m~~!t.~1rr~At:~~~I.~]~)~~~~~~f~~~.~l hone j1J,p . 31S..:::>rump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidentiaI $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~;'."'"'''~'''"''. "".' '~-::""''''~''f'''''~~'''!''i';;,~~''<C''1IJtn.'' 4 SUBTOT.4'T:'OFiifBOI':J'.$',Jil'Ilt.,,~'.J:'!.<,'.. 1. ~~~~.t1'~.Jl:~~-.;t.,~:<~~~:f~~..:~" ~ ~ % State Surcharge . . 9 10% Administrative Fee $ 43.00 Owners Signature: 5~ Sf) ~\ Shared Drive(T:)lBuilding FonnsIElectricnl Permit Application 1.Q3.doc . Status: Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line }d T- . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM200S-00769 ISSUED: 08/0S/200S APPLIED: 06/21/200S . EXPIRES: 02/0S/2006 VALUE: SITE ADDRESS: 0 Martin Luther King Pkwy ASSESSOR'S PARCEL NO.: 0000000000000 springfield TYPE OF Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Signal and street lighting for Martin Luther King Pkwy project - multiple locations Owner: CITY OF SPRINGFIELD Address: 225 FlIT" STREET SPRINGFlELD OR 97477 Phone Number: 541-726-3753 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor LANTZ ELECTRIC License 84679 Expiration Date 07/14/2006 Phone 541-726-0659 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: # of Stories: Height of Type of "eat: Water Type: Range Type: Energy Patb: Sprinkled Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a UIDEVEL0PMENTrINFORMA TION , 80J 03NOClN\f8\i :>1 tjU U:J:JN3lN1AlO::J lON S/11l1\!83d S/HILJ30Nn f'!~'7" 'n, ..,. Frontyord Setback:dO a 'Overlay'Dist: Side 1 Setback: /I M 3Hl.:J/ 381dX3 ll\iHS l#'Street 'rre~ Side 2 Setback: Paved'Drive Rqd: Rearyard Setback: % of LcifCoverage: Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: IPUBLIC IMPROVEMENTS I Street Sidewalk Type: Notes: Storm Sewer Available: ATTENTION: Oregon law requires you to Special Instruction: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You mav obtHin ~nnjpc:; "f tho 1" doC' hH calling the ",,,,,,ef._l,"ul'" me lelepnone' I number for the QfQV.aluation ,Descriotion Center is 1-800':'l32-?344). . $l'er Sq"Ft Square Footage Tvpe ofConstruchon or multiplier or Bid Amount Downspouts/Drains ~ ~~~_~aA ~r~ ~ Description Value Date Calculated I of 2 (lO,~Lo . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00769 ISSUED:. 08/0512005 APPLIED: 06/2112005 EXPIRES: 02/05/2006 VALUE: Total Value of Project F~~s Pair! I Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid $44.10 $30.87 $441.00 $5.00 $3.50 $50.00 6/23/05 6/23/05 6/23/05 8/5/05 8/5/05 8/5/05 Receipt Number 2200500000000000816 2200500000000000816 2200500000000000816 1200500000000001150 1200500000000001150 1200500000000001150 Total Amount $574.47 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. Electric Service: Approval required prior to utility company energizing service. By signature, I slate 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 8/ld the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wiD be made of any structure without permission ofthe 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 l<i located at the front of the property, and the approved set of pl8/1s wID remain on the site at all times during construetiolL Owner or Contractors Signature Date 2 of 2 225 Fi.!'th Street Spriiigfield, Oregon 97477 5H-726-3759 Phone Job/Journal Number COM2005-00769 COM2005-00769 COM2005-00769 Payments: Type of Payment Check '} ., J 'I 8/5/2005 . RECEIPT #: ~~ 1200500000000001150 Deseription Temp Power 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By LANTZ ELECTRIC Received By IIh I of I ..ity of Springfield Official Receipt .velopment Services Department Public Works Department Date: 08/05/2005 Item Total: Lbeck Number AUlb.ortzaUon Batch Nomber Number How Received 22693 By Mail Payment Total: 3:04:28PM Amou nt Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50 " ' i '. ,'.' CITY OF SPRINGFIELD, OREGON .J SPRINGPlBL.D " I 'f5 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541) 3689 :~~ ELECTRICAL PERMIT APPliCATION """ ~ City Job Number LtJ/4II lOor - 0 0769 Date b - 20- 0 ~ .,~_ . . t. ~'[!Q~~.fi'~~~~~ 3. f51 ;1.(IIII-:1',,1/ /.....:UG.L t....... ?~t"Y LEGAL DESCRIPTION 00000000 00000 Servlee Included 200 Amps or less 7 $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsIVolts $375.00 Reconnect Only $ 50.00 _.\I"".~ w jl.lIENTI~~~e:W;t'teQ~,:nj\\J;>~1i~~t~~rMol '0110\'1 ~le~~~~~~~",\'{Rl!I3c~J.i Notilica\\on 1.1)11" eljl! ~~WUg . \tie {\lIes bY $ 5000 ,,0 952=1:ltW . ~onies 01 . III 0,," u 'lfla'f'O\P~ IO~l?!lfe telep\'lOlIv _ $ 69.00 0090, ~o ffele\JllPSfto &titmt'l' Notilicau"'" $100,00 :~~~=~~1~=:~~~;~_~~~iM<11!m JOB DESCRIPTION S-/a-.