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Home My WebLink AboutPermit Electrical 2007-4-26 \' " SPRIN ZON GD<2.. INITIALS f'JY'" 1 DA TE U /l,l..,p /0 SOURCE ' M '" >';' ., CITY OF sPRjN iELD~, oREGdN::,.~' ",,~ ::'~' , ..." '.. . ., ~ ~, ,,':1 l> ".~' _ .., f;' : '_ . l .; ~_, 225 fiFTH STREET. SPRINGfiELD, OR 97.t77 . PH:(541)726-3753 . fAX: (5.t1)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CDm 2fi7rl -' mt /J II , . \ I. LOCATION OF INSTALLATION: ,3. Lf I ~ 2 Fa 1'S'(--t ,^\iI S\"' LEGAL DESCRIPTION: ~ '8'02 oS d.~ (JV '-fOy- JOB DESCRIPTION: D\~-T('-ess *\~e\M .J:v'\S~J.\vL 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor ~ C ( Vir, '\"1 Itt f{(lM (.o~p MtA;t If\, S\ sa.. Phone 92.a--l.f.s4~ Address 'd-.\, City AL~Arvo{ , Supervisor License Number q'o c..( l...fp... /010 a ( Expiration Date Constr. Contr. Number {"../O S q \ Expiration Date 09/0,., q~;';':]''''k;'' Owners Name 1")\9 'I~~~A_~ (~\lWnC1 Address~_ rr~:=(~\dJ ,J C;ty ~ ~ Pho", 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 D '... ,=:::;j r :v '-. 1.1 :1 i f\.~ ..;I< "'-1' ....,L..,.,--'.;-../ " j -~---;~;:, -.. ---- ( '.j ....,.,;~,~ '''-,; -,~.~ ~I Date Lf ,,^ 2,0./ Or COMPLETE FEE SCHEDULE BELOW A. New Residential - Single or Multi-Family per dwelling unit. Service Included 1000 sq, ft, or less Each additional 500 sq, ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $] 06,00 $ ]9.00 $50,00 B. Senrices or Feeders -Installation, Alterations or Relocation: 200 Amps or less 20] Amps to 400 Amps 40] Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 Amps/V olts Reconnect On ~ 0 r, C IE : THIS PERI\AIT cu C. Tempora'1\,rffl'ices ot'l't!ed~~"LL EXPIRE IF THE WORK HORIZED UNDER THIS PE Installation, (\GMa~&NcfrOOIVfftj~ ABANn RMIT IS NOT 200 Amps orANY 180 DAY PERl-GO r~ID FOR 201 Amps to 400 Amps . $ 69,00 401 Amps to 600 Amps $100,00 Over 600 Amps or 1000 Volts see "B" above, D. Branch Circuits $ 63. 00 $ 75,00 $125,00 $] 63,00 $375,00 $ 50,00 New Alteration or Extension Per Panel One Circu,it.A!J!:;.NTION:,Oregon law r~~I~@}s~0 ~:~i~do~J~[~~~~~~r a'Cl8pted by thepf.~9on Utility '-Jotlflcatlon Center. I nose rules are set Tort; E, 1\1 iscemllQN;t~~iQ~Uelt\Q 11(Ut7.~~~ 08fi !I@,?'iftl.Qibn 0090. You may obtain copies of the rules ~ Pu:np or irrig:ab,"ing the center. (Note: ttlQlteUephone Sign/Outlirf&UIng_for the Or~qon Uti/itycNlotification Limited Energy/Residential' --,~ -l Q('\rL')~?$'-2'31l6). Limited Energy/Commercial I $ 45,00 '1 roo Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4. SUBTOTAL OF ABOVE t..{ roO J (,,0 '1 ~u 7... 'u ./ ~ 5~ 1:>'=> Shar~d Dril'~(f: )/Building Forms/Electrical Permit ^rr1icalioll 8-06,doc - 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Status Issued ~'4CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00611 ISSUED: 04/26/2007 APPLIED: 04/26/2007 EXPIRES: 10/26/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4162 FORSYTHIA ST ASSESSOR'S PARCEL NO,: 1802052200404 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Distress Alarm install Owner: MAINSTREAM HOUSING INC Address: 433 W 8TH A VE APT 001 EUGENE OR 97401 Contractor Type Low Voltage Electrical I CONTRACTOR INFORMATION I Contractor License MARTlNVEST,INC. 40591 BUILDING INFORMATION I Expiration Date 09/28/2007 Phone 541-928-4544 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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: '\VVu0'~v,", "....'-' ~Si..fU~ffiMt(~ort Energy Pat,h: ~llqoN ^lHlm UOOa.l~9.Of'\ ~8 tt5iJ,\\e~ Sprinkled ffrl-11mJ)~'a,al a4l :IB\ON) . .l~~IYpan . T .o~o0600 aUO~ ..._~ "\r.>1no A'eW OU^ I DEVELOPMENT'IRFtii&X_.l4l <> ~OO- WO-GS~6 ~~V~~fJl~ uu 1.11..::...... In.l aS04.L '.lelUaa~. U PARKING .lO~ las are sa a dope se\n Overlay Disf.ll Iln uo5a.lQ a4l "q pl. rlAtN3ll'" # Street Tree\,;~q8i\ sa.lmba.l M'e\ uooeJO.N'1'iandicapped: Paved Drive Rqd: Compact: % of Lot Coverage: ' Frontyard Setback: Side 1 Setback: Side 2 Setback: ' Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Side"G'~fnfee/WO OB ~ ANV H 0::1 03 N 0 O~~R9~~IDmUMtl3 V\lltd O:J LON SIIIV\l1:Eld SIHl }:J30Nn 03ZIHOHlnV >ltlOM 3Hl ::II 3HldX3llVHS IIV'JH3d SIHl :3~il0N Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of 2 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 + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Total Amount Paid Amount Paid $4,50 $2.25 $3.60 $45.00 $55.35 Total Value of Project Fees Paid I Date Paid I Plan Reviews I 4/26/07 4/26/07 4/26/07 4/26/07 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00611 ISSUED: 04/26/2007 APPLIED: 04/26/2007 EXPIRES: 10/26/2007 VALUE: Receipt Number 3200700000000000237 3200700000000000237 3200700000000000237 3200700000000000237 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. Low Voltage: Prior to cover. Reauired InsDections I 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. Owner or Contractors Signature Pal!:e 2 of2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone c:...., of Springfield Official Receipt i dopment Services Department Public Works Department Job/Journal Number COM2007-00611 COM2007-00611 COM2007-00611 COM2007-0061I Payments: Type of Payment Check cReceint I RECEIPT #: 3200700000000000237 Date: 04/26/2007 Description Low Voltage - Commercial Indus + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MARTINVEST INC, Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 47077 By Mail Payment Total: Page 1 of I 2:36:18PM Amount Due 45,00 2,25 3,60 4,50 $55,35 Amount Paid $55,35 $55.35 4/26/2007