The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2004-12-7 City Job Number COW1-z.oo L\ _ f') f 41 \ Date 26-368'). " -:l ~ 0 &.-!: ~"0 o~ ,. \9 Ot.. o""'~ "J';:' ~ l$'/ ~ ~~ 3, r!J"CeMPEEPE. iFEEr~~Jf\:T;f;B .; ." ,>0, ~....W~~~. . ~~~,~,,....- "}- .~. .., ~C9 '?9. 0/l$'\5> ~_~ _ _ _ ,~. 0-." _ ~ _..... Ul( __ , A. ~Ne~~if€s.ia~iiti~$~~~"ti~l ,;pN~li~,y~tt~~~h iiAW1~"""'''''rlAl.'.t~~,f,,~~u,,:~ ~ 'r~~~u~"'~ Service Included "~@~. ~@C';"'''~ I 000 sq. ft. or less . $1 06,t9 ~.. Each additional 500 sq. ft. or . "'"",'ot, portion thereof .00 (.\SI.n:ft;.;) '';' 1/ - 3" -0 '-( ,225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54 1ELECTRICAL PERMIT APPLICATION 1. ~~~r.cr~F1LNS1'I!tl:r'l!it.T.. 'a@,&~"tf~t~ . . - .'. -'~"'f..;"<1.'o/.'oll>;""",,,,,",,.....'r.-i~i;~..... ,~ ..,..... II Zl.{ tMA-IN ST LEGAL DESCRIPTION r7D3s5Lf( D l(L(oa JOB DESCRIPTION AD/) 'S L,t'lL<-\'lh Permits are non-transfcrable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days, Feeder t?n",,&;;'m.<~'~,;;""'D~~'""'''''''1l''r-.''~.'''''.'='. "l<.i-::ll." "'.<jiT;"'~I>"s.~.;~.~""',"!r.'" . "",.",,M""jt<~""",~.'.'~ ~~m"""'~.'. . 2, ~~r~~~Jfil~~~~~ B, ~~~$,~.\1r,:Eeej\~F nstallatiQl!~~~~i~~~ Electrical Contractor t ()- s Ue('),,' (' / --z::7e- , pf7 &X ) lf~d City ~p"/()JA-dr) Phone 7C//-dd.S0 Address 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125,00 $163.00 $375.00 $ 50.00 Constr. Cantr. Number 4CZ9lfS Jo -0 /-0'7 3 <6 IF? q -J- ()B c. !~.1:re:ri1:;~6t~a~y, s1"f.vices~gf~~eotrs~:. _-':'~l<'~_)rY'R_ -"'-"'''f~, -'. J', Supervisor License Number Expiration Date NOTICE: Ins. tallation, Alte~ationor.Relocation I HI:) PERMIT ~HALL E!<J'IKt It I nc "u.." AUTHORIZE~0!9~?A Wm~ PERMIT IS NU I $ 50.00 '201 A:mp's to 4pRtmps 0 FOR $ 69.00 COMMENCr4{)J')~gslfot360~~ripf $100,00 ANY 1 60 OAdv~rE~bORmps or 1000 Volts see "BOO above, D, mBHffi:mtGi~.1:uit~.'B', ';;!1!!.",1~4"fB'I~loj!'.l>~1i!,~t,~~;';;;!,jlf",1 ~~~?~ - ::l~~~'i?~!:Mmliim!bl~~~~;.'M...~ New Alteration or Extension Per Panel / One Circuit $ 43.00 'I J Each Additional Circuit or with "7 b Service or Feeder Pennit L.. $ 3.00 Expiration Date .~:::f:C;~ Owners Name L V\. \<:.1\-.:." leA Y ( 5?(2./1'I& 75/vd Address ---c,'-/7l( ~ l/lb-cd' C:!' E, i~'Nfu~~lf,j1lWg(~~~f~~fYii'lfllii'a!1!\WE~~i~ii'';fiW~. '-'l ~~~ii~~;i:'~' - - '~"!~~~i:.h"''''' . ?i~.;..ti~~,Ji~!.:~ City Phone Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25.00 The installation is being made on property I own Wh~trENTIO~!~fl!9~rgwCf.e~SiMO\.I.~O $ 45.00 is not intended for sale, lease or rent. follOW Wl!,igwliuJ!lIe.dJilYP~~rRso~~~~fu~ is $45.00 + Surcharges Owners Signature; Notificati~.n~~~.' "I,."':"'" .....~....11 1/ '7 in OAR 9:>2f~fi~~-Cl ~.., .;. ". ~~ -, y mav obtain coprl::S" 0090,. ou. 7% SIl'e'T S~.gthe telephone "3 L{ 3 calling thelg,,{~ istr!l~tyJ'Jotification l.{ '0 number fo ll'!!t 44) ceif'Or*{BOo-332-23 . 