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HomeMy WebLinkAboutPermit Electrical 2010-7-6 ~' I Electrical Permit A . 225 Fifth Streett Springfield, OR97477t PH(541)726-3753+ FAX(54 1)726-3689 COMl:O/o-Do %9G. Permit no.: Date: 7-6-(0 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. E-mail: Th" II' . b . d 'd' I C 200 amps or less (2) $ 6300 $ IS IOsta atlOn IS emg ma e on res! entia or larm property . owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 8700 $ property is not intended for sale, exchange, lease, or rent. OAR . 479.540(1) and 479.560(1). K. , toN liON: Oregon la,' ri,~OI to 600 amps (2) $126.00 $ Signature: . ,~~;li~~~~;~I;~~~?Pte.;J by e~ 1,000 volts, see services or feeders section above 'iif:0J7:x;'tfJ',,:C0f\l:rM(::J;oR:HNS1"AL!L:!I.\'flq(~Ui~<< ';;Q'};~ j.!'3~6 ru EBrfJf~<l!itih"ew, ai/era/ian, ex/ensian per panel Business name: / r.IA<'1..A C~k:'(JO~~G'Wl",.m. l:.li J."I;;''ljnl~~U~ 9 .:'.i ~'h-circuits with purchase ofa service or feeder fee: Address: Pn Rni Lf/'11!90 n~,dl;~g_ ~ne ?enter, (Note ets e t~<lrcuit i'l $ 6.00 $ gy~ City: 7-J.11'..""'''' I State: {")y cJ~~m: ,'<1'.(1 ilit"tNlJNffllli!f6'ijh circuits without purchase of a service or feeder fee: Phone: SYI 7':d,- J '171 I Fax:7Y1-7-$'/" 6;i;:;;' - 'f'~t branch circuit (2) $ 55.00 $ E-mail: /I/,1Ce f) (.AJ11fCy€tf::~/6'C.tvt( <e>1.>:l Each additional branch circuit $ 6.00 $ CCB license no,: J6l/s( 77 1 BCD license no.: C"6( Miscellaneous fees: service or feeder not included Signing supervisor's license no.: .3oA3S Each pump or irrigation circle (2) $ 63.00 Print name of signing supervisor: l1..vt FG;.;It:r"t;/<i3: ""'- Each sign or outline lighting (2) $ 63.00 Signature of signing supervisor: f \~ 4 I ~ ___ Signal circuit or a limited-energy panel, $ 63.00 $ ~ - alteration, or extension (2) Each additional inspection: (I) 1;,;,';;'5 i\C~' .'. (A) EI~s\t"l'l"'i!Mb~~'lees NO ER1\I\\i St\I\\.d~mlnl.'m'';,' ..;tlSe1$s8!00) . 1\1IS POO\ZEO UND \(IJ~%\r'ITI1irrg'C'.(12 x [AJ) Jl,U1\1 " 0 'w COMMENCED 0" "1l':)Technology Fee (5% of[AJ) ANY 180 DI\'{ PEP iWTAL fees and surcharges (A through C): ; ,>i:r;j;J;,\;11!.:0QAI!!~GOVERNIVIENT'MI"ROVAL:.,; :,'." :' Zoning approval verified? 0 Yes 0 No 1I;'~\:?;~:;;;;"'CAI.EG~RY,;0~:CONs:rRUCTI0N '.. ,.. ,..:. .,.' o Residential I 0 Government I 0 Commercial ~:'i!>'ii;i.J0E3iJiSIJ:E;IN~,0RMAmION;ANDc;.I!.:OCASTlON'? ':,' Job site address: 7;;<:.. d.,-1o 0) City: ~ ',n. /) I State:Oy I ZIP: Reference: 'J ~, ') I Taxlot.: :,.;"G;;~';:;;t;;1:;':;~[)~SQRIIi':rI()f\l ;0~;VV()RK:':P:':b " IIl.sl.J/ ilkl>.c.,1 $<-,;'<' Awl I- '^- ClY",,;'1, For ~ L~. tft~1 /:vvnJ cIOJf/n1t- '</,,,A'J"t, l~tfs~~:ft)ii:~l::.::;;r~'ltf:f1RClf1ER:r;Yc:ClWNERc~l:,:,:::, : .:":':.,. Name: I ^.... ~._<r'+- Q~Jv,C:.1- Address: S~ Zz06+ 17-"'" LtY<lW' City: ZM:~n.. I State: 0. I ZIP: 'l7Y'C)3 Phone: S'II-Hl;J.-0/00 I Fax: ~ ~~~<x.\\ ~~\\) ~~Ib ~ 440-2584-1 (9/08/COM) V' ::;- '"-",1 FEE:SCHEDUL:.E,": ',", ..... c '",,'_' - :), y. . ;~::':IQ;. .,...." .;-: "::'.'J"'.I~ l' Residential, per unit, service included: . ,,'I': c,; " '.1' Total,: ,,~c()st: H 1,000 sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: instaflation, alteration. relocation 200 amps or less (2) I $ 81.00 $ ffliRL 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation $ $ , $58.00 $ .' :.