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Home My WebLink AboutPermit Electrical 2004-7-20 v ,"'~"" . ". ,~ '" llNGFIEED 'OREGON1''t'\j!': J".-;:'t ':~'~'r'~;:- '~":"'.~~!'>'.i'~' ';,.~, .. :~-;~~"l : '\",._ ,. ,,~,~~'\,~,"f~. ..,:~~~!-;;.'>--{';~..i"""'~'~.-~'~", 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (5IHd7,*~iJ,~89 , . zo . 9 prOject as sub . , ~~~o~~~~~:r~ ~~~~AlTI~~ t 0l( 'ap~;~~~~:dn::a~ not raqUi~~~~ t,~~~o~~:;ng I. ~f?CJfi"i'f/i!ljl!FSIFLI1i!.'IQN:,'::':~f{j 3. ~.2:~id;,~iEffl!,,;g!:!~t'{[?RF.iO~;!7;''2'o;i~_.'2'i l/:;.3b ~ -'II:'I~;;I - ~r '_""c=u~:nz~~S~g:at~r~.=:.... ,~~, LEGAL DESCRIPTION A. ~NN'R~idrntiaT~~;g'Ie~;:~f~1[i;:t~';j;~IY.$5lli~v~tiirtiLuriii.~;;;) 170 Z. 32..00 . 00 '--to L Service Included Signa~supervis~9IeCtriCian ~~_ l- <T JOB DESCRIPTION LovJ VoltA'H,'-' j ~ Cll2c <.::. Permits are non-transferablnd expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder WdNiRACrO'R.iNSTAiMtION4(iNLyTl B. ~s~~fic~~o~;F.eO'd:i~J..i;;st~lla'ii;;;;/ AlteF~tio-ns ~~:R~lo~ktio~:~" i 2.. t.:.~.J.~~~~ ."'~.k<".,, ","u,'<'ft _'" "'.,....:$~t,'(,-,"':.-l>.'..,j L~~~~:;;r:'".C),:$7"'~"",. -.,>..t;:;;,-".,-"",,,,,,, 't_ .....;-;..~.."':1... '_::::,; ',...-<1."_" '>,'~'~" Electrical Contractor ~r.<V','t--;' vI G..)': a, fa.: 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 ' Address ;:)'fr??! 4Je''7f- II 401 Amps to 600 Amps $125.00 " . NOTI~AmPS to 1000 Amps $163.00 City ~f~.--fP Phone f,f3{,.<-(qerer THIS A 'rJ.Q.OQAmpsNolts $375.00 ..J !l!\h\,~lMl;l EXPIRE IF THE WnRI< $ 50.00 AUTHORIZED UNpER THllfEBMI.L1S<N~ 47 j-j r ~ COMMEftCrn:'ffi)"~!.Ul"wmiliii;d'~n'U", 'f.:,~\::',",' ...:':/,K '. "~::J Supervisor License Number ;<. ')) ANV 111irDAlifiWroc"-~J:l."l1;.I;:\:lIlG-:::- j . ." ." '. ~ Ie; I ~/ ,'lr,,, .of Installation, Alte;ation or Relocation 200 Amps or less 1>763"'1 201 Amps to 400 Amps d 401 Amps to 600 Amps /) - Z(').-.'}C'C r Over 600 Amps,or 1~00 Volts see "B" above. _ D. ri~~i.~~~~~tlr5iitr;~t.'1':-~~\~I~;;,,~:{:&:1:~::~:~:~,~,'~', ,.:-~-~ ;~~~~~;~;,?~~';, .~'::-i1~~;) ,31 . , New Alteration or Extension Per Panel / y'l... One Circuit $ 43.00 / Each Additional Circuit or with LI t Service or Feeder Permit . f $ 3.00 I J;~~1t~~.~.::E:i~il'IhSIJiWiO;I;JI 10 ; . -.---""-=iUI..,.'"ii8l' -"-'--'.- -'- ," N~1~0AR~0.00 . ~.: iffi#Sn copies at tt\tl1'Ul8S tmO.OO U'iiiiffi~flf~~t8: thetele~ 25.00 n_~f.tlr,r~a,Utll~ 45.00 l{ \ Minimum Ele&mtiltm.lifnl~~c"m Fee is $45:00 + Surcharges 4. [:~UBTOTAL~QE~3)lgIY~\<;1'lt~j';f'~r"11 / '" 0 . Wt':.x;<" .;t;Y<'''''",o,,;;t/''l'1::::S;'1.1'~:1!ii1,;;;:L.:J:.~l.:..!.~..:;,.,j~ v 7 /0 t 111~ 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.~ $ I9'~__~ , ' $50.00 Expiration Date Constr. ContL Number $50.00 $ 69.00 $100.00 Expiration Date Owners Name Al-1dr6v ~J Address /{-.,/ b Ar~rL4,,1t:""" City (-lA-C.