HomeMy WebLinkAboutPermit Electrical 2010-1-11
~.. ,<> l'
CITY OF SP~INGF~ELD, ORE(';ON
225 F'ifthStreettSpringfield, OR 97477 +PH(54I)726-3753+ FAX(541)726-36R9
Iril;~{i5~1>A~~TM~~f,ru:~niNLil;C;; ,:1
I
I
Permit no. (!Jj- 93'1
Date: O//J//lqltJ
Electrical Permit Application
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. . .
li:!l'iI:j:l;f;:j~;):I!t:>CAL1;GOVERNMENTI:jAI?I?ROVAIE;T::1!,1W'~!l;;j,?jl
I Zoning approval verified? 0 Yes . 0 No 1
1,~i:;::,~~~~~~TEG~:~~~~r~~:~TRlJl:~O~j~:~;c::;;I;i:'i I Residential, per unit, serviee included:
li;:j:1'E;IJOB~SITEI;INF;6RMATIONi!iAND:\Lt:>CA-TION,j;:~ii;::\:in /1,000 sq. tL or less (4) $134.00 $
I Job site address: :311 b GlcL~ St . I I ~,~~~oa?ditional 500 sq. ft. or portion $ 2S.00 $
~",~~~;~~j:i~~I~TI~~;a:F;,wi;~~rl;:~:~, ;:: ,IC';! I ~;~;:;~~:~~;i;;~ :~~~:r ,;;"odular : ::::: :
Iln5t""lI. ped~S-f:vi0.-Vl tJr.u'VliVlA, 1 I Servieesurfeeders: ins/allatian, alteration. relocatian
15\..1"'~ fb_S+t;li ~ Stf,J.(JvY I 200 amps or Icss (2) II $ 8100 $;7,1
~~!'t,;(!,';!!*Jti,.,'tI?ROPERTYil'OWNER':i.';ri:!"b,\'i::l~r;~i';"i~;t,': I 201 to 400 amps (2) I $ 95.00 $
1 Name: ~~ IYn,oYl:':>. a- J');'Stfl'a--- I 401 10 600 amps (2) $158,00 $
1 Address:VtJ \~ ~,O j 1601 to 1,000 amps (2) $205.00 $
1 City: y::"1Y1~~ I State:~1 ZI~. I Over 1,000 amps or volts (2) $469.00 $
I Ph I 1 Reconnect only (2) I $ 63.00 I $
one: - Fax: _ _
I E-mail: ITemporaryservicesorfeeders:ins/allation.alteralion.relocal;.m
: This installation is being made on residential or farm property I 200 amps O[ less (2) I $ 63.00 I $
owned by me or a member of my immediate family. This I 201 to 400 amps (2) [ $ 87.00 I $
property is not intended for sale, exchange, lease,or rent. OAR
479.540(1) and 479.560(1). 1401 to 600 amps (2) I 1$126,001 $
Signature: lOver 600 amps or J ,000 volts, see services or fceders section above
IfL~:tr,;'jH::i)~"i:'fK~;\}itCONTRACTOR!;;INSTAI.liLA.rrIONi/'~'~~';:,~tMr~:~~,S'i;l~J r Branch circuits: new, alteration, extension per panel
I Business name: Wl'1T-EF.../PI -rn'L I a. Fce for branch circuits with purchase of a service or feeder fee:
I Address: l 'J'-I ~;2, I -J-.J WIA :.=:,.9 I 1 Each brancb circuit I 1 1 $ 6.00 I $ (;..
