HomeMy WebLinkAboutPermit Electrical 2010-1-11
1"' :....
225 Fifth Street+Springfield, OR 97477 + PH(541)726-3753+ FAX(S41)726.3689
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I Permit no.: CCf - "'3D
I Date: tH /" / ID
Electrical Permit Application
,
CITY OF SP~INGFIEbD, OREGON '
This permit is issued under OAR 918-309-0000. Permits are nontransferable, Permits expire if work isnot started within 180
days of issuance or if work is suspended for J 80 days.
II~E,,:;\;\W'i\i:;IiOCAIl!'GOVERNMENr:WARRROVAIl!:i~0'@.::B:i;:,'1
I Zoning approval verified? 0 Yes 0 No I
11';\:\i%;;i!f'!llmtl':::CATEGORY:'OF;~CONsrRUCrION!''!:1i\;:m:':~i::",m,1 I Residential, per unit, service ineluded,
,~~~~~;:~~E~:'~T~~~l;\i:~P:1~gc~;~~~rj~~;~;::::j i ;~~;~~p:i~~:~II:~o(:~~. or portion ,.' :1::::::
I City: Spn'l'\Dhp..L-J I State: I ZIP: I I Liil1ilcd energy (2) $ 32.00 $
i;~;:~~:~;:~'~;~~~RIRTION:OF;::W~;~~}~~;i:":,:, ,::::11 J~~il:~;n,~~~:;~~ Fe~~~r (;)'odnlar $ 63.00 $
II I d I I Sen.-ices or feeders: installation. alteration, relocation
VlSto.J re tE5f:V"jf'..u/\ tJCU-V1I~
~:~:~,'~~&~~;O*E~t~,gt"I;'h:",,;,,~;'jj :~:~:::oo:~e;:;~; ; ::::: : ;?\ /
Name: Ltun.e... --rv7NY1~I+ l\'stn'if' I I 401 to 600 amps (2) $158.00 1$$
Address:\)(} ~ \.0\.0 I 601 to 1,000 amps (2) $205.00
'I Cphityon~e-: f:_:h_C~\PnO.. I St1aattFeea::{)fx: \L_ l_zIP:LI-m\ .1 Over 1,000 amps or volt, (2) $469,00 I $'
\ I Reconnect only (2) $ 63.00 I $
1 E~mail: I Temporary services 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 afmy immediate family. This J 201 to 400 amps (2) $ 87.00 $
property is not intended for sale, exchange, lease, 'or rent. OA R
479.540(1) and 479.560(1). I 401 to 600 amps (2) $126.00 I $
Signature: lOver 600 amps or 1,000 volt", see services or feeders section above
nj~1;\:\:!t:l:jS~!~00L:lCONTRACrOR~~INSTAI.iLATION:!1:7~~i fiL'~~"i[~'_~r~~~~~!~J I Branch circuits: new, alteration, extension per panel
I Business name: La.v'I't-E Qrk,'c- I a. Fee for branch circuits with purchase ofa service or feeder fce:
I Address: ,J'-/ fj,'Z,/ -H L<.hA S'5? , I Each hranch circuit I I I $ 6,00 I $ 0
[ City:~ ~'~I'_ I ~tate: OK I ZIP: C\-:'fL~DS I b. Fee ,for branch c:rcuits without purchase ofa service or feecterfec:
I Phone':i-\r-1U,Oi05<) J Fax: -:,'-l/ 74, 1.34 Lj =t I I First hranch circuit (2) I $ 55.00 I $
I E~mail: -cCLMtJlovook.CG:>COVY1Co..st , ~ j I Each additional branch circuit I $ 6.00 $
I CCB license no.: 5\ 'tip ~Cj I BCD license no.: Jj) :>z <>~ I Miscellaneous fees: service or feeder no/ included
I Signing supervisor's license no.: ,)L( q:l:s ~ Ead,l pump or irrigation circle (2) I $ 63.00 $
J Print n~me of signing supervisoill VVl .lD.Arrt?1 J Each sign or outline lighting (2) I $ 63.00 $
J Signature of signing supervisor:'\. --/\~ . J2.J.- I I Signal circuit or a limitect.cnergy panel, I $ 63.00 $
." I ....~ ..... ~ alteration, orextcnsion (2) .