-t:7i!f"- Phone 52./ ~ 340) OWNER INSTALLATION The installation is being made on property [ own which is not intended for sale, lease or rent. Owners Signature: 7% State Surcharge 10% Administrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Forms/Electrical Pennit Application I-03.doc . CITY OF SPRII'ilJJ<1ELD Building/Combination Permit PERMIT NO: COM2004-00892 ISSUED: 07/19/2004 APPLIED: 07/19/2004 EXPIRES: 01119/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4436 MAIN ST ASSESSOR'S PARCEL NO.: 1702320000402 Springfield TYPE OF WORK: Electrical Work Only .....~~ I PUBLIC IMPROVEMENT~'" "'O~" f}I.~ o,,~~~*~~ p.~eS~ o~s6'J\il~ \O~ ~ot\ ~1:Jft ~ ~:&f.\ "o'i:l~~ 9'O'l.$ ~ ~."'" ~P""' \I\~~~~::'~~ _;:.1. _:.r \9 ,-5 I Valuation D~g~ TYPE OF USE: PROJECT DESCRIPTION: Low voltage and 5 circuits Owner: HEAD ANDREW Address: 1616 ARDENDALE LN EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor AMERICAN EAGLE License 153834 I BUILDING INFORMATION I # of Units: # of Stories: Primary Occupancy Group: Height of Structt{lIt-lCl'?-'+- Secondary Occupancy Group: Type of5'{t"~ ~ ~Cl' Primary Construction Type VN W~ ~'i'~\\ ~ Secondary Construction Type: ~\Cff::. ,,~"~d'I\~ ~1~'t.\) rCl'?- # of Bedrooms: l'\) \It.\\~\ U~lJliRrg~~. '\'(.\~ n.'?-\tt.\) Cl~'tidk'fed Building: nla :t.'fl-\'u AX\ _.['n. , rC\)~~iD~~L"8PMENT INFORMATION I ~~'{ '\ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 'Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Page I of2 New Commercial Expiration Date Phone 12/30/2004 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: Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus Total Amount Paid . . CITY Ul' ~noNGFIELD ' Building/Combination Permit PERMIT NO: COM2004-00892 ISSUED: 07/19/2004 APPLIED: 07/19/2004 EXPIRES: 01/19/2005 VALUE: I Ff'f'~ Paid I Amount Paid Date Paid Receipt Number 1200400000000001101 1200400000000001101 1200400000000001101 1200400000000001101 1200400000000001101 $10.00 $7.00 $43.00 $12.00 $45.00 7/19/04 7/19/04 7/19/04 7/19/04 7/19/04 $117.00 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. L.Rf'ouirf'd In~nf'ction~ I Rough Electric: Prior to Cover Low Voltage: Prior to cover. Final Electric: When all electrical work is complete. 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 readahle 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 Paee 2 of2 225 Fifth Street Springt1eld, Oregon 97477 54'1-726-3759 Phone . 8P'~~.!!"~~~ '.-'- ,I,. ~. J ~, --'" "',- .l JiiilY of Springfield Official Receipt .elopment Services Department Public Works Department Job/Journal Number COM2004-00892 COM2004-00892 COM2004-00892 COM2004-00892 COM2004-00892 Payments: Type of Payment CreditCard 7/19/2004 RECEIPT #: 1200400000000001101 Date: 07/19/2004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Low Voltage - Commercia'Indus + 7% State Surcharge + 10% Administrative Fee Paid By STEVE GREEN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 000444 220212 In Person Payment Total: Page I of I 1I:28:17AM Amount Due 43.00 12.00 45.00 7.00 10.00 $117.00 Amount Paid $1l7.00 $117.00