~,J ic': $ / b!;eP $ /'1, fJD $ t5,).~ $ fCt3..o5 Status Iss u ed 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: COM20]0-00896 ISSUED:07/06/201O APPLIED: 07/06/20]0 EXP]RES: 0]/06120] I VALUE: T~: F ~ '. , ,,:.:~.~ ,;r ;.. , .-.. -.;.,~. "";;' J"J., , .i;- SITE ADDRESS: 725 HARLOW RD Bus Station ASSESSOR'S PARCEL NO.: ROW-MISC SPRINGFIETYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Service and circuits for GuyLee'Eastbound L TDIEMX station Owner: LANE TRANSIT DISTRICT Address: PO BOX 7070 EUGENE OR 97401 I CONTRACTOR INFORMATION ~ Contractor License CAMP CREEK ELECTRic:' LLC" 164877 BUILDING' INFORMATION ~ Contractor Type, Electrical . ~ \" # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type Water Type: Secondary Construction Type: Range Type: # of Bedrooms: Energy Path: , Spoulffilc1Clluilding: nla 0. \.1\re~~~.' , _ 1'1\,\01'1, OI6~~~ ;OOV ' FORMATION :':\ \ E. les adO? 1\10se p..'i\. - \o\\oIN!\I centel, 10\Jg\l 0 lilies bY Frontyard Setback: ~\O,\\icatlon_OO~ _OO~ 0 t\lco~\es(O"W.ll.~\'W. ' Side I Setback: in Op..R 9S2 rna~ optaln Note'. \'IllS~~~ ita\.il)lRqd: Side 2 Setback: 0090. '{ell \Ie center. ~Ol\ \Jti\l\lI R~ rive Rqd: Rearyard Setback: calling \01 t\le .ole_~Oo-33~l) ,tot Coverage: Solar Setbacks: l\\Jrnpel centel IS ~ Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction I PUBLIC IMPROVEMENTS ~ Commercial Pbone Number: 541-682-6100 Expiration Date 06/09/2011 Phone 541-746-1471 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Square Footage or Bid Amount 1"'.',',;1" '1,'1 Pa2e I of 2 ~' " , Value Date Calculated ," ; Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,jt', ' ',. ~ 1"":''''.' ii"::;;' " Total Value of Project I 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 $19.80 $8.25 $84.00. $81.00 Total Amount Paid $193.05 . I Plan Reviews I Date Paid 7/6/10 , 7/6/10 7/6/10 7/6/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00896 ISSUED: 0:7/06/2010 APPLIED: 07/06/2010 EXPIRES: 01/06/2011 VALUE: Receipt Number 1201000000000000801 1201000000000000801 1201000000000000801 1201000000000000801 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, i'1~.'~~c!ipn~ requ~sted after 7:00 a.m. will be made the following work day. "(~i" ,"'" ._ . A L ReQuired Insoections ~ Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. 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 thflt any 3-';1d 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 tbat 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 1''.1., ,:. ~t~: :! \, ~;,;d,~~. ~ti Paee 2 of2 Date 225 Fifth Street . . . Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000801 Date: 07/06/2010 3:20:03PM Job/Journal Number COM20 I 0-00896 COM2010-00896 COM20 I 0-00896 COM20 1 0-00896 Payments: Type of Payment Check cReceintl Description .. Penn ServlFdr 200 amps or les~. \.. . Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Amount Due 81.00 84.00 19.80 8.25 $193.05 Paid By CAMP CREEK ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb In Person Payment Total: $193.05 $193.05 6363 .'"',' I,'!l \" -. , . '.~.'. ~,J/'~: Page 1 oft 7/6/2010