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Home My WebLink AboutPermit Electrical 2004-4-22 / jac! as submitted has the following 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: ~~~1d~~~g~s not require specific land use ELECTRICAL PERMIT APPLICATION Zoning 1) () City Job Number QOW\1-OOt\----OO4-51 Date i/22~tJ Date ~- &'3- oef- I , f ~qi#/l/~Y::~tt/'lftlf} (;W~f/l~8!12'1tf~~~f&~v L :R'i!-IESCRIPTION A.N~~Lg~,Sl<!~n,tl~!: :~l~gle{)r.l\'1!l~tt:F,l1pil)'p~! '9:w~IlJngt1111t~j;<: " llll.\qCD orJ:fj) S~;~~~~ -~::~:~~~. -, "'." ,". ".,#,"" .", "..,."" . ,., ,,~...,~, "',, ,,','" ,.",". JOB DESCRIPTION 1000 sq. ft. or less $106.00 tfh g S 7/trAlD ~y 6eNe~ 111M I N:5T4iI.. ;:~o~:~r~ 500 sq. it or 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. Electrical Contractor L. R. Brabham, Inc. Address 68 West 1/ Q 1/ Street City Springfield Phone 747-6638 Supervisor License Number 4944S Expiration Date 10/01/04 Constr. Contr. Number 8699 Expiration Date 12/18/04 Signature of Supervising Electrician -g v? ~.,,~/ - /' Owners Name btll gg Address SOD &: LJt4 1iYLJ1/JL City tit 11- J1{ q 1 t/-o I Phone 33 t.f-. %1 7 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 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B.),!;;;;:Zf;:ii~~'~~ti~~~~~f~~~~~~~~)~~!~4 .' , ' ___-r.:N,'nO\\t:C\eg ',,:i.rj"D':'lOn U'll I''){ ~() 200 A~'s bfless' ~',..c\c',')t2d, 'c,\j t:~~ '::'l:_6.~..QQ ';0(10\\0 I .:,'n\' \N~U\8bc." ,'" c" ",';c,~:::r",d ' . . 201 Ainps:!o 4n~~;:t2,\', ~ :';Gc'::'~':',,\j:$.-":71i)Q(f .,'~c7{~S, OtJ 401 ~~~t~~~~~.. ~(JO'l 0 \,:".,:,~,~~~1 .:. ~is!oo::s .11"\ "'Al~\ 'tI:J...,' .;" ~ r.n~'~ Ctl~i'~-:-':: ~-~:.. ", P\ p"" 601 A; U .to 1 AOA ~ ~{j'-~... ,\ ' .' r. -, f~163.;O(,)Y:L I c1'O ()O l{Wou. \"'V~. . ,.,"fl" r\'r,:,\':::. ','r.,' :,: ,.... " _' Over tb'6I~I' .~Ptts~~";~~_;'~'~'V.'-' }"I',"y:~;:iJi5J),6,~.D,';<'1~ Reconnect W.o.-lo,' t.;;;-) 'J, ~'<" _ . .,', ,,,$ 60.00 '.lU' ~,,' . - " .- c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 D. $ 50.00 $ 69.00 $100.00 New AlteraN<1J"ffef!ension Per Panel One CircuitTHIS PERMIT SHALL EXPIRE~f4~PfE \tillBJs: Each. Additi9.JIt'tlfftrf,Ei7~rlfU~IDER T11~ P!;;.QJ\4!I IS ~ 00 Semce or Fee'der P~fMltL. $' S;eJU I CQ';./I\V'IEI\JCED 0 :1 IS J-\!JI\I~;jOlkD FOK E. ;'[!~~"Ui.~~~~,~r!~~~B!~fg~~~~:~J~~~1~1;~K~~~,~~~i~;~~~~_tl~~~_ Pump or irrigation Sign/Outline Lighting Limited EnergyIResidentia1 Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. q cA~ , CD rolf, 5 Lf q~,aO 1078.7Lt 7% State Surcharge 10% Administrative Fee TOTAL Shared Dtive(T:)/Building Fonns/Electtical Pennit Application I-D3.doc CITY OF SPRINGFIELD. Status Issued J Building/Combination Permit PERMIT NO: COM2004-00457 ISSUED: 04/22/2004 APPLIED: 04/22/2004 EXPIRES: 10/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3957 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1702190003300 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: installation of standby generator TYPE OF USE: New Industrial ATTENTION:Oregon law requires you. ~() 1-11-'/' ~. ,1M ",til'mtpr! by the Oreqon Utility EUGENE CITY OF \J~ific~ti~n Center. Those rules are set ton CITY HALL EUGENE OR 97401 In OAR 952-001-0010 through OAR 952-00 ;n:n:. \,:'1 ..,.."'} f'\ht~in ~nnies of the rules \ --...:J':'l~ -, ,,- ~ F:fter. (Note: the telephone ' I CONTRACTOR INl<'tJRNl}tTIO~ 0 gon Utility Notification I I u....""v , fv' L re - . _., :_, ~ 1:'''''' "'''0.9'=114.). License Expiration Date Phone 8699 12/18/2004 541-747-6638 Contractor LR BRABHAM , Owner: Address: Contractor Type Electrical BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Pat~OT1CE: Sq Ft Other: THIS PERMIT SHALL EXFWU!e~ili~SAKtBll\Area: ~11:"j,\.[~ ~ J I l\l' th \'~ F;::~\i~iIT 10 imr DEVELOPMENTfN.Pmt'M'A: IS ABANDONF=n FOR II~ -aEQUlRED PARKING ANY 180 DAY PERIOD. Overlay Dist:' Total: . # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: Frontyard Setback: . Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I' Valuation Description I Description Type of Construction $ Per SqFt or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Page 1 of2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 1000 amps/volts Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Perm Serv/Fdr 601 to 999 amps Total Amount Paid L.fees Paid I Amount Paid $92.20 $64.54 $33.00 $375.00 $126.00 $225.00 $163.00 $1,078.74 I Plan Reviews I Date Paid 4/22/04 4/22/04 4/22/04 4/22/04 4/22/04 4/22/04 4/22/04 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00457 ISSUED: 04/22/2004 APPLIED: 04/22/io04 EXPIRES: 10/22/2004 VALUE: Receipt Number 1200400000000000528 1200400000000000528 1200400000000000528 1200400000000000528 1200400000000000528 1200400000000000528 1200400000000000528 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. I Reouired Insnections I . 1 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. ,~.~-/.// Ow~er o~ntractors Signature ff P" Pa2e 2 of2 '-I / z Z /() L/- Date 22~'Eifth StTeet ,Springfield, Oregon 97477 541.;726-3759 Phone ("ity of Springfield Official Receipt lelopment Services Department Public Works Department RECEIPT #: 1200400000000000528 Date: 04/22/2004 11:50:43AM Job/Journal Number COM2004-00457 COM2004-00457 COM2004-00457 COM2004-00457 COM2004-00457 COM2004-00457 COM2004-00457 Description Perm ServIFdr 200 amps or less Perm ServIFdr 201 to 400 amps Perm Serv/Fdr 601 to 999 amps Perm Serv/Fdr 1000 amps/volts Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 126.00 225.00 163.00 375.00 33.00 64.54 92.20 $1,078.74 Amount Paid Check L.R. BRABHAM ddk 030540 In Person Payment Total: $1,078.74 $1,078.74 4/22/2004 Page I of 1