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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 VI- ""-?'~ ' 3. :1:~gM~~f~{t~~,i~~~~~,;!~~~:3'2~~~Cf'j,.'j~;....f;, IV/~ "J/~ 0/ /: .s'~, ;.,:'" "<T'';JWV'''i\(,' : "';'~""<!iii~?"'~t7"j.\mc::f!"" ":i;(""'j~~~~!~';';;;', ":',",i ""'is" A. ql'Tlm:Re~id,en!iaI,7,SiIlgle:oI1J\t!11._, ' . ipii-?8~Il~tur unit.', ..:':, s:;:;:~:;;;;;;"~'"".,-~< '~~~~~:o: '~" ". "" "- $SO.OO 1. LOCATigN,DF;J!,/S'lAfMTIOj{ I Z"'~~"L~' ,.",:;:~,;..m \2-\ 00 JOB DESCRIPTION ?.oo Aw-f AA 6'rt>IL- aMi!" 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. ""':"~.~:"" ,'_>'~"/' _"':,:"'.'>f<_.":>.',:~.., :.' . ";-:,/'-'7/ "':,,-_:_:<c:'+'W',':._':::::Y_"":-{:_:";~_ ":;;:::>,~., ~"":"?":<""_7 Supervisor License Number 5/03 s 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 b] / $ 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 .......~Oftl1:,R4CrQR.IN$T4LLAP.oN,dJYI..Xi: B. 2.," ,,,,,,,.,':i$jf,:d""'""""",Lc;h",k,idi,,,j"i,.d2k';""?t~0.c.:v,0,,,L,J:; :""A;1'\'*~ ...r- / - " 1::\'7'" ,', I. 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':"":- CI J...I : :Jt t,'.'"'" ,:.:RecbnnectOnly -, - I '.-, '1.1 C'::-'~l ...~ ~J.';" ~-,' /1 " 'J ' .1 VI.'.ed IrS 1 .... C. Owners Signature: Inspection Request: 726-3769 $ 43.00 $ 3.00 4. 7% State Surcharge 10% Administrative Fee TOTAL b> )O~ b"S~ 7l.( 7..1- 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, %() OV . ,,\ . <"e':> '\ \J'i0.\~'" ~ o...\).' o~ ,of.. <,,\ \'O-~ f..: O<..e~<..e ,:>e\:\j\j\' _(\0 .1 \'<" \0':> f' o,~ ,,-'0'\ "-,' U\-_~P.o v J c.e 'v", O\^: P.<"\).'~ "'~. ~~~~~~NTJUclQ~~I\~~~QN1 ~~ ~ <,,\).'\ .. ce~\.~\j\j\ IJ. C co'9''''. \'0e I.'" ~~\"F' 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: ~ ~\j~ ~ , .. ').<<, r ~\j &, ~ '# ~\j~ Sidewa~~~~~~~ D~~~~ns: . ,.~. ~~ ~~<;::j ~ ~ ~,~ r-v~'~~ \j<<:- ~~. ~~ ~~ ~~~~~ ~~~ ~~,,\~\j \<<~ <)~ ,'" ~... <o\) '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 ,'- ! _~s;:;;o~,~~ ;iii",".",' "".., ',I IIIL..-- TII ' .."...'.,"',..,.., ! ",' ,'i J '.. ....~.._-,....... ~.- '.- ....-...... 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 ':'1 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 1;'-[; Payments: Type of Payment CreditCard f ; 'T '/ I \ i.~~'.: ; :f.J , :C '/ :( ~~ ;\~ 'f 3: .~. , , 2/24/2006 :~ 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 d'b . ~ 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