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Home My WebLink AboutPermit Electrical 2009-8-24 Electrical Permit Application 225 Fifth StreettSpririgfield, OR 97477+PH(541)726-3753tFAX(541)726-3689 1~~~fofO , -0 C> 9/7 I I Date; ~ - ZC{....() CJ I This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not.started within 180 days of issuance or if work is suspended for .180 days. 1!TIf~Ai~ '1;.,I.:()C~I.:~~OYESl'lME:l'lJIP;eeROV,6;Ir.w1:I!~~~1IlI 1 Zoning approval verified? 0 Yes 0 No 1 1~1i!1;;'!!iiil'i1~.';CATEG()S~ILOEl::C()NSJR.lJC,J'ON,..'!!iiil'!!iiilC~\:')1 I Residential, per unit, sCn'ice included: I,DResidential II(] Government. ,I 0 Commercial ..,1 11,000 sq, ft, or less (4) Iff4i'~J,OB*iSITE'~INFi:OSMAJIONJ!fP;ND!!HrOC,6;JION~:t:1 I I I Each additional 500 sq. ft. or portion ' Job site addressl qo I J;,~I'J1IAh;""c..1 uJa'j thereof ,$ 2S,OO $ 1 City: Springfield I State: OR 1 ZIP: 1 I Limited energy (2) $ 32.00 $ 1l::~~~~;i~~;'!!iiil~DE~,~,~~~~;\;~~i~1f€'!!iiil.~1i!!i I ~~~71~:nS~~~~~~~ ~e~d~r (~)odular , $ 63.00 $ 1 1 I Services or feeders: instailation, alteration, relocation Install Electrical Service and branch circuits for International IWay West LTD EMX bus station. 1 1 200 amps or less (2) : 1 $ 81.00 81.00 1 201 to 400 amps (2) $ 95.00 $ 1 Name: Lane Transit Dislrict 1 1 401 to 600 amps (2) $158.00 $ 1 Address: 3500 East 171h Avenue 1 1601 to 1.000 amps (2) $205.00 $ I City: Eugene 1 State:OR 1 ZIP:.97403 1 lOver 1,000 amps or volts (2) $469.00 $ 1 Phone: 541-68206100 1 Fax: I I Reconnectonly(2) $ 63,00 $ I E-mail: I I Temporary senrices or feeders: installation, alteration. relocation This installation IS being made on residential or farm property I 200 amps or less (2) $ 63.00 I owned by me or a member of my Imme?iatefamiIY~1.!'is 1 201 to 400 amps (2) $ 8700 $ property is not intended forJsale; exchange,-Iease,'or rent .OAR. . 479.540( I) and 479.560( I ).~ ~(J. ), ~02.00"'''/t,I'''' o' 6,,"11/ I'e 401 to 600 amps (2) $126.00 1 $ . co!/,'-' Ou 1,' 1'1-- .r II) 91/. '. Signature: IlV/h:/7g tti!J:qy r.?O,O 1:/0,s$ ,.. $ 01"1--" $,5 ,9_ver 600 amps or 1,000 volts, see services or feeders section abovc l&lij~2ljji~E1!:2GlCON;r~C'td~\T:INSjfAl!~\Tld!:!lt~~~~:!1 O/I~,B~i.~~Ch circuits: new, alteration, extension per panel I Business name: Camp Creek E:1e-ctri(F~LC;J. (1V~:Pies' U-4R ~1,stl{a::Fee'for branch circuits with purchasc ofa service or feeder fee: I Address: PO BOX41900'~-'''' ;.;~~I/ iJL:l)e;:;el',I~<'IO~;~[hbranchcircuit . 114 1 $ 6,0018400 ! City: Eugene I State: OR 'j -'z.fu,: .97 4d~:':'l?I]II)~'I' b)Fec for branch circuits without purchase of a service or feeder fee: .0 ~ _ ,If._ 'It, 1 Phone: 541-746-1471 I Fax:541-741-6208~'i'). oqllo~ Firslbranchcircuit(2) I I $ 55.001 $ I E-mail: mike@ca,mpcreekelectric.com I I Each additional branch circuit $ 6.00 I $ I CCB license no.: 164877 I BCD license no.: C81 I I Miscellaneous fees: service or feeder not included I Signing supe~~l~92.s license no.: 30238 I I Each pump or irrigation circle (2) $ 63.00 I Print name #'.s.igti~r.tupervisor: Dave Feiereis~ I I Eac~ sign or outline lighting (2) $ 63.00 I Signaturb11t~~.r!:S~^err- isor:.-l. ~ r./_ - I I Signal. circuit or a li~lited-energy paneL $ 63.00 $ _ . ~t'}'I..g t "'w.. ,<:? .--? alteratIon, or extensIOn (2) UIl1, vl)'l.?, . of.;, 4lvy IJJfJ);. CO {;, '4LL I Each additional inspection: (I) 780 CfO /VOflT f-f/>IR 04y 'IT IS II-;IS 'f II' />fITIOi/841v0;flT~if,/1;OJ4J~ . /'lffOfj IS~ ~~ o.:\..