HomeMy WebLinkAboutPermit Electrical 2009-10-27 (2)
225 Fifth Street. Springfield, OR 97477tPH(541)726-3753HAX(541)726-3689
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I Permit noc;..o,uz..c> 0 9-0 I S"'1i'
I Date: I 0 - 2-7 - 0 '1 I
Electrical'Permit Application
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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.
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I Zoning approval verified? DYes D No ~1i"';;~j!\t~',*",:!l&';~ii"""""!j!II"'m'II~Cosifl~I!1!:$Ot3I~"
:<~umber.ofjmspectlOns,pe";.ttemi(')!~.fi Qty: !ii:t"eo'a">'JiI, ~~-c'o~'t'~"
1~;1,~~~{i;iCA;Y:EGORYl!L0F.t:CONS;T,Rl!JJ~;JiI.9N~1~~li~ ~"''''''~o.<:~~'"'''....''''''''c~'''' ""-",,, ,""", ,.",.:v ""LS,~.
I I I Residential, per unit, service included:
D Residential ~ Government D Commercial
~:71e::1T;E~~~::~;~~N~i~1~Ci~iN~~f~~1 I ~~;;;:i:~::::s~o(:~ ft or portion :1:::::: I
I City: S~I/.~-F,<-\J. I State: DTL I ZIP: I Limited energy (2) $ 32.00 $ I
I Subdivi~ion: 1-70:s '3 3. L( y. I Lot no.: cuod I Each manufactured home or modular I
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~'<~"~""':'fJ;p,,l!'~riR'o"nER""'ffou'''''E''R:!!\~'~J~~''''W:''''.,..::tl1 I 201 to 400 amps (2) . $ 95.00 $ I
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I Name: C> b.cT I I 401 to 600 amps (2) $158.00 $ I
I Address: \{ ~ -, IfLANS~c> ~u.(J- I I 601 to 1,000 amp~ (2Lnn 10 $205.00 $ I
I City: S*Le-~ I State: oIL I ZIP:,"7,~(I: dl~~~rr\~ott..~~W;YSKs\lJ.tI\it~il $469.00 $ I
I Phone: I Fax: _ _ \. . ..~eslae OR'ecqh.!'k'~M)fllNeS)are :~~ l~~i. , ,$ 63.00 , $ I
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I E-mail: ,,).~,1~,H.l.IUll ~r 0' _~~'\IMtltlfl:)UGrv~.l:t:l~J: f~t\m-b,/nstallation, alteration, relocation I
.. .,,, '>"-9-11 I '00 ; poCO?i,;!>! '(j ... I I / I
This installation is being made on residential or farm p,tpp'ertYjou r la~ ,,""illlfl,u-tn.1h\l'kelep\1One _ $ 63.00 $ f-;J,
owned by me or a member of my immediate family. RiisJV,'\I' th I C 31101110 ~R~~~t"otI1IC""v" I $ 87.00 I
property is not intended for sale, exchange, lease, or rentY6~~1 Ie r t ,a ureQ _"'?2_;<.;;>,,4). I $ I
479.540(1) and 479.560(1). nurn Cl nt .r4RJ \o!WGamp:; IL) $126.00 $
Signature: I lOver 600 amps or 1,000 volts, see services or feeders section above I
1~~'~~~C:0Nm~C;TloB~INS:rP,;IfLfA'1jIQNf~~~);lii\li;' I Branch circuils: new. alteration. extension per panel
I Business name: Su r1 d~LA ~ j \ 1ZJ<c..~\. 0 ! a. Fee for branch circuits with purchase of a service or feeder fee:
I Address: 'P. D .~->< 12.<1 I Each btanch circuit I $ 6.00 I $
I City: F'D~-:;--6 l6r=t::o=-l State: D\Z- I ZIP: <1711-6. I b. Fee for branch circuits without purchase ofa service or feeder fee:
I Phone:>>> -9.;'7 - C>664 I FaxS"..3 -J5j. e>U>{.. I First branch circuit (2) $ 55.00 $
I E-mail: C!,c. he. 6Z f;,,~~.... (.I~L.::. . COllA I I Each additional branch circuit $ 6.00 $
I CCB license no.:b'7L\L\-z. I BCD license no.::S7-~Lj6 GI I Miscellaneous fees: service or JeM~[;.'!.o!-inclucied
I Signing supervisor's license no.: '3>4 Z 7 _ 5 I I Each pump or lITIgatIon Clicie' (2)" ... \11('\~'(,$ 63.00 $
I Printnameof.signingsupe~isor: b~h~ C. UdSov tO~~lgnOro'!l~t~~)'':.~~lf; ~1)~;63.00 $ I
I SIgnature of slgnmg supervIsor: ~ _ c.. ~ \-I ~1~:\'~;~~Eh~~~~5~'1 O~ .; $' 63.00 I $ I
.\,fi\3\\1- '~~. ,
. ..A ."c ~Ea5\V~t!~Jjlf\~~ ,tion: (I)" $58.00 I $
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'- ~ W [}, ~A)' Enter subtotal of above fees / 7
~O-,~ (Minimum Permit Fee $58.00) $ b....
