HomeMy WebLinkAboutPermit Electrical 2007-1-3
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SPRINGFIELD . ZON ['f'\ltJ2-
~ INITIALS NM
A!. . DATE \ ~g ~Ol,
IliO' SOURCE~IUj
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COMPLETE FEE SCHEDULE BELOW
"
. CITY OF SPRIN('IELD, OREGON
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225 FIFTH STREET. SPRINGFIEL.D. OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
7 "f'{ ::S.":: ~ <? 60 I Amps to 1000 Amps
Phone 3'14 ~.",t.'II-'" I Over 1000 AmpsNolts
" u 'Jollow rUI~~~d~Rec\)rinect'O\ily'JUII"''' yuu 10
\j ". oplea oy the Oregon Utili'y'
. . 19IJ!jcalion center;?jhOSp. rlJ!IO."',, . ~.' . ~ .
~ 7 ~ Jj!r>~jAR Q<;2-00':coo" .ewporarylServfEef>or..Reeaers
'l - U trirougn OAR 952~0~ . - .
0090. You may o~lal'n ':;1'.'1ip'f> nHh, ...1,,' .
Expiration Dale _lcJ - ~1"7:J 7 ,.: . C'lllin.a.lhe ce ns ii1latlOn, l\lreratlOn.or.Re!9cahon
, _ n er. (Note: the telephone.
. -." Dumberforthe GfW!lkm~mil!es Dlificali
Constr. Contr. Number q() ":h:IlJ .,"I.'.' -- r,enleris~Qti6cr-8'3~} 'I ps on
. .;, 401 Amps to 00 Amps
Expiration Date <- /'7 - fJ 7":..'.:
ELECTRICAL PERMIT APPLICATION
CilyJobNumber I"nlA/'\ 7h07~ 000 /1
I.
LOCATION OF INSTALLATION:
. -
cSt I Z- 1M At/V
LEGAL DESCRIPTION:
17()"Z. -:3431
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03.<)02..
s.r
JOB DESCRlPTlC ~: . .
f'J\Gl ~p 4V\.t \
Permits are non.transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
CONTRACTOR INSTALLATIONONLY
2.
Electrical Contractor ~ """" (P-u~
- (;
Address /?fj <J11PY[ fU,..r>
City
~
Supervisor License Number
Signature of Supervising Electrician
. ';-'~:'~_"tl' ,"
Date
A. New Residential - Single or Multi-Family per dwelling uni .
+ ~ - - . -- ..- -
Service Included
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
B. Services or.Feeders - Installation, Alterations or Relocation:
j
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
63
$ 50.00
$ 69.00
$ 100.00
O:,er ~OO Amp~or 1000\l0~ts ~e':':B" a~o.ve: ~. __ ._..
D. : Branch Circuits: .
.... - -'~
~ ,,/J -&- . JJ :.:,."""', New.Alteration or Extension Per Panel
(~~ /C<--r/)L~ ...,.:NOTlr.~. One Circuit $43.00
/" CJ ..: ":'..:O:fHIS PER'M Each ~dditional Circuit or with
\) I I. B .--.. ".: IT SHS\!rb<l!')!jrl1i'!MrPfFt'W $ 3.00
Owners Name ~V\i" . ~('fAOO}IORIZED UNDER'THIS;~~~ t",-.ORK______H ..__.. '''..
Address (" II J- m",''\ 8{,.:::C~CED (,I<f\ 'S'~~A1N'm.fNE~}t~~I~~d.~r no!incl~ded)-~:",~I."s~a~latioi':.
City Sf~ ~d Phone5'1ki.~i.~~Y PEP~.Q.hJ, or irrigation $ 50.00
. ;..>:,..,.~. . '," Sign/Outline Lighting $ 50.00.