+ L~~ b I <;.irY1,A./~ tJ.... vYtL/.c:. . I. / Permits are non-transferable and expire If work Is not started within 180 days of issuance or if work is Suspended for 180 days. BtroAm>c:.crORijNSii:':4'f;'~#oM'()N'f,E:."Jj'l 2. ~~,,\.':--J-i:'i';:o-~~~~t:Ii-''''>?-"''~ Electrical Contractor LLlI'\tc..EJedn'c.. Address 3J-j~31 -\-\ U)u F1 ~ '-J City~W\e--;OC Phone ";f 2{,0(", 7::J ., Supervisor License Number 3'-1 q;J,;<; Expiration Date lof II '280-::+ , . Constr. Contr. Number ~ (") - 3.o..:~L Expiration Date :::tl \ I 200~ Signature of Supervising Electrician ,,~~~~ Owners Name CA-...,. <.l f- S"r,;~t,..t:t5{d. , zz ~ <::;+L--. So-r Phone 7Zb - 3 7 S.J Address City S'PI::=~ OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 E~\l'4~~~/,..~~1:'~.''f.~'''~~~''''1~.;e'N':\.~~t''~ii1'!f~11\. B. er.vJf~~~~ts~~~YatIOI!;h\:JJe~tIon~iPra:c.elocahon~' 44/ New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43,00 $ 3.00 E. ~~.M~i~iili1j}~7(Se~relr~~~1'irr;tti1i~ili"dfJ3~E:aii:r~II~ti'~tJ ~"~---.....r-''''''~'''''' -.J"-~"""-''''''' ".."...">>:-'hl......_..-... - .t-'\..,;~.. ._.~-~-,.~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidentiaI $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges ~~""'..C.1~~~;,;r.:",=,~""'''.'''~'l;-~..N~'.O'Y~ff};j.'!'h.''-'i'}~''''-'''.~~"~ Owners Si ature" 4 '" . . OTA'L;OEJi'BOVE""'" ..~,,~ . , . gn ,'lOTICE. ALL EXPIRE IF THE ~~'l\1t:rw~,.,.,'''''~it>~~ . '.lJ,""~'ii,,, THIS PERMIT SH 'oJ .. ,_. .~nncn 11~In~R 1HIS PERMIT IS Ni% State Surcharge ~~MMEN(iDOR IS ABANDONED FOR 10% Administrative Fee Inspection Reque~:I'126f.3~769AY PERIOD. TOTAL L-/ L{ / 3D '(,7 114/0 S;/S-97 Shared Drive(T:YBuilding FonnsIElectrical Permit Application 1-03.doc Status Issued . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00769 ISSUED: 06/23/2005 APPLIED: 06/21/2005 EXPIRES: 12/2312005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 0 Martin Luther King Pkwy ASSESSOR'S PARCEL NO.: 0000000000000 springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Public PROJECT DESCRIPTION: Signal and street lighting for Martin Luther King Pkwy project - multiple locations Owner: CITY OF SPRINGFIELD Address: 225 FIFTH STREET SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I 0\1 \0 Contractor leC\\1ltes'/ \)\iliti License LANTZ EL!,G.~'ll, _ ()le90{\ r,lol\" 84679 ~~~'\IOt'-l~d~?\ed If>;BmIlDlN~iN~A TION I f>. ... lUleS tel '\, U~'n ~. lJrM ! 1, \0\\0~ eel" 0 \\\10" ,. ,\\e e # of Units: .i{ICa\IOl\ \..oO\. O~#'Slorl~"o~ Primary Occupancy GtGuJ!.:1\1'\ 9,,::,'2..00 o'O\al{\ C o~.IgIit W1,~\\f~ Secondary Occupancy c>>roo/cr 'Iou tl\a,/ {\\el. ~~ PMm!\at: Primary Construction T~Cj \1i1\9 \\\e Ce e OlegO ~~~~e: Secondary Construction Typl: :oet \ot \\\ is '\-~O ange Type: # of Bedrooms: (\UfO ce{\\et Energy Path: Sprinkled Building: Contractor Type Electrical Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Phone Number: 541-726-3753 Expiration Date 07/1412006 Phone 541-726-0659 nla Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: HandIcapped: Compact: Overlay D1st: # Street Trees Rqd: Paved Drive Rqd: % of Lot\cO\\erageDR\\ ~Gi\~~~'^li SI-\1\ll t!.~,~;I'~MI1 IS NOl \ ~~~OR\l,tO I:PU;~l':';~J~P.ROVEMEi~TS' 1\ cNCt\) V" CO\'JIMI- 1\'1 \ltRIO\). 1\N'i ,80 \) Sidewalk Type: DownspoutslDralns: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Value Date Calculated Paee I 012 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00769 ISSUED: 06/23/2005 APPLIED: 06/21/2005 EXPIRES: 12/23/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fl'l'~.PllW Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid 544.10 530.87 $441.00 6/23/05 6/23/05 6123/05 Receipt Number 2200500000000000816 2200500000000000816 2200500000000000816 Total Amount Paid 5515.97 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 Rl'Ouirl'd In~ 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 Pal!e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726'-3759 Phone . Job/Journal Number COM2005-00769 COM2005-00769 COM2005-00769 Payments: Type of Payment Check 6/23/2005 . RECEIPT #: u~. ~ ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200500000000000816 Description Penn Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By LANTZ ELECTRIC Reeeived By djb Page 1 of 1 Date: 06/23/2005 Item Total: Check Number Authorization Bateb Number Number How Received 22385 In Person Payment Total: 10:55:26AM Amount Due 441.00 30.87 44.10 $515.97 Amount Paid $515,97 $515.97