57J1 Inspection Request: 726-3769 Shared Drive{T:)lBuilding FormsfElectrical Permit Application 1-D3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01413 ISSUED: 11/17/2004 APPLIED: 11/17/2004 EXPIRES: 05/30/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line SITE ADDRESS: 1124 MAIN ST ASSESSOR'S PARCEL NO.: 1703354104400 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Improper Wiring. Repair Code Violations Owner: KRYL LUKAS Address: 3474 SPRING BLVD EUGENE OR 97405 Contractor Type Electrical Contractor C & SELECTRIC I CONTRACTOR INFORMATION I License 3849 BUILDING INFORMATION I Expiration Date 09/0112008 Phone 541-741-2236 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: uOiICt,F.angeType: . . TUE WORKSq Ft Garage/Carport I~ EitergycR1ath:L EXP, IRE IF fl \ OTSq Ft Other: U\S PLHN'I'oJ "'~ oM,T S N T 1\ 'SprinkIed,Buildlng:S PEn itIa Occupant Load: ...IITunQI/\-U U\\1UL.I\ .' ._............"lrl'''\ t:np. ,.- -- ,,,..~ ..~~.~,.......- IrDE~OPMENTJNEORMATI0N , ANY HIU UM' , ~...- Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I ATTENTION: Ore~il.JwalJ(erypellS you to follow rules adoptfW ~ the Qr,\l,qo.n Utility Notification Center. '1'~ostpml!j'sua'rt'%'lit forth in OAR 952-001-0010 through OAR 952-001- 0090, You may obtain copies of the rules by calling the center, (Note: the telephone ;::.:...__. ._ HIt:: Un:tYUlI U\lllLY l'oIVml\,lQ'-I\J11 I Valuation DescriDtion~r is 1-800-332-2344). Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 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 Minimum/Adjustment Electrical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend CIrc Ea Add Total Amount Paid . . CITY OF ~rKu{GFIELD Building/Combination Permit PERMIT NO: COM2004-01413 ISSUED: 11/17/2004 APPLIED: 11/17/2004 EXPIRES: 05/30/2005 . VALUE: I Fees Paid' Amount Paid Date Paid Receipt Number 1200400000000001621 1200400000000001621 1200400000000001621 1200400000000001672 1200400000000001672 1200400000000001672 1200400000000001672 $4.50 $3.15 $45.00 $4.90 $3.43 $43.00 $6.00 11117/04 11117/04 11117/04 1211/04 1211/04 1211/04 1211/04 $109.98 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 Reouired InsnectionsJ Rougb Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 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. Ifurther 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 Pa~e 2 of2 22~ Fifth Street Springfield, Oregon 97477 541-726-3759 Phone '" . 8:P~'J:lINP!l,IlLD,""," _ ,_ :. Wit, J//i6;., - - : .., - .... ........ lliiii.ty of Springfield Official Receipt .veIopment Services Department Public Works Department RECEIPT #: 1200400000000001672 Date: 12/0112004 8:15:13AM Job/Journal Number COM2004-01413 COM2004-0 1413 COM2004-01413 COM2004-01413 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard MELLIS SA GEHRKE Item Total: Check Number Authorization Received By Batcb Number Number How Received djb 001620 In Person Payment Total: Amount Due 43.00 6.00 3.43 4,90 $57.33 Amount Paid $57.33 $57.33 12/1/2004 Page I of 1