HomeMy WebLinkAboutPermit Electrical 2006-2-24
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
ELEt;lKlCALPERMITAPPLICATION 0/9 '
City Job Number C.OM 'Z-CO b - 00 Z Z. Z- , Date '2 - Z ~~~"b
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JOB DESCRIPTION
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Permits are non-transferable and expire if work is
,i' not started within 180 days of issuance or if work is
Suspended for 180 days.
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Supervisor License Number
5/03
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Expiration Date I {) - I - ;L 0 0 7
Constr. Contr. Number l b l7 '-I <j
Expiration Date /0- /;)... - :2 0 0 (0
Signature of Supervising Electrician
1000 sq. ft. or less
Each additional SOO sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
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/ $ 63.00
$ 7S.00
$12S.00
$163.00
$37S.00
$ SO.OO
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600
D.
$ SO.OO
$ 69.00
$100.00
New Alteration or Extension Per Panel
/.1//11) --=,; L. .; One Circuit
- / /' Each Additional Circuit or with
I ./? Service or Feeder Permit
Owners Name <:::lA~t'L~ . f.>('e>.........,
Address Z <)~ 0 Qt., ~ ~c. S ttOTI OE:,~s~e~a~~?i~~,(~~~~~~/f~id~rnotbtcll1~ed);Ea:c~ Jn~tillatiOl1i'
City ~&C~e- Phone b'r:J _ 5*~6~:~HmixPIRE"IFTH'E~'W()RK~4""WW$~:~.~o"""'Wi'i,m"
COMME~O~!B~ERMIT IS I~u J $ SO.OO
OWNER INSTALLATION ANY 180I&AV~Eftroti~~Hcre~~ED FOR $ 2S.00
The installation is being made on property I own which Limited Energy/C~mmercial $ 45.00
is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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Electrical Contractor 1-/ M/ e -, t:/ f,:J:J!~/laJ.J.i;:'i ;',~U?Am.p~A~r,~.~~~, ,'..
I .' 'v':',~O_:h'r,~" L 20lAnips to400 AmpS!'''' '0'0
Address Po !SoX 21ft? ~~Cm<..~_~2~(~~r~Jll/~PS:J9,ioo_AIDPs-'""
L . c~-~', ,: '~~' I':~;j o;6()1!LMrips'to,100~O~PS, : ;'-:1
City .1A/M~ Phone ;;X'~?OC.~ ~c,,:~Py~t,I-OOOAmp'sN~lts':"":-
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Owners Signature:
Inspection Request: 726-3769
$ 43.00
$ 3.00
4.
7% State Surcharge
10% Administrative Fee
TOTAL
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Shared Drive(T:)lBuilding Forms/Electrical Permit Application l-03.doc
: Status
~"
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-00222
ISSUED: 02/24/2006
APPLIED: 02/24/2006
EXPIRES: 08/24/2006
VALUE:
'~\ 225 Fifth Street, Springfield, OR
. 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
i SITE ADDRESS: 1212 C ST 1
~; ASSESSOR'S PARCEL NO.: 1703351412100
Springfield TYPE OF WORK: Electrical Work Only
': PROJECT.DESCRIPTION: InstaIl200amp meter base
TYPE OF USE: Repair
Residential
Owner:
Address:
SHERR! BROWN
2560 FRIENDLY ST
EUGENE OR 97405,
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Contract~\\?\r0-'i0.0~ ,\j\j\' 0'O\'?Y~ ~o\e. :\.~\\'\ ~~~nse
FINLEY Ek~~(fJ'2; ((\'0-'\ ",\e<'" "o~ ~n.1):~.:r61748
\~ ~~\j.1l"~lire~1~ReRMATION I
~ ci;:.\\' e<" \V ~e<" ,oJ
~\).~'O M't~tories:
. R-3 Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Phone Number: 541-683-5403
,'5
: Contractor Type
Electrical
Expiration Date
10/12/2006
Phone
541-689-4708
-
': # of Units:
" Primary Occupancy Group:
I
4 Secondary Occupancy Group:
I;' Primary Construction Type
~ Secondary Construction Type:
# of Bedrooms:
VN
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Frontyard Setback:
~ Side 1 Setback:
: Side 2 Setback:
; Rearyard Setback:
Solar Setbacks:
Description
Tvpe of Construction
Total:'
Handicapped:
Compact:
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Sidewa~~~~~~~
D~~~~ns: .
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'I Valuation Description ~\j ~ ~
~
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS'
" Street Improvements:
f. Storm Sewer Available:
,;\ '
:: Special Instruction:
Notes:
Value
Date Calculated
Pae:e 1 of 2
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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
+ 8% State Surcharge
Perm Serv/Fdr 200 amps or less
Total Amount Paid
Amount Paid
$6.30
$5.04
$63.00
$74.34
Total Value of Project
Fees Paid J
Date Paid
I Plan Reviews,
2/24/06
2/24/06
2/24/06
I
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00222
ISSUED: 02/24/2006
APPLIED: 02/24/2006
EXPIRES: 08/24/2006
VALUE:
Receipt Number
2200600000000000244
2200600000000000244
2200600000000000244
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.
L Reouired Insoections I
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.
Owner or Contractors Signature
Pae:e 2 of 2
Date
225 Fifth Street
Springfi~ld, Oregon 97477
5~1-726-3759 Phone
. ,Job/Journal Number
COM2006-00222
COM2006-00222
COM2006-00222
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Payments:
Type of Payment
CreditCard
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2/24/2006
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RECEIPT #:
~ity of Springfield Official Receipt
Jevelopment Services Department
Public Works Department
2200600000000000244
Date: 02/24/2006
Description
+ 8% State Surcharge
+ 10% Administrative Fee
Perm ServIFdr 200 amps or less
Paid By
FINLEY ELECTRIC
Received By
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Page 1 of 1
Item Total:
Check Number Authorization
Batch Number Number How Received
714230 In Person
Payment Total:
3:03:21PM
Amount Due
5.04 .
6.30
63.00
$74.34
Amount Paid
$74.34
$74.34