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Home My WebLink AboutPermit Electrical 2005-8-1 .'~. ;',. .~F[y:.&>~;SR()<v.rmLD,.OREGbNjff.~\:r~'~:\.~ "225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-S689 ELECTRICAL PERMIT APPLICATION CityJobNumber ~'OID7,~ Date 2 ~);,~"'M,g,b~'f,';W~.MlI~~K,'/i B. ~~..\.. Wio' ir~)I . ~ ~~~ ,~,. ~~~ 1 f: . : I ..:' Sf :\l L lXPiH~ If- HH: \'I'C~I.'\ Electrical Contractor ElUENt:.. t:IE~nJt!. SUIllct.200 Af'!1ps or less ;', I',~l'~ i', " ~IIC: Ih..H 'T$,~3,.P31 20 I Amps to 400 Amps.' ,:: ,\'. ' \ r, ,: : \ It~~.OO 40IAmpsto~OQAml?s,:i,,:; $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only I $ 50.00 I. idl (! "l -\)'0 . ; :.' , J:t,/flil ~ '. .~,. '~"',..'!:. Lfl,~ . ~,~ .~. '~~-;'''7''':t..,,,:i'~'' ~,.',:, 'o, ?->32!S 12b....w~ LEGAL DESCRIPTION 17- ~ 2Z- -,~.- -. 07700- JOB DESCRIPTION Av. fJ. ../ ~=:sr:::~:::~ expire [rwork is not started within 180 days of issuance or if work is Suspended for 180 days. Address /.20 /i1tJ/l//UJ6 s.::,-. City &l&t:.NE Phone :3 L/ t./ - 3 f::' to / Supervisor License Number 313 S-.5' Expiration Date I () I, / rJ...o () +- . Constr. Contr. Number 9 () :J () D Expiration Date _ ~ /t r / 0 go t t- Sigliature of Supelvising Eleclrician 'Y",~~~~ o Owners Name Address 33?--5 'Pk City ~~~eNt Phone 7l.f~ -bl(J6 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 [t::-te ing proie~~ has the follow;n\< nd does n~iT rillan? use Zoning ~ 1"\.fJ' . 1111. __ ...!::"~U A. If:ii!-GBlai~~~fP.iffif$.111i'~bit:i)l ~~ .r~;~~ ~""M""1<'J~'~u.""-"",~,~",~-L.~_~ .-- - -.- Service Included 1000 sq. ft. or less Eacb additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 t;fJ.oo C. ~~~~~~~~'iilll Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 ENTION' 2reoon law r"l1ulI"~ you to Over . p~.p'rJ. ...,XoJ.~ &~t'~.tI~',~1;>~y.e..n Iltilif\I , ..1.:t..'~/' \.1lt ..,. "'"''''.... .'W,;. ~ "\"'-," "'\'.'I.~'''";eo;' D. 'illr'~ ..... .. , c ~~...~ .... " ",,' ... n;' New iAlfeAfii8ii'orCExtrrGic\htper'P;;HellAR 9C.2 O[) 1 One <f.Ib'lfit You may obtain COpl85 of 'he $' ~ioo Each AddiiiilnaltCfrcliiic;fWiili"Jot". li It; . c ,,' .' ServicerorrFCedef'PennitOre9on Utili:'! . ., ., $ 3;00 r.:mtPor i~ 1-Ann-8:l2-~)~ ~I E. "'~ ,~~ . U:~!)'I!o':'; ~ "a~~}p~, ;jj.'lliJj'~';1Qli:(r :.'l~:,j,:~tl''i' .....fl'..~~"';..,.;.-:;:-...,.al~~ ~"'''' 7' . ~'~:.itot.. ,,",- ....,...,.,: ~~'i\-m ~;~TJ~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Ene~gylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is 545.00 + Surcharges 4. t~;~~:;:f.: !.~::"~.'/t~~ ~ '~'~'!~:.. ' . '. , 'I :l::',: .,', .~.: hf).00 ~SO S.Oo 58.!;;O 7% State Surcharge 10% Administrative Fee TOTAL Sbarod llriY<(l':)lBuildiaa _I Pcnnit Applicotioa 1-43.doc / -ii~ . . CITY OF SPRIN~FIELD Building/Combination Permit PERMIT NO: COM2005-01033 ISSUED: 08/0112005 APPLIED: 08/0112005 EXPIRES: 0210112006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3325 PHEASANT BLVD ASSESSOR'S PARCEL NO.: 1703221202200 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Reconnect only TYPE OF USE: Repair Residential Owner: Address: 541- MAY THOMAS D & TERESA R 3325 PHEASANT BLVD SPRINGFIELD OR 97477 .' . .,;,r Ii: T\~F V:Ct-'K .. I ,~il\"I..~.\""'- ",I.~~q\1 j. ,. '''.R It1\S[l!'lio.neNumber: . U ll\"Li~' FOR '..' ' ",,,,ILC ,~ IS ~\3r\~\lJOI~I::O ,,' . l",L.LO On \,UI'il,l,l \ .......' lll"n ;\l\lY "\t)v ut"\' ,_'- I CONTRACTOR INFORMATION I 541-746-6478 Contractor Type Electrical Contractor EUGENE ELECTRIC SERVICE INC License 90200 Expiration Date 03/17/2007 Phone 541-344-3561 BUlLum... u"ORMATlON 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 Patb: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION. ulreS yOU to ATTENTION: ureyutllaw re6 egon~,Q.YIRED PARKING dopted by the r 'r.orth Overlay ,?!st:JW rules a Those rules are ~iltal. # Street ir[.~~~:R.ljd:1 Center. 0 through OAR ffilln'd'il:\-pped: Paved Dr,I,v8RHd:52-001-001 . opies 01 the <i:llilip'iO't: % of Lot(Co. verage: may obtain c t the telephone ""v. . . r (Noe: ..' callinp the ~e~~.~nnn Utility Not\hcat\On 'PUBLIC IMPROVEMENTSi8r is 1_800-332-<:"....,. Sidewalk Type: Downspoutsmrains: Street Improvements: Storm Sewer AvaUable: Speciallostruction: Notes: I Valuation Descriotion I '" Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paeelof2 , . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-0I033 ISSUED: 08/0112005 APPLIED: 08/0112005 EXPIRES: 0210112006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Ff'f'~ tlWU Fee Description + 10% Administrative Fee + 7% State Surcharge Service Reconnect Amount Paid Date Paid S5.00 S3.50 S50.00 8/1/05 811105 811105 Receipt Number 2200500000000001023 2200500000000001023 2200500000000001023 Total Amount Paid S58.50 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 Rf'ouirf'rl r'Wf'~tion~ Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined tbe 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 of2 225. Fifth Street , Springfield, Oregon 97477 ~ " 541-726-3759 Phone '. " Job/Journal Number COM2005-0 1033 COM2005-0 I 033 COM2005-0 I 033 Payments: , Type of Payment , . , Cred,tCard '< \'. J ,. :' , '. . ,. \.' .' " 8/112005 . RECEIPT #: Description Service Reconnect + 7% State Surcharge + 10% Administrative Fee Paid By EUGENE ELECTRIC SERVICE .~ ~- 2200500000000001023 Received By ddk Cbeck Number Batch Number Page I of 1 ~ty of Springfield Official Receipt .velopment Services Department Public Works Department Date: 08/0112005 Item Total: Autborlzation Number How Received 001223 In Person Payment Total: 2:59:24PM Amount Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50