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Home My WebLink AboutPermit Electrical 2005-6-17 v 225"FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number [Owt ZOO ~ - 00 71.{ Z r"!"',-. "''-~''.'" -_ ..-.....-<",....,......~, .- _~ .~.~<'r.. ~.~ ,..,,,,_..,..... ....J!l~..~'.... 1. ~!l!.l}ArIJ21'f:i9.Jf1lN$r4!t'Y:'lJQ!'t.c~;f.'@lt"!.'ij 3. 5 70\ y1.1 A/ltl ~T LEGAL DESCRIPTION 1702. 331.f1 01/0( JOB DESCRIPTION 1000 sq. ft. or less __ (l' Each additional 500 sq. ft. or le~.f> ~Jc"- (lJ~ F,"rCc.vM. ~ ~ portion thereof Permits are non-transferable and expire if work is S~.() Each Manufact'd Home or ,- not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days, Feeder $106.00 $19.00~ $50.00 1'\ -:::NT\ON' ~tll\YYn6n~'{~ ~cation to;\~~ rules ~~y,tu'~f~e~:set lortb / $ 50.00 r _ ation Ceil\l.Il~DI~El!!~f\ 952-001- $ 69.00 ''>IUau A,vn 952-0QlDo\\.~\\tb<>6ll6 Am\.V\e rules by $100.00 In n hlaio cOpieS' o. vvo-C. '(ou me(}\~f~0~~~'9!'7J:.Ollfl~~?e ..~" ab~ve. _ . . __ =-, calling ti'6'~tl~;0;g~~tk~~J_~~;1:f~r,~_!"~'~';'~ number lor ,,<\?_ . ). Ce~s\1t8~'frotl'"Or xtension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Pump or irrigation $ 50.00 Sign/Outline Lighting S 50.00 OWNER INST ALLA nON Limited EnergylResidential $ 25.00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. i: Minimum.Electric'Permit Inspection Fee is $45.00 + Surcharaes . t\I(YPC~: oq\;,.Jt1t v,u"" e " . \ lIT s\-\!\ll EXPI, 'IV ~3'l",:;1l!':Ym:;-""..._"_' "-$( . "","W" '.!f'J (""...... Owners Signature: TU\S PER' \ OED TU4,:,I"SUBro:rAIJOFABOVEk,,'?;,o. ~~l"-:,"i,ir;.,,,, .J'-' ~Ul\-10Ri2ED UN n \~~NbONtt)~R~'~~l\211:"''ll;f.*'i:~~<'"'''' "b'" " ~'" '.,~~NCED OR IS !\ 7% State Surcharge ANY '\ BO D!\'l pERIOD. 10% Administrative Fee '';CONFRACToRiINS'TALUnoNroNLyl 2. k~""ffi<.Mll.L'i"~i)rllMt:"X~~o\i:l:.~,,,..'L"~~::~e<_"'~~-~ Electrical Contractor~j3tPL JJ~ e/ur :me, Address JSJ.S- uJd(dnt-.... ))r 6'mt 0 I Phone 3i.f'/-f71()"" City t::; (/I-<UYtl / Supervisor License Number lf7 3 i.f- S Expiration Date i () - 0 & Constr. Contr. Number /567t..t Expiration Date /,1 Jd 7 S' ;;reg;:l:ctrician wners Name ylA c.. D..o....A-1 J ~ ~9 ArJ City lOb 16ft.. et.AG-t7-(E Phone Address Inspection Request: 726-3769 1.~' ___~:_~f'''J1'U!it,,~-:;.:~it~l';':;:_~~:'''-'h~J.~-'~~-''~l1~..t.P~,~~, B, ,S.e~iCes''!.'''le.''i1ers''i:"Installa tirin,',AIterations, oi'jReloc~ tioq:"": ~. -'c' ,_ -', Y?1:~;'~Ad,,",~;5!:~""nt'..":l'.~,:;:r.:~'''~''''''''''',_,5;;'''''''':_.''''_,....~."~,,'_v 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Aqlps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C ~T""",' ",""",""""IS'''''''"''''-" '-,"'\'F''f''''d'.\\','''''':~,'''~'~~,',!!!n,_'11!~''~:\l .~"e.mp'or;~f:Y\ ,.~r~c~e~,o.~;~....<<:~_ersS:"li';1L9f;;;i' ",';p .. ";.,1;,.,, ,,\.,.~,?,;,,'l~ sv $ 43.00 $ 3.00 f!:",~",,'1;..r; ,':' ':',1,".;-_lJ"TcF'"'~~-;""'-""'=""1t,\~~,,,...,,,,,,.,c:~w->?:,'r'< '.., ."'^-~".>f~:: .'':; "~~':;'~ E. i:IWSj:~!!a,~t~~~:(~~~~~f~~]~{)j!'t,iJ,i~~l!.d!