HomeMy WebLinkAboutPermit Electrical 2010-7-6
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753.FAX(541)726-3689
COAAzorO -00
Permit no.:
Date:
7-{; -/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.
+~'.ii;';:':'~I..Cl.C:AI..'GOVER.NMENIARRROVAUv
Zoning approval verified? 0 Yes 0 No
~:::;Ji'!ff/<;<::8IEGQB'f;f0F:,,:CONSIRI.J<::IION:::':. . ::.'.'" ,
o Residential ~ Government 0 Commercial
:i!?f,n': .UOB;!SIIE::INF;0R.MAmION:,AND:L.O<::Al]ONi
Job site address: :5').7 )/.""1)
City:..s /"1M i;.,~ ZIP:
Reference:
he )~ /)' fvkf""
Address: SSD6 Zeo'f" i7T1- Avenc/"
City: - 'It- State: Or ZIP: 97f/03
Phone: 5'1l-b?J2.- GleO
E-mail: _ -;-~.
This installation is being made on .reside~tial or(\a.~ Rr?p~erty)re
owned b~ me 0: a member of my Immedlate_:..~~W~!:y.,.::'.'Flils aeje g{
property IS not Intended for sale, exchange'Jlease~(or'rent:"01>R')te
479.540(1) and 479.560(1). 009V/1h 952-00"'1' fer. T
. O. Yo -0010
SIgnature: call; _ .U 1118 0
:f:,': :.<::ON:r:BA<::moB.INSIAI..Id,A,;f10N::;' .'1'Plf?nt' .
k " , e Ore 0
Address: '1/5'00 -800:3
ZIP,?7 I?
6 0
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
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NOTICE-
TH .
/S PERMIT
AUTHOR/ZED US
COMME
ANy 180 NDGED 0
~DW AYPE
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~
440-2584-1 (9108/COM)
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N'lIrifber,oifJn~pe~tiQ~;j~'~;,'it~~,;(~):Z~~;~Q~~,I,:,,;~~J:;~sf~JI::,"~~~~r:l~
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Residential, per unitt service included:
1,000 sq. tl. 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: installation, alteration, relocation
200 amps or less (2) I $ 81.00 $ f;/~
20 I 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
200 amps or less (2) $ 63.00 $
n i~Olrt)h~qR amps (2) $ 87.00 $
'b 41Yf.!t<Oi~~' )10 $126.00 $
0
r '~.. '"" '" '"'.,wm"~ <"",,~"
0 .IbgI i ~BiO!i1,:~lteration, extension per panel
; ,':~~~eetfwe r ~its with purchase of a service or feeder fee:
,< ~~~~f:lli~i;JJiuit /Y I $ 6.00 I $\S')I!3!
b. Fe'e"fur branch circuits without purchase of a service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: ser,vice or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
,.0l.:"",;~. .^ IT ~Sl: .;'.: ",;:: .:::~".,/:'"
:~ ~&tIEl1t::;JbjkiriliOfabo.0~"(;CS $/~
N 'JiMu~m:erp';,.tif~ $.5l!:~0)
BS2,lll[~)j,igfl'~:?iA]) $t.9.~o
R/ i:;rmj{go'i'~YJ[~~5%.s [Ai; . $ ~)..<'
TOTAL fees aud surcharges" (A through C): $ /9'3 rx-'
CITY OF SPRINGFIELD
Building/Combination Permit
. -~ 1 ,', - I, ,
,.
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
PERMIT NO: COM2010-00898
ISSUED: 07/0612010'
APPLIED: 07/06/2010
EXPIRES: 01106/2011
VALUE:
:. ~, .
SITE ADDRESS: 527 HARLOW RD Bns Station
ASSESSOR'S PARCEL NO.: ROW-MISC
SPRINGFIETYPE OF WORK: Electrical Work Only
,_..,~":;:':,, ii").' . .... TYPE OF USE: New
PROJECT DESCRIPTION: Service and circuits {or"Pheasant 'eastbound L TD/EMX station
J;.;.;,: .," ~\ {
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkl~d'-Building: n n/a
_ . ...., '. '...rur-'n,: ,
I DEVEL6PMEN'mNf()RMATI0N;j~~eoql/ires you to
. regO U.
,,: "":;0000 ".,' ""c-001-00 '''use rUles n tlli~EQUlRED PARKING
. .- '. ", You 1 0 thrOU hare setto u,
'''OverlaY''\.ll1~iJ may ob1ain cap' g OAR 952_0;:t\)tal:
# StreetJlfl!.e~~)\fi!l':1ter. (Note~~% of the rUles bnandicapped:
Paved DrivSr!/{!9)e Oregon Utilit e te/:Phone '\::ompact:
% of Lot Coverag~ 1-800'332_l/:4)~/flca/jon '
Owner: LANE TRANSIT DISTRICT
Address: PO BOX 7070
EUGENE OR 9740]
I CONTRACTOR ]NFORMATION ~
Contractor Type
Electrical
Contractor License
CAMP CREEK ELECTRIC LLC. ]64877
BUI!-,D1NG ]NFORMA TION ~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Commercial
Phone 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 Garage/Carport
Sq Ft Otber:
Occupant Load:
"
: i~:
Sidewalk Type:
Downspouts/Drains:
., ,
V aluatioil~De '
AUTHOR All EXPIRE IFTHE WORK'
$ Per Sq FI'OM ~rtJIlIOORgTHIS PERMVtll&NOT .
or multipliJt ME/IillOO<OOq3UJl13ANDONED F '
.,:~:::.A~lr~2;89,f{Ay PERIOD. ' OR
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. I':
Notes:
Description
Type of Construction'
., Paee I of 2
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",.
!'i '~-::1~f~~X;'~::<<::_:'8~~;_.:
Date Calculated
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00898
ISSUED: 07/06/2010
APPLIED: 07/06/2010
EXPIRES: 01106/2011
VALUE:
",{.,-
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
'i'T~tal Val:~eof Project
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
Date Paid
Receipt Number
$19.80
$8.25
$84.00.
$81.00',;:::
;~.?~~:;:~::.
7/6/10
7/6/10
7/6/10
, ,7/6/10
1201000000000000799
1201000000000000799
1201000000000000799
1201000000000000799
'~"" .. .
Total Amouut Paid
$193.05"
I Plan Reviews ~
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. ,:
Reoui~ed InsD~ctions ~
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'that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the L';'('y1 ohh~"Sfate of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structur~ 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, aud the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
,
!
l:c"
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000799
Date: 07/06/2010
3: 18:30PM
Job/Journal Number
COM20 I 0-00898
COM20 1 0-00898
COM20 I 0-00898
COM20 I 0-00898
Description
Penn Serv/Fdr 200 amps or less' .
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
,
Amount Due
81.00
84.00
19.80
8.25
$193.05
Payments:
Type of Payment
Check
Paid By
CAMP CREEK ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 6363 In Person
Payment Total:
Amount Paid
$193.05
$193.05
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Page I of I
7/6/2010