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HomeMy WebLinkAboutPermit Electrical 2003-11-7 ~ 'i' .~~'. " '. CJ.TI(bF'S~,4NG:Fll:Lh"O~GON'" \. ..... ,,: , , . ~ , . .' ,~. . . ' ~ .... I'~ .:, 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION COIM z.co3-c.\\ )2~ Date City Job Number r. ,',' ..-.....~~,.."!-...,_...c: .--....1;;--;;~..... .-., .I.;..\\.....:;rl I. ,''LOCATION.OF:INSTALLA1'lON,.. ;"",,,,"'~ ~~"'~""-""'~~~~--~7..:..~-.I',J, '."C'. '\ / /;;7' /71flLA'..~~' LEGA~ DF~r1> 1DTI,qN -rl. 7.Q;}L--:S..5.'::l t. .. 0 Lf L{ cO JOB DESC!uPTION tfaJlI.~~~./$MpA~ i1~k;. PermitS are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, if'coNTRAci:bliYiJ;r;u"'*fJIiIFf'N'ON1Vl 2. tJ!~\.iL..~~'b:li~~':i,....!f..~Jj; ;",1()r.t~ti;:~t~~'. Electrical Contractor VrOCfSS- dI,~ Address va. i:x-....L /)~ (;),.q 7 Phone 135'-76 d / City Supervisor License Number l/'7.?/os Expiration Date J()- / - dGo4 Constr. Contr, Number /~-I 7<'--0 Expiration Date q, (1. ,;J.oO~ Owners Name Address 5 PI21 /lfG- I3l.1 [) City -6A..6trifE('" Phone . , ,I '~".. OWNER lNST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~~ .t'(,l-OS l~b~3 tJ' . Ir'::-....7.~.,_.~. '.;'_"_'_ ~..,"._":;.---....~-,....,,.~,,_, .-~lit'~~...,,:'" 3. ,;COMPEETE;FEE'SCHEDULE'BELOWi"'-':;'2-"~'" ~'!..';...~~",,~"""~n"~~,-,...~,~~"""~::;'''''''.i.'_ .~ ,l:i~~~., A.. ~fN~~,ii~iaiNfii~~siif~ji~1fr~iitl~~~~TrfWi;iid~;]t;irt~@.~ ~,~~ ~~~~~~~.;Q':,r.~.;;::,;~~" ',' ~,~t'''_~~j;i,..~:'!.~ 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 ~. ""~"'''''+;'!%~t ',"C.~:'\ "P""',';f/'~ ''/'!Y' .r.:::: f''"'-;4.,,t',:')..,'JS:;:~,,.< ~\'" ...~.~,7t.;~c .>~ <; "j B. l~fiJs~~~~~~~e,f~~ffL~\~!~~~H~,Jl~I~~~!\!!-~.t:u~,~~.s_;gr~~~~B~~~~~;~ 200 Amps or less 2' $ 63,00 201 Amps to 400 Amps I $ 75,00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps "a\) \0, $163.00 ~eS , . '\\\\" Over 1000 AmpsNolts ~0o.\)' r:/' U . _<;\$375.00 Reconnect Only (\ \~'I'l Ol0g _ <;0'- ':0$ 50.00 I~..,<",:.,~~~'l ~0.;;~~€.~~)~.~.""~..,, "wi"" c.' :r.Binp'ora'.'~r.iilS.\lr. rv;c'es:orcl'.eeders' '~"N'~,"c'~",..,.:, ,', ;.~ ';',.c ~<"i ~€.""""~'e"::.s;---","- . (:l:fJ",=~,\'It;i1ftc~'(Ia:l'.,""-' ~""~ "'''''' . !>- II ,..N t\)\e .I.e(\\0~;"\C) \'(\1 ~c\eS 0_ ~0\0~~ce\lOt' \OIIInstallatlOn,.A1lera lIon 'or -RelocallOnO\'\' ~0\~\ff.~l?s-~~I~Sl'O~0a.:' '\~o\~;~,\\\'l ~"A'\. $ 50.00 ,......1. \\'V. ~ ,. l\ U (\ '201 Ainp~ to.:WO)~p'S}~O " n.,~~.t.-u $ 69,00 o\), \"~ IV' ....".;, 0'401 Ain-ps.... to.600~ps _~v $100.00 C'o." \V' \,.' . "e~ ",,1tP'f' Oyerj600 Amp) or 1000 Volts se<;.:'B" abov~: . D ~'li'7 -,' ItC' ;'''''~'t'''''''' "<" ",~l'~ ,<-: ,"""c.::;j~"yr'I!I.:.i!' ~;"'~"S'~ . hi~..r~fI,~, .:,_'tr:f:!!1 s,:::"~~1"-'~:.>~::~i:::M~-';~'?;l;t1'~..l<1:<" ';i:~,.'t):~\r';.;Yf~&::'l~ t2J/.:;.c:;.oO 7 s:;; CO New Alteration or Extension Per Panel One Circuit ;F- $ 43,00 Each Additional Circuit or with lAD 20 CO Service or Feeder Pennit I'D $ 3,00 c....:>. .' ~ E. ~Mi~~~Iia'ri~"liui(S~"''i~'eJfi~di~~~~~~ii~~-,'jj ,. .,.v,,",.,,~......;; ,. .." 'c, .,~I.U1:.":~\\,i1>f-\'t'" '_" ." -c" 'J.Q1\"~' :i S\\I\..\.\. \\\S \,t.?\ ~(I~' Pump 'orJrrig~0'n~\ U~~t.\'I '\ 'l')(\~t.i j<t.\lo SignlO~t1~\WlIlit1rliP 0\'1 \S (1..\)1'1 $ 50.00 Limited !E~ergy~~~tialc:\\\Q\). $ 25.00 . \'A)\<" (11\..'1 y~ Limited Fneril~\tiercial $ 45.00 }l\\"~ Minimum Electric Permit Inspection Fee is $45,00 + Surcharges r.,''''~ ~ ",,, ~_.-""" __ ",-,,,.. ' " ,"0..-." ' '.,' p' " ~ ~ . ,."", ' 4 1~S'UB''''"T-O--T.'''','?O''F' ;.;:,.O...VE.....