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Home My WebLink AboutPermit Electrical 2007-6-26 ZON ~)7 _ INITIALS N ~ DATE <L' 1'~0' / (/1 SOURCE ('n '><!-f 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541 )726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COv1A '7.-0 07- 0 D 8' r D 1. LOCA..TION OF INSTALL4TION: ~40 7r\~ ~-F LEGAL DESCRIPTION: I,033b/J 676t:>~ JOB DESCRIPTION: AJd '7 C(.,~",,\'h Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTR4.CTORJNSTALLATION ONLY Electrical Contractor EA5J5/{)( G~((rR}(. Address 31;), $'.:s BDse A GeE LAN E City Sf~lO Phone _ 07 Y'l"dY11\\\ Supervisor License Number l.j 7;) 7'::r,v ) 0 - I -). 00 '7 117770 Expiration Date Constr. Contr. Number Expiration Date 10 - (,. :.:l 00 "7 Signature of Supervising Electrician ~u ~ .' '1_ i.. Owners Name S-"",. c."O / V fj<:. Lr:: r:- Address /7 LAv.Jr~t:.~ S1 City ~(,.(rN~ Phone 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 -'",Zb ~ 7 Date 3. CONIPUlr. FEE SCHEDULE BELOlV A. Ne~y Resid~ntial- Single or IVIulti-Family p~r dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B.Services or Feeders- Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 ~~J\\" '\:!It .' 40\~1' to 6?~ -N11P~C)"\ '60.'L.AJ.11pg'to\:\ '000 AWns _ c..'..' . r '. \' " .~ 1-\ I (~ (\\ \' 'Over. WO(}:t\\!1\psN alts '1tettW16~t Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less , _., i\",:....C' '/1,;1 \ 1.0 . . ,,.;nf91~J;llp~tQl4t)'0 ~i'rip's~' J,"- , i" ;', .' :;~~l-,Aplpsto~(jOO'A~~" . \~.. ',;,...,p ,', ru. . .: -.'... ".: '(': '-",', ,. '- , : :-, (j~er.~(){), ~~P~~r'\t~~'~?~~S~~~B"'above. D~;'Brailch~c,:ir~lLiti'o(t\.jDJ1;.\\\,;S by ... ',:""', ':;-.:t.-,-. .:'".!,-:l ~..:.:.\:.:i~.<<::j...",.",;..J,.:....._..-.:. ::>...'>......:;,. " ~:, ~e~AIt~t:a~iolioi ExteIlSi.Qrit~f~tanel O,n~Circuit. .~ - .' c' ,>'''~' .,.' E~ch' .Add'iti()'naIC~tfit'dr r~ith \ ,', .." tv -Service or Feeder Permit $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 '( ~ E. l\'liscellaneous (Service/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUB[?TM.OFABO~ ~~\ .. '1 8% Sta~e Surcharge ~. ~,..J\ . 7Z 10% Administrative Fee (:1' "t . '0 5% Technology Fee . 'fr ((.07 TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application 8-06.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00810 ISSUED: 06/05/2007 APPLIED: 06/05/2007 EXPIRES: 12/05/2007 VALUE: SITE ADDRESS: 540 21ST ST ASSESSOR'S PARCEL NO.: 1703361307600 PROJECT DESCRIPTION: New Service Owner: TROCHEZ JULIO F Address: 17 LAWRENCE ST UNIT 1 EUGENE OR 97401 Contractor Type Electrical Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential I CONTRACTOR INFORMATION I Contractor License Expiration Date Phone EASTSIDE ELECTRIC INC 117770 10/04/2007 541-915-9828 BUILDING INFORMATION I r ,\"\t. \NO?''' .,."rf', t.~?\?\t. \ "\ \S ~a' 1~~jStotJ~s: \\ s\\[\\..\.. \s ?t.?~\L~~lze: H~~~t\O'f.'S&\ictu~~.mt.? \\\ ~DO~t.~"Ft 1st Floor: T\~H\!~41X.D \s [\'Of\: Sq Ft 2nd Floor: Wiater ~):;~e~Ct.D a? aD Sq Ft Basement: Ra,{!gJ.\T~p~: D[\'{ ?t.?'\' Sq Ft Garage/Carport Ene~~y{PatJj) Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction R-3 VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: . ~OJtJIlt:.\O # Street Trees Rqd: .., <eC\\i\~eH. aIidl~~\Jpned: , \'11' \ 0))" r\ \ Paved Drive Rqd: ~e90('\ 'a: \\le O~e'1~~p-'at'f~\_ % of Lot Coverage\.y\\O~" 0 ('\\eO '0'1 ~\)\eS -0. Q 962-00 :'\\t:\" c; -0.00,;" \\lOse \I O[\'p \)\eS '0'1 [\ ,\~\f\1 ~\)\e. ,...o(\\e~. ~ ~",~0\)9 ~~ ,\Ie ~ _....P- I PUBLIC IMPROV~~;~lN;PSl ~~oo'\ -o~~;$\ CO?\~C>\\~e \e\e~.~~-;\\O(\ \' .)..... \J ou (NOW. .' ~o\\\ \(\ O~ '{o$ f\I~i~~w:a\lk T6',p-cl,\\\\\'J '2/\'\} , 009v. , \\le c, <> O~e9 ~ t'l,32''2: c-o.\\\(\9 \&ij.W~SP,~!lJ:SJ.Drains: "",'oe~ ~e\' \5 (\\J\" cell\. I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00810 ISSUED: 06/05/2007 APPLIED: 06/05/2007 EXPIRES: 12/05/2007 VALUE: 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 + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $6.30 $3.15 $5.04 $63.00 $0.90 $0.45 $0.72 $9.00 6/5/07 6/5/07 6/5/07 6/5/07 6126/07 6/26/07 6/26/07 6/26/07 3200700000000000363 3200700000000000363 3200700000000000363 3200700000000000363 1200700000000000826 1200700000000000826 1200700000000000826 1200700000000000826 Total Amount Paid $88.56 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 ReQuired Insoections I Electric Service: Approval required prior to utility company energizing service. 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 Pal!e 2 of 2 225 Fifth Str.eet Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00810 COM2007-00810 COM2007-00810 COM2007-00810 Payments: Type of Payment Cash Change Job/Journal Number COM2007-00810 COM2007-00810 COM2007-00810 COM2007-00810 Payments: Type of Payment Cash Change cReceintl RECEIPT #: 1200700000000000826 Date: 06/26/2007 Description Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By EASTSIDE ELECTRIC EASTSIDE ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person . Payment Total: Description Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By EASTSIDE ELECTRIC EASTSIDE ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb djb In Person In Person Payment Total: Page 1 of I 11 :46:40AM Amount Due 9.00 0.45 0,72 0.90 $11.07 Amount Paid $12.00 ($0.93) $11.07 Amount Due 9.00 0.45 0.72 0.90 $11.07 Amount Paid $12.00 ($0.93) $11.07 6/26/2007