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Home My WebLink AboutPermit Electrical 2005-9-30 . - ~""mitled has lhe following win~f?Jtl.f~~!t~cll}<!s the followin 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (54f)726-3689 ~::;::;~R~ '~d u'" ELECTRICAL PERMIT APPLICATION Date ,. ..,."'<.~ City~b~~~_~[)MWC:~~~I54-S "_~t:.",,Y<!,c)(~'::~~':oal~'~.~ 1. ;'LOCATIONORINSTALLAl'ION ,~'. .' 3. 'COM.PLETEFEE SCHEJ)[}LE Bb"LOlV' '., ,,::__ ...~...... _ ..~~'._.:..:j.......... _, . _', .;, ~.:.. ~~ - M .....' . ,.~. . .. ';"_:"';:: >;~:,,":;':.:~:; ^.~, ,:..;,..... . ,.... ".""'.-.'.;",,,...., ' ...; ~;.....,".,,:.~.,," .r._.:.;...e....~.. .~.,'::,;_:;. "'_~,...." ,;..-". , . ""d- ,., ." .__...R. .. ...~ .' .~- . 5'7/1 E ~~t- LEGAL DESCRIPTION JJ D"L .~~ '4- JOB DESCRIPTION 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof EadNJ1JUlft'd Home or M (f#4S~' i'otS . . F~tJTHOR/Z~~-~Aie~XPIRr IF 'nt W$J~'oo B. ':'~e~tWMfJlciEii~~~~~THIS:PEijWlal&'~Q~,~i?ci~ri~';""," ...._})"iy.+8frDAY PERT05~~ljtJNElYF(jR"-~~' ""'~": "'........ <::".,,,,, ilt.Ltl'lc...200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts $375.00 Reconnect Only I $ 50.00 O~"JOO ~Y1~ &rVIU- . Permits are non-transferable and expire if work is i' not started within 180 days of issuance or if work is Suspended for 180 days. r:':'-"'~" 'r.N_~"" ';->~ :-~-'-..::;~; ~." . ''''1 -~7'" ,- . ''-'>.r. ~:.. ..;.:;;:;t~'::"'-' '-.""' '0',;_'::. .'..' ":"':"~ y-,", 2 f;CQNJ'RACTOR IilSTM;I.A.'JjON. ONLY,,; . I.. c....:...o"'...:.l.._..-.~._<....._....,........ ^_............,..;"'. ,..~.;._.,..,..;_~"..._,. .......,. ..:......:. Electrical Contractor t=u:).Q..\,\.lL E\,,{ A-~I'C Address . i 0 0 VYlrW\ n".p ~ : City F-I J.~ J In ~ o Phone ~ -~514L Supervisor License Number ':2..1 ~.;:::; S Expiration Date 10 I a -, Constr. Contr. Number q () ~ () (') Expiration Date 2.,IDt - I Signature of Supervising Electrician -J~~ Owners Name fur&.- 5fo~ Address 5711 E... <5t. City Spr'~ Phone ~7"sr.:,,=,(p OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 .~~~ '0-': \ <\ t) ~ .......... .... ,.,...-........ .... ,.......... . . ~.. ......... ,'.h";,'" '" .... . A. > N~"'Re~ideritial ~Sin~le,or lVIulti~lfanlily ~erd,veiliIlg u!lit' ". ;,._ .."...,..,,_,.~, ...."........_..,.. V' ".u_' '..'~. .-.,........, _.~. .', N........,. _.....~ ..... ,'."~,w,,'l,__... Service Included $106.00 $ 19.00 St>. ()() ,u;.:~( :'_"; :....; .h~'::; ,>'.:-:":-'-"~P" . :'~, ~"~"': '....7..~":.. ~,.:_{ .,,~.~,~_~ .,~~: . 'j C. "'l'elllporary, Sehrices <jr Feeders . ,-._., ,.'w..........,._, '" ;.;......-,.."..'. .... .,....."'~''"_ .'.. .,' ..: . . .. .....~. --'. ....,..1 ,.-,. ",,:_.~. Installation, Alteration or Relocation 200 Amps or less $ 50.00 201~ili5S~~~gs $ 69.00 40 fO}Jm'PSt1.918~0~p~gon law requirF!~ yo& 00.00 NotifiRi t' Q pred by' the g fO ~.', 5gfi~~.~%et1~~~.:g~.'~,.~~e.u..ies,r,.'~,', Qd.J, tiljt.y,.:,'.c.,..."".' .-:........_ .". D. diRrAinl.;irc:(fl1s0{)1,Othr . . ',arr s~tforth '. ;:~. " " .... ~::~t;~:::1~~~~~ir.~:h=;~/~~Oi~ ,....,.,.--..~ ....,.. dNe~iFcui~or the.Or~ (~o~e:. the telerhClrfe~roO Eac~ Addil!W1tlJrqircf-j.t~9 wit'Wllty Notificati n . SefVlce or Feeder 'tJehiHPO-332-23H) . <$ 3.00 0-::.... '..-~~~:~:'~',",:_ . -. '~A.;~ ..~. "-:'-.-;'~'~"- '",' ,"''>' ,..., .;,.,,,. -.......\... '-~-- .