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Home My WebLink AboutPermit Electrical 2006-11-29 ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA-X: (541)726-3689 ELECTRICAL PERMIT APPLICATION CityJobNumbe,(Qrn"'Z.(5\;)(Q.- 0\5\5 I. LOC,4.1JON OF INSTALLATION . .. .., -' .. _(;, Crrr 111";/-" ;-L-.r~ <<.Je LEGAL DESCRlPfION . A. New Residential.- Singleor Multi-Famil)' p.e~ dwe~ing unit. I { 0 3 ~-1 4:::l 0 / / ()D Service Included JOS DESCRIPTION 1000 sq. ft. or less _ Each additional 500 sq. ft. or S:,{'r;'LII /' t': dr-""~.fl. .)-I-ku.rC ( b -vPUportion thereof Permits arc non.transfera~le 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 r. I I , 2. CONTRACTOR INST,y.LAUON ONLY ... _ ,,.: _ ' . _H _ ..__...._..p ._, Electrical Contractor ~",J' '\ ~f")l ~ e PI eC. ~ , Address j f) YD M" I.e. 1.4.,r City Sf /-=-L J!l Phone _,J-I ,~"O~ Supervisor License Number '-I C,1s--<:. Expiration Date I (') /01 / OJ Constr. Contr. Number ~ ,_& L( I,..J.. L( Expiration Date I....{ )f?/o '/ Signature of Supervising Electrician -~,~ Iv I t,r/r #m.J/L. N (JS, LLC- Owners Name _ ~ '-!.! P,. F of',.,,~ / , , Address .(150 W P-.5A JV)j.lon .Sr City ..tij"af31JY _ Phone ,- J {)/&- OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 L-D-L \\-?''i-zauC, NM ' SPRINQFIM0v'E'~PZ- I ~ Date --. ':".':',:'7%'. '_.~ ..-- ._~ ~y '-.." \\/?{1}O<P 3. .. COMPLE1'E FEE SCHEDULE BELOW -, - -, $106.00 $ 19.00 $50.00 B. . -Se~r\'ices or Feeders -Installation, Alterations or Reiocation:. _-=: ._'_.._'~' ~ ,.- . ~'..J._ . :~"_ __. ~ -. . . -'.' .' .' 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 '..,'" , t-, ~ . I .. . ': - . - ,.. -- . . . ~ . C. 'Tefnporarv Services or Feeders . .' ~ _ . _ '. ~ -... --' .'. Installation, Alteration or Relocation ...__.. e{ " - 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps -+-' $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "S" above. D. Br.Mlil~r.,liils ." _' . ." _ New lIW,~~tPJ.IWi!:M'n'ij~hlpfr)lPa'Jl,f: IF THE WORK One crrbtiTt~ORIZED UNDER THIS PERflSI43!@lNOT Each <i"l9i!\?,q~ll~iFE'tit8rA"'ig> ABANllInf.JED ~g6l /' C/O ServlcAwr8\'j'DAY~ERIOD. ~ $'. rr--- E. . Miscellaneous (Service/feeder not included) -Each Installation ,:'"' . ....... ' ., . '. - .-. ..-. ,- ...... Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges . cru (# 9;. -<,Ie; / 5 .5;:) &. (j"V 1?4,15/ 4. SIlB.TOTAL OF ABOVE roc, ..', v /0,'.. - . '-' .. '3% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Elecuical Pennit Application I-OJ.doc r __'N........ ~ I WiL,lf " ' / I . ., .', '.. .. ' . .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01515 ISSUED: 11129/2006 APPLIED: 11129/2006 EXPIRES: OS/29/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 698 NIGHTHA WK LN ASSESSOR'S PARCEL NO.: 1703274201700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Service change Owner: NIGHTHAWK NPS LLC Address: 1750 WASHINGTON EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor PREMIER ELECTRIC INC. License 151749 Expiration Date 06/07/2008 Phone 541-758-4284 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 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: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Description Type of Construction NOTICE: TI :x: '-~IlIVIJ' ~HALL EXPIRE I I Valuation Descriotion I AUTHORIZED UNDER THIS P F THE WORK COMMENCED ERMIT IS NOT $ Per Sq Ft Square F']f,ta2e. OR IS ABANomll'n.cnn It' I' B'd A IV I"'t.1 BD DAY pyalufn '1Jatc'(!'8Iculated or mu Ip lef or I moun LnlUU. Notes: Pa2e I of 2 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-0I5I5 ISSUED: 11/29/2006 APPLIED: 11/29/2006 EXPIRES: OS/29/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fp.p.s~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $6.90 $3.45 $5.52 $6.00 $63.00 11/29/06 11/29/06 11/29/06 11/29/06 11/29/06 3200600000000000593 3200600000000000593 3200600000000000593 3200600000000000593 3200600000000000593 Total Amount Paid $84.87 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 Rp.onirp.d wsnp.~t;on~ 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, 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 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 Paee 2 of 2 22~Fifth..street Springfield, Oregon 97477 541-726-3759 Phone ~ .~i ~ <:;aof Springfield Official Receipt _Iopment Services Department Public Works Department Job/Journal Number COM2006-01515 COM2006-01515 COM2006-0 1515 COM2006-0 I 515 COM2006-0 I 515 Payments: Type of Payment CreditCard cReceiot I RECEIPT #: 3200600000000000593 Date: 11/29/2006 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By PREMIER SERVICE ELECT Item Total: Check Number Authorization Received By Batch Number Number How Received njm 032657 In Person Payment Total: Page I of I 10:04:37AM Amount Due 63,00 6.00 3.45 5.52 6.90 $84.87 Amount Paid $84.87 $84.87 I 1/2912006