HomeMy WebLinkAboutPermit Electrical 2010-7-6
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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:
~
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~
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:
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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', '
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1"":''''.'
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" 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., ,:.
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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
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7/6/2010