~':. "~........- ..~.,..~~- ;.:;. -. .....~ . ,._,..,.~....- _.. - ~-:'.'" E. :rl\1iscell:lDeoll~ (Seryife/feedel: nO( inclu4ed) ,,",,Each'I,~~t~iIatioIl' ,................N..'.. _".~~~A'~..".__ ~,.. ....~.. . _,..~,"'..., ,......~.. ......~~." , ' ... "~..-,,.. ;,,1;-, .A_" . ...:.........._:>~...__.-~.~. ..M..... , ~. .... ,....,--_.. ~'"~.~_. ,,_.. ..,_. 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 ~'~':" ~'..''''.~'_' ~:""'-_'."':"""'_'" .-:r,'....:.,.. . 4. ,SUBTOTAL'OF ABOVE.' ':. ~.,' ~..: 5D.oO .~.SD f;.OO t;g. SO .:.... .':" .. ,~L'-: .:. ~~~ ....: . ;"':.;..: __~.... 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fanus/Electrical Permit Application I-03.doc CITY OF SPRING~l~LD Building/Combination Permit Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2005-01343 ISSUED: 10/03/2005 APPLIED: 09/30/2005 EXPIRES: 04/03/2006 VALUE: , SITE ADDRESS: 5711 E ST ASSESSOR'S PARCEL NO.: 1702331403900 Springfield TYPE OF Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Reconnect only. . Owner: Address: Contractor Type Electrical Contractor EUGENE ELECTRIC SERVkE INC NOTICE: THIS PERMIT SHAll fXPIRE IF THE WORK ~LJniQRIZHl YN9(R lIltS PCRMIT '8 NOT I CONTRACT~~~o~~BANDONEO FOR rc.nltftl. License Expiration Date Phone 90200 03/17/2007. . ...541-344-3561 Phone Number: 541-337':'5666 STONE DARLA 5711 E ST SPRINGFIELD OR 97478 I BUILDING INFORMATION' . # of Units: Primary Occupancy Group: Secondary Occupancy '. Yrimary Construction Type Secondary Construction # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Lot Size: Height of Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport En~rgy PfiftiTENTION: Oregon law reSfl.,Ft Other: Sprmkle~lIow rules adopt~nla- th ~c~~t1tK\l~~gd: / .., - en oy e Oreabn IItillnl I DEVELOP~~i'I~~Q~T.t<?l\TIL1ose rules are set forth ~hrough OAR 9!RE~tRED PARKING Oo:?;You may obtain copies of the rules hy Overlay Dlst:lng the center. (Note: the tele hl;:..otaf: # Street llrees)er tor the Oregon Utility N t'f~I:iI'.a~edicapped: P d D. R d- 0 I Icallon ave rive q-.:enter is 1-800-332-2344) {,;ornpact: % of Lot Coverage: . IPUBLIC IMPROVEMENTS' Street Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated 1 of 2 Status: Issued CITY OF SPRING111ELD;. Building/Combination Permit".' PERl\flT NO: COM2005-01343 ISSUED: 10/03/2005 APPLIED: 09/30/2005 EXPIRES: 04/03/2006 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 + 7% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.00 $3.50 $50.00 10/3/05 10/3/05 10/3/05 1200500000000001438 1200500000000001438 1200500000000001438 Total Amount $58.50 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. 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 wiD remain on the site at all times during construction. Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-0 1343 COM2005-0 1343 COM2005-01343 Payments: type of Payment creditCard :1 :, ~ . " 1 .. .( 10/3/2005 RECEIPT #: Description Service Reconnect + 7% State Surcharge + 10% Administrative Fee Paid By . EUGENE ELECTRIC City of Springfield Official Receipt 1elopment Services Department Public Works Department 1200500000000001438 Date: 10/03/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 003920 In Person Payment Total: 1 of 1 8:24:51AM Amount Due 50,00 3,50 5.00 $58.50 , ! Amount Paid $58.50 $58.50