\.. \d 440-2584-1 (9/0B/COM) $134.00 $ ! $ $ $ I (A) Enter subtotal of above fees (Minimum Permit Fee 558.00) 1 (B) Enter 12% surcharge (,12 x [A]) I (C) Technology Fee (5% offAl) I TOTAL rees and surcharges (A through C): 1$165.00 $19.80 $8.25 $193.05 , CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00919 ISSUED: 08/24/2009 APPLIED: 06/25/2009 EXPIRES: 02/24/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Li.oe SITE ADDRESS: 901lNTERNA T10NAL WAY Bus St SPRINGFIETYPE OF WORK: Electrical Work Only ASSESSOR'S PARCEL NO.: ROW-MISC PROJECT DESCRIPTION: Electrical Conduit for L TD Station TYPE OF USE: New Commercial Owner: LANE TRANSIT DISTRICT Address: PO BOX 7070 EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Electrical License 164877 Contractor CAMP CREEK ELECTRIC LLC # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: t. BUlLDlNG,INJlORMA:TION I ATTENTIOI. db tne ure!,jv" u",", lollow rules adopJ~f St~ries:',eS are set lorth N t'I'lcatlonCente,. .1.- ,,..,^"Q52-00t- o I OHeighl'oflStructure in OAR 952-001- 6ty~e ofJIi€at:J1 the rules by 0090. You may 0 W ("ri-' 'he telephone calling the cenLa ~r,' '(p.~;tv Notilication berlor the RangelType. - 44) num . . M~ ''''^-?3 . Center l'Energy'Path:- Sprinkled Building: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Phone Numher: 541-682-6100 Expiration Date 06/09120 II Phone 541-746-1471 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basemeot: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I NOTICE: LL EXPIRE 'F~ife}v.lik1lF~)e: THIS PERMi6~~~ER THIS PERb'll~Jfl,~JlslDrains: AUTHORlZ OR IS ABANDONED FOR COMMENCED ANY 180 DAY PERIOD. Street Improvements: Storm Sewer A vailahle: Special Instruction: Notes: I Valuation DescriDtion I Description $ Per Sq Fi or mnltiplier Square Footage or Bid Amonnt Type of Construction Paee I of 2 Value , Date Calculated Ii , -~8~1!!Pl!j,!1!~~J:;!!J~i"I!\~ r ~,N," ;,- - : ,:,n(,,'1': Status Issued CITY OF SPkll'''Il>FIELD Building/Combination Permit PERMIT NO: C()M2009-00919 ISSUED: 08/24/2009 APPLIED: 06/25/2009 EXPIRES: 02/24/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fee,' Pai~ I Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm ServfFdr 200 amps or less Amount Paid Date Paid Receipt Number $19.80 $8.25 $84.00 $81.00 8f24f09 8f24f09 8f24f09 8f24f09 2200900000000000952 2200900000000000952 2200900000000000952 2200900000000000952 Total Amount Paid $193.05 I Piau Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 workday." Reollired Tn'oectioo, I Underground Electric: Prior to cover Rough Electric.: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that aoy and all work performed shalf be done in accordance with the Ordin.ances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUP ANC:V 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 wilfbe used on this project. I fnrther 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, aud the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date hee 2 of 2 , .'.\ 225 ~Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00919 COM2009-009l9 COM2009-009] 9 COM2009-00919 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: City of Springfield Official Receipt Development Services Department , Public Works Department 2200900000000000952 Date: 08/24/2009 8:48:24AM Item Total: Check Number Authorization Received By Batch Number Number How Received DJB 164230 In Person Payment Total: Amount Due 84.00 8.25 19,80 81.00 $193.05 De~cription Add, Alter, Extend Circ Ea Add +5% Technology Fee + 12% State Surcharge Penn Serv/Fdr 200 amps or less Paid By CAMP CREEK ELECTRIC Amount Paid $193,05 $193.05 Page I of I 8/24/2009