~X;;Ij:~~~!~.I!~tj,<>1!J "3 ~o ~.",Q TOTAL sase Shared Drive(T:)/Building Forms/Electrical Permit Application 1-03.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: COM2005-00742 ISSUED: 06/16/2005 APPLIED: 06/16/2005 EXPIRES: 12/1612005 VALUE: SITE ADDRESS: 5701 MAIN ST ASSESSOR'S PARCEL NO.: 1702334103101 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Temporary power for fireworks stand Owner: MCDONALD'S CORP 36-113 Address: 106 16TH AVE EUGENE OR 97401 Contractor Type Electrical TYPE OF USE: New Commercial I CONTRACTOR INFORMATION I Contractor JOSEPH BUNCH ELECTRIC INC BUILDING INFORMATION I # 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 Available: Special Instruction: Notes: Description # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: License 156761 Expiration Date 08/21/2007 Phone 541-344-8745 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 'fI,\:;<<:--'f.. Sidewalk Type: '" \\\\ ,S ~\:;\ DownspoutslDraiD!iR'<<:--\'\:.<<:--~~ ,,\:;<<:-- ':0......"-"- \\\,S f0~S "'\'V~' 't..'0 S ~'\:.<<:-- :o"""~'V ~\~ \ '('\:.<<:--\~' \) \j~ ,S ~ ,\\\,,,,:, \\\<<:--'1..~~\) \:;~Q.,,\:;\). ......\)" ~\.\'- ~ \. c,\)~\ '0\\ \) ......~~ \ Square Footage or Bid Amount Overlay Dist(j \0 #Jj~tl!f~O .~: 0\'1 \a.'IIp~~jItle~~I!"'" ~i\OW Ole~ed '0'1 \'*t~ctt1a~'i!~' ~;:~ lu\eS!~~~I. in~S.~.:n Ot-~ :~\\~S '0'1 ~;\i\iCa.\;~i:O()'\ -()t"'~i:It(l\IM~1W~\lIME~JS I \1I Ot-t\ 1lIa.'1 0 \,1'lO'~'. . ~O\ll'~- O()~~i:~\ne ~~:\~;e90~_~~~%a~~)' :oer \Or . S '\ .~() lIUlll cell\er \ I Valuation Descriotion I Type of Construction $ Per Sq Ft or multiplier Paeelof2 REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00742 ISSUED: 06/16/2005 APPLIED: 06/16/2005 EXPIRES: 12/16/2005 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 Fpps P.lWLI Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $5.00 $3,50 $50.00 6/16/05 6/16/05 6/1 6/05 2200500000000000779 2200500000000000779 2200500000000000779 Total Amount Paid $58,50 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. ~rpd Insop"tioos I Temporary Electric: Approval required prior to Utility Company energizing pole. By sIgnature, I state and agree, that I have carefully examined the completed application and do bereby 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 wlll remain on the site at all times during construction. Owner or Contractors Signature Date Pal!e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3159 Phone , I , Job/Journal Number COM2005-00742 COM2005-00742 COM2005-00742 Payments: Type of Payment CreditCard ~ I :: . . :' 6/16/2005 . RECEIPT #: ~, ~~ JiJ.ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200500000000000779 Date: 06/16/2005 Description + 7% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less Paid By JOSEPH BUNCH ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 157240 In Person Payment Total: Page I of I 11:07:07AM Amount Due 3.50 5.00 50.00 $58.50 Amount Paid $58.50 $58.50