HomeMy WebLinkAboutPermit Electrical 2005-6-1
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL P~IT ~fflCATION
City Job Number ( , , ~ -ljf-\V\ Date
1.
3.
A.
LEGAL DESCRIPTION
~tJ ) /J1 ~ coU dull-/J
JOB DESCRIPTIO~ -, . LI / ~ %
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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
$106.00
$ 19.00
$50.00
B.
2.
Electrical Contraci;lVEWIP.~ ~~ECTRIC, INC.
P.O. BOX 23154
Address EUGENF. OR 974Q?
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Phone 3'1'1 1{2 ~
City
Supervisor License Number 337':3 -- .5
Expiration Date 10 - f - 0 7
Constr. Contr. Number f tt f 7
Expiration Date .r"-/? .-c6
c.
Installation, Alteration or Relocation
200 'Amps orIess ':: ',':;:: _ \. . ,
201 Amps to 4QP ,Amps ,', .~'
401, Amps to ,6\)0_ ~mp_s j '_.. ~ ~
J, . O.(,er'600Amps or 1000 Volts see "B" above.
D.
,',,--, .
$ 50.00
$ 69.00
$100.00
I ~.
,I "-".J
$~
Own'''N~; ~~'(~
Address 'J...ll. ~- {1 '\ r ~ E.
. 6, ~~/)-''''lkTEfJTION: regan law requires you to .. .
CIty ~c N ~p',,'V%~&S 6d~~!'3rj ~~ !h,= Qregon lRHftf or ImgatlOn $ 50.00
" olir!'~atilJn Center. Those-rules are seH~tffiut1ine Lighting $ 50.00
OWNER INSTALL~il{!,QN 952-001-0010 through OAR 952,-00(00 Energy/Residential $ 25.00
!he in.stallation is beiHP~4~C6H W6We~W\lAfWf1~l\ of the rU~d Energy/Commercial $ 45.00
IS not mtended for sale, regs~rdil ~rl{. cen er. (Note.. t,he tElJ~roo~ Electric Permit Inspection Fee is $45.00 + Surcharges
number for the Oregon Utility NOUtil
Owners Signature: Center is 1-800-332-2344}1. L{ 5" Of)
~i15
'I. 50
ci.Lh7
New Alteration or Extension Per Panel
One Circuit --I
Each Additional Circuit or with
Service or Feeder Permit
l(J .d)
$ 43.00
$ 3.00
7% State Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
*.~~q,
Shared Drive(T:)/Building FormslElectrical Permit Application 1-03.doc
"
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00649
ISSUED: 06/0112005
APPLIED: 06/0112005
EXPIRES: 12/0112005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 201 42nd St
ASSESSOR'S PARCEL NO.: 1702323201800
Springfield TYPE OF WORK: Electrical Work Only.
TYPE OF USE: Addition
Commercial
PROJECT DESCRIPTION: Add one Circuit at Burrito Boys
Owner: KOCH CRAIG JOHN TE
Address: 2778 W 29TH AVE
EUGENE OR 97405
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor License
LIVEWIRE ELECTRIC, INC 56697
BUILDING INFORMATION.
Expiration Date
05/16/2006
Phone
541-344-4928
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:._ ' .,'...
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
ATTENTION: Oregon law requ\l~~~ IMPROVEMENTS.
fnll ru\ s adopted by the Ore;;:'s;i)ort
Street Impr~{~rmenrstenter Those rules are set 0 n NOr~CiE' Sidewalk Type:
I\:ot:flcatlon . hOAR 952-001- ' .
Storm S~w~rf~rttlijaJ>l6'31-001?thrO~9 fthe rules by THIS PERMIT ~QM1!1~@J~tsf:I?ta;ipsfHE WORK
Special I~stru~tion: may obtain cOPI~S 0 I hone AUTHORIZED UNDER THIS PERMIT IS NO
',.,t8r, (Note. the te ep . COf! MEI"CED OR T
Notes: "J,. . ... ,;:" ltinty NotificatIon (, ',I ~I,~ , IS ABI~NDONED FOR
I.. ";~ u-vJ~-2344).\!.'Y 180 DAY PER/DO.
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD}
Building/Combination Permit
PERMIT NO: COM2005-00649
ISSUED: 06/0112005
APPLIED: 06/0112005
EXPIRES: 12/01/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
LFees paidJ
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid Date Paid Receipt Number
$4.50 6/1/05 1200500000000000698
$3.15 6/1/05 1200500000000000698
$43.00 6/1/05 1200500000000000698
$2.00 6/1/05 1200500000000000698
Total Amount Paid
$52.65
I Plan Reviews I
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.
Reauired InsDections ,
Rough Electric: Prior to Cover
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 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
Date
Pal!e 2 of 2
.
225 Fifih Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00649
COM2005-00649
COM2005-00649
COM2005-00649
Payments:
Type of Payment
Check
6/1/2005
RECEIPT #:
City of Springfield Official Receipt
lelopment Services Department
Public Works Department
1200500000000000698
Date: 06/01/2005
Description
Add, Alter, Extend Circ
Minimum! Adjustment Electrical
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
LIVEWIRE ELECTRIC INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
llh
10136
By Mail
Payment Total:
Page 1 of 1
7:39:03AM
Amount Due
43.00
2.00
3.15
4.50
$52.65
Amount Paid
$52.65
$52.65