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Home My WebLink AboutPermit Electrical 2007-5-31 SPAll ,ZON ~~~ ' INITIALS _ DATE 6.' _\.Q \ SOURCE ..ll ~W 225 FIFTH STREET. SPRINGFIELD, OR 97477. . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Numb~r C.OCo1.1 C:Oo 7- 00 7 7 7 Date 1. LOCATION OFJNSTALL'lTION: ;)CJ:::D J\hA~-\- \JAo.j LEGAL DESCRIPTION: 303, \ \ U .s, ~I(u,{ /80 - ) JOB DESCRIPTION: .j, I.,,.k,,,, .i_ IY\~' \ 'R~U'" 1t 1--41-' IUI Ie.. eh rrf ~+- ~u~ ~~-Ic- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. cr7~o3 031300 2. CONTRACTOR INSTALLATlONONLY Electrical Contractor 5e.-\e..d-YD"0-. 1 h c..... Address I?:2S SWl~'\t~ \?J City ~~""cl Phone SD~-13q4~ Supervisor License Number '"3> bJ....\ S J~t::.~ Expiration Date. I()I,ID~ Constr. Contr. Number toy 31-1 \ Expiration Date _ I . dll~}o~ ising Electrician / --~~~ --- Owners Name CA. S ~tc.Ely )(u.c:~ t..-f- ~A-~ I{' { Phone Address Z'CX:>O ~,/ .I'~/- City Fr.u::rr:;7Y- e OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 .ELD ., 3. COMPLETE FEE SCHEDULE BELOW A. New Residential- Sifigleor 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 $106.00 $ 19,00 $50.00 Jlei) 'i~Qr. yi~es or. Fecders- Installation, Alterations or Relocation: ,'.t- "'r-L~. rH~'0<PA:tH~Abr @$$ALL EXPIRE: IF Tile v,o~a3.00 AU 2bJIOi\wPlH~ ~}W~srHI . v f$~5.00 comN1NM~19 ~~ 19n~] S PERfvdT ls-NqT25.00 AN)60i1~FA~~~qsJIAwpsANDONtU I:-UR $163,00 Over 1000 Amp~J\.I'6Us $375.00 Reconnect Only $ 50.00 C. Temporary Services or Feeders Installation, Alteration or Relocation , 2QOj\mps_or less $ 50.00 'l~dlr.1tih')~yt400'A\95~-i law reqUires YOU$t~.OO fol!f6"t-..{M ~~<f~3ijlA~P; by the Oregbn utijti~o.oo :1~~lf~g~.&i~~~b)J#i~~ha~~~:~~9~\t_6~ 1)(190. a,raBc'h~'9c8mair( copies of the rules' ~al!~~lf~tiQJJ1QeJ!,;:(fem!4!P. Hm 'eM~hone "tlfO>rrMJit1mrttll1' Oreqol" Utility Nnti1icatitfl'3.00 Each Additional Circuit or with "l"lA~' Service or Feeder Permit $ 3.00 E. Misccllancous(Service/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 -YS. Db Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OEABOVE. 8o/? State Surcharge 10% Administrative. Fee ,,,,';-"""".)"-',"',"'", .' ,"c',' .. 5% Technology fee "3, I.,., D ~ 1-1.~ ;) :25 s::; ,3~ TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application 8-06.doc CITY OF SPRINGFIELD Building/Combination Permit , Status Issued PERMIT NO: COM2007-00777 ISSUED: 05/30/2007 APPLIED: 05/30/2007 EXPIRES: 11/3012007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2000 Nugget Way ASSESSOR'S PARCEL NO.: 1803031103800 Eugene TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Install reader and telephone entry at south gate Commercial Owner: UNITED STATES BAKERY Address: 2000 NUGGET WAY EUGENE OR 97403 I CONTRACTOR INFORMATION I Contractor Type Low Voltage Electrical Contractor SELECTRONINC NOnCIE: License Expiration Date Phone T' '/" - 64341 02/1612008 503-245-9988 BUILDINQiN~6fuxT'H~jN1LL EXPIRE IF THE WQ c "V'''LLU UlvrJER THIS P RK # ofSto'rfiJe~MENCED OR IS ABAND t~M/i~JS NOT HeighAN'Sth1ttll).,W PERIOD O~FJtll9ffloor: Type of Heat: . Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPME~LJlYf_QRMA TION , . . .. ........ .S. ..G.'<;;~VI law reqUires ~~IRED PARKING foll~w rules adopted by the Oregon lm~ty Over~~tifl~!ition Center. Those rules are J;~tI6:r # Stn~etJ~~!}'1~o1-o610 thr hOAR g-HA_IUucapped: Pav~ ~r..v~~(r: . o~g ~jQRact: % of .J~flCov~r!J.UJ~Y obtain copies of the rules I call1flg tne center. (Note: the telephone r'lJmh~,..' fr,r th~ ('l"A~nn I ltilit~' f\1,..t;f;^-~~:".:':-, I PUBLIC IMPROVEMENTS. M..... "'''''11\ Sidewalk Type: Downspouts/Drains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa!!e 1 of 2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-00777 ISSUED: 05/30/2007 APPLIED: 05/30/2007 EXPIRES: 11/3012007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid Receipt Number $4.50 5/30/07 1200700000000000656 $2.25 5/30/07 1200700000000000656 $3.60 5/30/07 1200700000000000656 $45.00 5/30/07 1200700000000000656 Total Amount Paid $55.35 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. ReQuired Insoections I Low Voltage: Prior to cover. 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 Pa!!e 2 of 2 225. Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Cj+- 'If Springfield Official Receipt D.. ,wpment Services Department Public Works Department Job/Journal Number COM2007-00777 COM2007-00777 COM2007-00777 COM2007 -00777 Payments: Type of Payment Check cReceint I RECEIPT #: 1200700000000000656 Date: 05/30/2007 Description Low Voltage - Commercial Indus + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By SELECTRON Item Total: Check Number Authorization Received By Batch Number Number How Received djb 60741 In Person Payment Total: Page I of I 3:08:50PM Amount Due 45.00 2.25 3.60 4.50 $55.35 Amount Paid $55.35 $55.35 5/30/2007