[ Each additional inspection: (1) $58.00 I $
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I (A) Enter subtotal of above lees
(Minimum Permit Fee $S8.00)
I (B).RnterI2% surcharge (.12 x [A])
I (el Technology Fee (5% of [All
I TOTAL fees and surcharges (A through C):
$ 8' -:::;- I
$ i()fI41
$ L/,551
$iD/,'):il
440-2584-J (9/08/COM)
CITY OF SPRINGFIELD
Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Une
PERMIT NO: COM2009-00930
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/25/2009
12/25/2009
SITE ADDRESS: 529 HARLOW RD Bus Station
ASSESSOR'S PARCEL NO,: ROW-MISC
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Electrical Conduit for LTD Station
Owner: LANE TRANSIT DISTRICT
Address: PO BOX 7070
EUGENE OR 9740J
Phone Number: 54]-682-6100
Contractor Type
Electrical
.\77:;;'f;':';;, V'''IJUII Jaw reqUIres Y9U to
NfOtll:;T <':~N'fR\!"ltl'f{ffit:J!Nre~tilltiIIY
, 0 I... '. !I( i'.~,! ,lt~jJ ,ureA !ll~ ..elforth
C t t ID OAR 952-001-0010 through O-i!J&&P.l~OI
C:"M~a~::E~OJRj,X~~~~~ain copies of IWllfJ.llAs b;
uaittflO""rp 1r..I"fM' +~; T1""
, nU"'~'BifrLMN6fl1S'P{l)Jm~Bf~1l ..
. l~'I!'i',il.\.t"-J.11!M~J. r on
. # of Stories: ,.,.. ,,''', i', :':: ":';',
Height of Str.~ctu!e
.:" Type of l:Ie~!i _,. " , .
-__', Water-Type: ',:' .-.,
-:'CC"'Range Type:
Energy Path:
Sprinkled Building:
i\Jti:Tff't.ro.
Expiration Date
06/09/20 II
Phone
541-746-1471
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Frontyard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
f/r,-'DErY.E-bO l!IVIE NT I N.fQRMA TIONt'
,l\UTHORIZED UND~R ~~';S' 'PERM;T~IS ~~~
COMMEN@.Y8r~N D.:ls~RA~JOONEd FOR
ANY 180 [~1~~~~~v'l~~::i1, ""'.,' ; ",:'
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation DescriDtion I
Description
:Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 2
"',
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Pending
PERMIT NO: COM2009-00930
ISSUED:
APPLIED:
. EXPIRES:
VALUE:
06/25/2009
12/25/2009
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$10.44
$4,35
$6,00
$81.00
1/12/10
1/12/10
1/12/10
1/12/10
2201000000000000030
2201000000000000030
2201000000000000030
2201000000000000030
,'.
Total Amount Paid
$101.79 .
I Plan 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
work day.
I Reouiredlnsnc'c,tio ('S .
I __...n.....
Underground Electric: Prior to cover
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 doneiu accordance with
the Ordinances of the City of Spriugfield ~nd 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
Page 2 of2
225 Fifth Street
Spri~gfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00930
COM2009-00930
COM2009-00930
COM2009-00930
Payments:
Type of Payment
CreditCard
cRcccintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
2201000000000000030
Date: 01/12/2010
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
TIFFANY LANTZ
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cJc 03534c In Person
Payment Total:
Page 1 of 1
I] :34:37 AM
Amount Due
81.00
6.00
10.44
4.35
$101.79
Amount Paid
$101.79
$101.79
1112/2010