I (ity:F ~J_ I.~tate: ote_ I ZIP: q-:jL~DS I I b. Fee for bralleh circuits without purchase ofa service or feeder fee:
I PhoneSLjt! -+100(O5"') I Fax: ")'-1/ -:1Lf 134 L./ =t I First branch circuit (2) - I 1 $ 5500 I $
1 E-mail: rCl:-hcJ bvoo k..(C;:> c..on)(ast, tVe:t I Each additional branch circuit I $ 6.00 $
I CCB license no.: !: ql" :to, I BCD license no.: 1/J sZ ~c--I I Miscellane(~us fees: service orfeeder not included
I Signing supervisor's license no.: ~7)Llq:.l:s I Each pump o'r irrigation circle (2) $ 63.00
I p~int name of.sig~ing supervisor:rl VVl .Ltuv*. . ! Each sign or outline lighting (2) j $ 63.00
I Signature of slgnmg supervisor: \-' .....'^" c-, _ I Signal circuit.or a limited-energy panel. I $ 63.00 $
, h....._. '" alteration, or extension (2)
. U
I Each additional inspection: (1)
I
$
$
~~
$58.00 1 $
440-2584-J (9/08/COM)
~~
~
I (A) Entcrsuhtolal of above ICes
(Minimum Permit Fce $58.00)
(B) Enter 12% surcharge (.12 x lAD
(C) Technology Fcc (5% ofrAI)
I TOTAL fees and surcharges (A through C):
$ g::;..
$ it) .'-('11
$ 4,5<:;1
$ILlt.'1"l1
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 Line
PERMIT NO: COM2009-00934
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/25/2009
12/25/2009
SITE ADDRESS: 3110 GATEWA Y ST Bus Station
ASSESSOR'S PARCEL NO,: ROW-MISC
SPRINGFIETYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Electrical Conduit for LTD Station
TYPE OF USE: ,New
Commercial
Owner: LANE TRANSIT DISTRICT
Address: PO BOX 7070
EUGENE OR 97401
Contractor Type.
Electrical
,~",,"\ireS \}ll~.~~~,J.
"J. GO!STRACTORINE0RMA.;r~ON I
p..1iE}~i\~~ 2,d;.)p~e\.I ~~J~~ fU\es a.\~ ~!,. ~ 9~.' .
Contraftor:J tUL'cen\8L ,\,OS UgD O/'.R 95~t.l~se
CAMP lJR~~~,~~F0GT-Rj(f~C~pies 01 \D,:~~"'MJl77
\~09(i:, '-{ou 'lJ3:iJ.l1illl\f0"NJ1!q~""~
Ca.\\II'\g \f \\"18 ore\JJ~ 332-2:V.4r.
number or \etf/9lt~rres:
Cen Height of Structure
Type of Heat:
Wate~Jype: ,..
. 'Range-Type:
; Energy Path,
, Sprinkled Building:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bed 1'00ms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I ,DEVELOPMENTINFORM~1!f.l...Nrf
MOi\\lt.. 1 S\-\/\,LL ElWIn'" ~\'.~\1 IS \\lU I
1\-\\S f'E\'.~~~\wmolJt,IS f' Il~ED FO\'.
/\,U1\-\Of\\ZU'\BTjk.a,&JR~/I':
CO~~ENCE a ~,:Ji\Iii3~ Rqd:
/\,~'( i 80 D~,gfCdrcoverage:
I pUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Speciallnstrnction:
Phone Number: 541-682-6100
Expiration Date
06/09/20 II
Phone
541-746-147]
n/a
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:'
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Descrilltion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
, Tvpe of Construction
Page I of 2
Value
Date Calculated
l~
Ii
Status Pending
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
$10.44
$4.35
$6,00
$81.00
Total Amount Paid
$101.79
I :' ~lan Reviews I
Date Paid
1112/1 0
1112/l0
1112/10
1112/l 0
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00934
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/25/2009
12/25/2009
Receipt Number
2201000000000000031
2201000000000000031
2201000000000000031
2201000000000000031
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.
R,e'1uired Tn~nections I
By signature, I state and agree, that T 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 allY structure without permission of the Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliallce 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 ou the site at all.
times during construction. ,~.,
";(- ,
Owner or Coutractors Signature
Paee 2 01'2
Date
City of Springfield Official Receipt
Development Services Department
Publie Works Department
225 Fifth Street
,-
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00934
COM2009-00934
COM2009-00934
COM2009-00934
Payments:
Type of Payment
CreditCard
eRcccintl
RECEIPT #:
Date: 01/12/2010
11:38:0IAM
2201000000000000031
Description
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
81.00
6.00
10.44
4.35
$1U1. 79
Paid By
TIFFANY LANTZ
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cJc 03572c In Person
Payment Total:
$101.79
$101.79
Amount Paid
','
Pa.ge I of I
1112/2010