OWNER INSTALLATION . ".'::>C;;2;h .., Limited EnergylResidential $ 25.00
The installation is being made on property FoWn which Limited Energy/Commercial $ 45.00
is not intended for sale, lease or rent. .' ",."N"';. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
,..." 4. :~SUBTO'TAiOFABOVi:- --.. .. .-- --~ 6:5
Owners Signature: . {','-'::.; ";" I"' __ ..:..:.._ ~_ u___~_ _+" __ _____ I
.:._'i:.;
Inspection Request: 726-3769
8% State Surcharge
10% Administrative Fee
5% Technology Fee
::soL(
b7D
J"
TOTAL
77'!.i-
Shared Drive(T:)/Building Fonns/Electrical Permit Application S-Q6.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00019
ISSUED: 0110312007
APPLIED: 0110312007
EXPIRES: 07/03/2007
VALUE:
SITE ADDRESS: 6112 MAIN ST APT 5
ASSESSOR'S PARCEL NO.: 1702343103502
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Change panel
Owner: DANIEL PERKINS
Address: 6112 MAIN ST APT 6
SPRINGFIELD OR 97478
Contractor Type
Electrical
Phone Number: 541-999-5057
I CONTRACTOR INFORMATION I
Contractor
EUGENE ELECTRIC SERVICE INC
Phone
541-344-3561
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
. # of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer A vaUable:
Special Instruction:
Notes:
Description
Tvpe of Construction
License
90200
Expiration Date
03/17/2007
I BUILDING INFORMATION I
# of Stories: '1:'"
Height of Structnre \.I,\e,; 'JO\\~'J .
Type~tl!~at:." ''''Otegon U\I \ (\\
VB ._ '\:,1'1 \ \\..Wa'J~(rJ!!el'J \"e s a.te set \0 '\
f\ '\ \ leI~iingJ:'Type:Jse t\.lle p..?> 95'2.-00
\ol~OVi t~on~i1e~:~a'!~if\tO\.l.g" 0 \"e t\.lles ~)
NO\\\\Ca\9S~Sl!ijnRletl' ~\~i!,dj\lg;lS O\\ele~H(al~e
.....d\Q ..,...h\a ._.''''A _ _..",n
\" _ ... ..........; ..~I. u_ . ._~......--
onI{'DEvELOPMEN'f'It!F,ORM\\lTION I
ca'"'' " t"e V'-~ ?,'!it.-r..v"
bet \ot. ,,, '\ _800-
n\.l{\"\ Qxeriay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I waR\<.
"01\~t.: SU1\LL E~\'IRt If ~~I'; I~id!ilvnlk Type:
\'ERMII \ \ IS \'ER," \ ,-
1\1IS lED UlmER 1\1 ONED fg\OwnspoutslDrains:
1\1J1\10RI OR IS 1\\)1\ND
COMMENCDE1\~ \,ERIOD.
1\N'{ '\80
I Valuation Descriotion J
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
~/
V-it'
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-000I9
ISSUED: 01103/2007
APPLIED: 0110312007
EXPIRES: 07/0312007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726.3676 Fax
541-726-37691nspection Line
Total Value of Project
L.fm P~\IU
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Numher
$6.30
$3.15
$5.04
$63.00
1/3/07
1/3/07
1/3/07
1/3/07
2200700000000000010
2200700000000000010
2200700000000000010
2200700000000000010
Total Amount Paid
$77.49
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, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify that any and all work performed shall be dODe 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.
1 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 constrnction.
Owner or Contractors Signature
Date
Paee 2 of 2
225 fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
~..... .
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C&of Springfield Official Receipt
.Iopment Services Department
. Public Works Department
Job/Journal Number
COM2007.00019
COM2007-00019
COM2007-000 19
COM2007-00019
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
Date: 01103/2007
2200700000000000010
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Perm ServIFdr 200 amps or less
Paid By
DANILE PERKINS
Item Total:
t::heck Number Authorization
Received By Batch Number Number How Received
djb 026999 In Person
Payment Total:
Page I of I
tt :55:35AM
Amount Due
3.15
5.04
6.30
63.00
$77.49
Amount Paid
$77 .49
$77.49
1/3/2007