(.., ',,' '*"" t,;.,.'. . " nL. '.t1U ", ;1> J' "'4AC .,,"",1 '",\ "....,1<7f-;j"l> ~_:i_',"-*'r\' :'. t'::i:'r'~ "\.<c;''''+-ki.~~.-~1>.' ~'j!.(,o.",;~;.sJ . ',',,' , ", "~~-.-.......,';;~'~~$" "';A'......~ :J 31. OD I(/J.n ,.;)~,I(J ;)70.:;)., 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnsJElectrical Permit Application I-03.doc '. . CITY OF ~rK11~ld<mL1J Status Issued Building/Combination Permit PERMIT NO: COM2003.01124 ISSUED: 11106/2003 APPLIED: 11106/2003 EXPIRES: 05/06/2004 VALUE: 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: PROJECT DESCRIPTION: 400amp panel, 2- 200amp panels and 10 circuits New Commercial Owner: PETER KRYL Address: 3474 SPRING BLVD EUGENE OR 97405. I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor License Expiration Date PROCESS AUTOMATION INC 151750 "n'V\~... 09/19/2004 BUILDING INFORMA TION>, ?'-"o~ 0~~,~(\, \'3-~' O\'d~ \0" ~O # of Stori~SjeQ,o~ 'Oi \.'(\0 ~\0S ~ ~ "!JS ~!ioi'Size: Height;!!f.Stru\',ture S0 \ 1(\ 01'1 ~0 \~ :\9IFt 1st Floor: ~~ji'e00! ~ea~'\ ,"\'(\~'(\\o'V~ SO'" ~0~:~ai.!\f2nd Floor: ~'i'~~!!,r-'I;~p"e:,0 0\0" cO~\~~0\0 o\\"Sq FtBasement: ,0\\CR~'\.\l~;TYI!lS:"O :o\iv(\ 'l!AO\0' ,~\\i ~ b.b.'ISq Ft GaragelCarport o'i.~!!liter~fPathJ~ 0 '!,.0\' \l 0(\0" ']:'l.'O Sq Ft Other: ~ o"'~" o~ \\\ cf~{' 0\0~ ,\\)''0'3 Impervious Surface Area: ('\ '" '\ 1c,,"{i!1 __I> 0.\.1 Phone 541-935-9321 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN SETBACKS I DEVECO.BMEN:f'INEORMATlON , Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: , ~()\'-~ . \t ,\\,\t. ~\J'\ _\.OI9.t. _' 'I~ \~ I PUBLIC I~R<V-EMfl\'fS.t:-\\\\~ \'~~~\) t\)l'\ ~~\~ 'il~~~~\) '0~\,-\~ \lSia~~alk Type: \>.'0\~ ~t.~e,t.\) 'ilt.~\\J~ownspoutslDrains: e,()W\ \ ?l~ \)\>." \>.~" (I.:v.'" \ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descrintion I Description Type of Construction . $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa~e I of 2 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 Ea Add Perm ServlFdr 200 amps or less Perm ServlFdr 201 to 400 amps Total Amount Paid . . U 1 f OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01124 ISSUED: 11/06/2003 'APPLIED: 11/06/2003 EXPIRES: 05/06/2004 VALUE: I Fees Paid J Amount Paid Date Paid Receipt Number $23,10 $16,17 $30,00 $126,00 $75.00 11/6/03 ll/6/03 ll/6/03 1116/03 ll/6/03 1200200000000002430 1200200000000002430 1200200000000002430 1200200000000002430 1200200000000002430 $270,27 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 I nsneetinns , I Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 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 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, 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 construction, Owner or Contractors Signature Date Page 2 of2 225 Fifth Street ,<' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01124 COM2003-01124 COM2003-01124 COM2003-01124 COM2003-01124 Payments: Type of Payment Check WI"'I~'~'~".~.~'? '~,., ',J --~! ........, . ,e"'"f" ..,..' Receipt #: 1200200000000002430 Description Perm ServlFdr 200 amps or less Perm ServlFdr 201 to 400 amps Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By PROCESS AUTOMATION Received By djb L'heck Number Batch Number Authorization Number City of Springfield Official Receipt,., Development Services Department, Public Works Department ., Date: 11/06/2003 9:32:34AM Amount Paid Item Total: 126,00 75,00 30,00 16.17 23.10 $270.27 How Received In Person Payment Total: Amount Paid $270,27 $270.27 . .