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HomeMy WebLinkAboutPermit Electrical 2004-12-27 .,,_", -;':, "~t"'';.'~~'~~l''!.'';'' _;t \.'~~ ,'.~ ":. ",0$__,,";,. . '~.." "', ..' . :t'....\' .t~~J:...:t<lf>:.'.;,..'..-~....."';..?;.'.:..~ '~;',j~').;; :~il:;;;f.q i;~':'~'.:..,ffi;)},~@'!Im~~,Gi)E}~~rr \IffiRlliEHm';'!l@'R.iw@@N/";,'" " ;' ":""<< (~' "if.,;\2.\~l ~~t~:~~~\~~:~~tJIl\~1'~~~~~4~~'M:~f~$1r~f~~:r~~;~.,...di.~1 "Z}~~'~\;Y(1:~~~it . ~ :~f*~~jk(~~( f~, f~~(~:( .:~ tl " .: ~; ~. (!\~~lk ~:>.-!.;(.~~t _ A 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541}726-3753 . FAX: (541)726-3689~ 'b.,1:,~ ELECTRICAL PERMIT APPLICATION . ~ ::oo:~ '%~ ~ 1> ~~~ City Job Number CoV\;\ 'ZIzO l{ - I S- 7 '7 Date %. 0- ~ o 0-0 "" ~ ~. City Ql fl, tAlE 1000 sq. ft. or less rl / Each additional 500 sq. ft. or ou \0 '1 b c/ /2.LV\..:-U portion thereof ....., teC\U\l'eS ~ ut~ , no" ,~~. n, ego" rth t.rl\~~!tl~~e-Jr ate set \0 "\. "'~:~8glti~~~o~?t 952-00 to\\OVl ~e~~(l\ef. \htOUgh 0 the {uh;: h,! ~\f\ca; () . ~ \ ,",0 pP. " ~(). c8"t8 . U\\\\\'I Electrical Contractor rilt. EJUc.. ~llinjt!. Sf.el.1~~~~~@tegon_332_2344). nurt\'o~~i\\e~ tw~-~~~s Address /.2() IntJ/\/12.iJ6 ~. 401 ~ps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only LEGAL DESCRIPTION /70] 3S / <-I JOB DESCRIPTION ;+ 20 <:) St:Cl.AIlc...<.:- I 2 s, G c:::, A. 1. t 2-- SO C sf- 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. $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Phone :3 '-Iii - 3 b (P I '-...,.'.";... .....,<.............<ii/It ~-:L3r(1 Supervisor License Number ~ T ..::> v Expiration Date { () II / ~O 0 :t- I Constr. Contr. Number 9 C? :J. CJ D Expiration Date .311 t-l () ~ Sigriature of Supervising Electrician $ 3.00 18 ~/--'yt:t;;::I Owners Name LrJ-rVc:...e- .~ D S t::--r Address :So .s 2 st- # C] E. City SYIr-~ Phone Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent 7% State Surcharge 10% Administrative Fee <6-1 ~f,7 8'/0 ?C/?Z Owners Signature: 4. Inspection Request: 726-3769 TOTAL Shared Drive(T:)lBuilding FormsIEIcctrical Permit Application I ~3.doe Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01577 ISSUED: 12/27/2004 APPLIED: 12/27/2004 EXPIRES: 06/27/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1230 C ST ASSESSOR'S PARCEL NO.: 1703351412300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service change and 6 circuits Owner: LANCE POSEY Address: 305 E ST #9 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor EUGENE ELECTRIC SERVICE INC License 90200 Expiration Date 03/17/2005 Phone 541-344-3561 I BUILDING INFORMATION I Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: ~OltCE: DorxPffi~t~~N~9NORK 1\-11S PERM\1 S\-l~~~ 1\-\lS PERMI1 IS N01 AIJT\-IORIZED U~~ IS ABANDONED fOR ' COMMEN~~? ncO\(\n Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01577 ISSUED: 12/27/2004 APPLIED: 12/27/2004 EXPIRES: 06/27/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L Fees paidJ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $8.10 $5.67 $18.00 $63.00 12/27/04 12/27/04 12/27/04 12/27/04 Receipt Number 1200400000000001788 1200400000000001788 1200400000000001788 1200400000000001788 Total Amount Paid $94.17 I Plan Review~ 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 Insoections , 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 Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission ofthe 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 ofthe property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pa2:e 2 of 2 ; r"~ty of Springfield Official Receipt . ~velopment Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 !If' 541-726-3759 Phone RECEIPT #: 1200400000000001788 Date: 12/27/2004 11:18:07AM Job/Journal Number COM2004-01577 COM2004-0l577 COM2004-0l577 COM2004-0l577 Description , Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard RUSS ROBBINS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 027654 In Person Payment Total: Amount Due 63.00 18,00 5.67 8.10 $94.77 Amount Paid $94,77 $94.77 I: I' " 12/27/2004 Page I of I