\Cy~^V I (B)EnterI2%surcharge(.12x[Al) $ 756
~ '0'\ I (C) Technology Fee (5% offAl) $ 3' r
~ I TOTAL fees and surcbarges (A through C): $ 7171
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440-2584-) (9/08/COM)
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01578
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
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SITE ADDRES~: . :' 3001 Franklin Blvd Eugene TYPE OF WORK: Electrical Work Only
. ASSESSOR'S P,ARCEL NO.: 1703334402600
: . : ~i ,-.'., L . TYPE OF USE: New Commercial
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PROJECT DESCRIPTION:',.,.Te.in~, power for coustruction north side of Franklin
,
Owner:
Address:
OR DEPT OF TRANSPORTATION
417 TRANSPORTATION.BLDG
SALEM OR 97301-3871'
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Contractor TYlle'
Electrical
. I ,CONTRACTOR INFORMATION'. '
, , ' ,. . 'PI' db' eqUlres y
'C" : ..: .,-','tY. " 'V ," Y the 0 ou to
.. Contractor In ~'N, 952~11..'~nter~iC.ltJ!~l)-ul r_htJ\J~\\p Date
SUNDOWN ELECTRIC c<9\\~'QOI~J!I(,&1.Q.~1f674il20unh ~^a:..e_ !Ult/iWSPII
, I BUlLrnNG_INF()lW.'A:['IOMtP~es oftli~ ~~k~~l- .
'!I "'" Sreg e. the teleph , y
Cent. on Utility N on~
# of Stories: er IS 1-800-332_ OtlfA1at;~IfC:
Height of Structure 2344). Sq Ft'lst Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
Phone
503-359-0604
# of Units: . _
Primary Occupancy Group:
Secoudary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
,
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: ~.;' it:
, DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setb~ck: :
Side 1 Setback: .. ' .
-t' .
Side 2 Setback: ,', ". j:. . ,.
Rearyard Setback:
Solar Sethacks:
, .'
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
pMQrWie Rqd: ',', . "." Compact:
~ii:f~tINlMIIJll&"HAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERM'" LS NOT
. PUBu" ""'''lfiJ'itMt'NTS;V', lJANDUNED t-UH,
I , (:,lNlr _ _ _' n:-,I:lJ.
'. Sidewalk Type:
Downspouts/Drains:
Street Improvements: ";.... .~.I ,~.~, 1b
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Storm Sewer Available:
Special Instruction:
. Notes:
.1 Valuation DescriDtion I
Description
Type of Construction
, $ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
.
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Paee 1 of2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01578
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
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Total Value of Project
\::
Fpps Paid I
,0
Fee Description
+ 12% State Surcharge,
+ 5% Technology Fe. ;2
Temp Power 200 amps or less
Amount Paid
Date Paid
Receipt Number
..'.f.:
$7.56
$3.15
$63.00
10/27/09
10/27/09
10/27/09
1200900000000001196
1200900000000001196
1200900000000001196
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Total Amomit Paid
$73.71
I Plan Reviews ~
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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
work day. ",.., "
I Re?lI\' ',~r11 "sneer ODS I
11,111 II. II' .1,10101,
.,
Temporary Electric: Approval required prior to Utility Company energizing pole.
By signature, I state and agree, that I have carefully examined the completed applicatiou 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 projeet.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, thatlhe permit card is located at the front ofthe property, and, the approved set of plans will remain on the site at all
times during consfructi~n. .. -, -.- --.... .
Owuer or Contractors Signature
Date
.
,
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.
Page 2 of2
J.~.: ~.,
225 Fifth, Strl:et;~
Springfield, Qreg()n,97477
541-726-3759 Ph\)ni';'<"
Job/Journal Number
COM2009-0 1578
COM2009-0 1578
COM2009-01578
Payments:
Type of Paymenl
Check
cReceiotl
\,.
,
"
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City of Springfield Official Receipt
Development Services Department
Public Works Department
'f:
RECEIPT #:
.~200900000000001196
Date: 10/27/2009
Des~ription ;';.: :::to
, ... Temp Power 200 amps or less
;'+ 5% Technology Fee
.',~ :.+ 12% State Surcharge
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>;. . r .'~ .,.'
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
'. ..~
Paid By
SUNDOWN ELECTRIC cq,
23090
In Person
Payment Total:
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Page 1 of 1
3:01:35PM
Amount Due
63.00
3.15
7.56
$73.71
Amount Paid
$73.71
$73.71
10/27/2009