HomeMy WebLinkAboutPermit Electrical 2003-9-25 (2)
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, submitted has the following
225 FIFTH STREET . SPRlNCFIELD, OR 97477 . PH:(541)726-3753 . ~~,~~~cg9 ~equ" s~eclflc 'and use'
ELECTRICAL PERMIT APPliCATION
City Job Number (OlMLOO;S - 00 ? &"1
1. 1F:LocrrTIONCEL&sn;rT'!~0M1i~l<<c%1i
~~...t;""",;l:~:,,'::...'J..;""":'.;:'~"'-~Ol'.~.J.."W.~.::4~;oio6:71""i' -"'~~:::oii~i1;3
( '-:1'0; i'- ,,^_:_;;";~~;;:;' '&/i..~~'-: -j' "
-, - '-'r8!W-, ,- ,
LEG~p ~~O,N.,,,--_._~,L ,__.
, '70333~'t .0'2.'=00 I
-...'..... "'_.".'. _.' .."'.' -" -"'1'" . OJ" .y- ..-----,
JOB DESCRIPTION 1000 sq. ft. or less
~ 0{XVirt tD UMS1Y\AcJiU\(l ;:':o~::~~~500sq.ft.or
fermitS are non-transferable and expire if work is IT AI ~~ch Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. -'., Feeder
2. 'Il~~~~~~~m~.h~ B. t~~~~~~El~f~I~~~m~ll~~~~i~i~zr~~
Ele~tr.!.~o~~~to~tl:3CrVV) CAtv) 8\BLiI r '0 200 Amps or less I $63.00 Jt'3-
I '51l11lY,Y7,IIlr--lfIL2-, ,20lAmpst0400Amps I $75.00 "1J:j-
Address I ~\V~k!?:2Y.:.\I_L.::?l ov. 401 Amp. to 600 Amps I.l.n SI25,OO
'I' , I r;:J'\ /.I ,I: '"-' 601 Amps toJ~~lle~~~\\li\'l $163,00
City 5,. t ~,.v l! ~ tll&'POl1e !Jug 9J'V S~ 00 Nl~u.o~~l~y..olQle9 e se\toft $375.00
" I' ~\TE \i~~"Wuse {\.lIeS ~ 9S?.oo' S 50,00 ,
1((j:HJ/ ~ \o\lOVJ~~~Gf.f\\!l~_ll mi~\:I:P~u~~.L~"~...=",~,.,.,,,.'f'l!TO""'_"
S -....-U"".- 0- N''':'''''~ :.,...,. "L J""\ 1-' '\\ce.~-;'~if~~":1 .,s.. .. . .,' "-~"-'''''?""'''~6RF:e'€(l~eJ' ."....~-, .~~~1:~~~-.5l;1~~~~~.:., ""<<~~~..1-'''I~iJ;~~i!'t'::~:'':'':L~
upervlsor eense mue ,(\' r 'oJ '-/ '10\1 S' "" ",I1",!.. ..:k="'t'I"":"'c.'.'..~. ,'''''~.,.'''''''''j,,,. -.1..~'...'''I'' ' "
, . . ' , f\ 9 " _....,...,~..". V'."'....."~'~:IT.."" ", -"~''''"''''''''-'-'''''''''''''''..' ,
I 0 0 I OJ I \ O/'. ,{(\a'j 0'0 ,INO\e., \\,\e , i\iCa\IOl\
Expiration Date '-t' nl"l90, '(OilJll1lla.!i<MIAlter~lb'.~\ltf 'ii~~catiol1 .. .'
,. /1 ca\l\l\~%.~ Q{~~I .33'2..'2.344). $ 50,00
Constr, Contr. Number b\ Itpl#'t> 1I\.lll\'O'2~~p!i'lO lId3\JZ"ps S 69.00
. ' 11.-"J0 1M::, 40 l' Amps to 600 Amps'S 1 00,00
Expll'3tlon Date '- 1i'.J
Over 600 Amps or 1000 VOIlS see "Boo above,
, I D r;;'"B~;:~~:~~lli~~';:'::'./;i~~l:.~4i;f"Ii:tl:~?'~':;"'~~:'1j("'~"if:lilMf~~~~f.t;';I;r1~~r.l!II~~~,~"l:!':-m;~b;i;~~'lj' ' :'9~
SI"""= of SlI"ervlSlDg EleetnC1~" . r..aDC ...~C:;\UUf.1iII~,"',,;!:.:~ 4:"" ' ~.:""-""~.;.j~.~1ili'~'i!!I4,\:&'",'~N""ll:;.l>:.'il.t i{lj'~ \~-\..
'0-- -t'" , ' ....... . ~"i;,;."ol~~::.'.-::.c.;r:N.~,~"';:~.Ji~~,,':!)t;..: _'ii.}~~""~.~",_':"'~..:J'""",~",,,'..I~~~;..,:_, iit~
09/25/03 THU 12:57 FAX
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Owners Name
Address
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City
OWNER INSTALLATION "
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The installation is being made on. ,......l""'..)' I own which
is not inrenc:led for sale, lease or rent.
Owners Signature:
-
Inspeetion Req uest: 726-3769
CITY OF
~002
Date
.?\ 1.5 (J3 n",~ 5'1~ - D -oct -0 ~ .
3. ~Eg!E~~i~~!;g:?~i!flk~~~~~
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A.. . ~1::NewLResidentfa('Jf;Sm<.'!;' 'c;!Ol[.MU1~~ffiV" ;~}a:,~t~fi~l1Jiit~~.r;~
;{;~.:..~ .,~~~;:'..,::~::,j;i;;'..",:>':."":,~..,,-:.':~/. -," ..~-..\.'-:..~.~-;:~,;;::.-:.; ::~~.J.::~,P.w..~J"L-i::;':~l::":'::~';';~'.:._"";;:'!~-:::
Service Included
S I 06.00
$19,00
$50.00
New Alteration or Extension Per Panel
, One Circuit ,,. \~I(\?\<.S 43,00
, E~~,1-dditiol1al Circei~l9\"twtlf: II " IS ~ClI 3'-'
~\J~er:viCe or Fes#'Pet'triit\S ?'C.?t-JI\ $ 3.00
, H\\',':"". ~f..I;)\~~.]i~n'.' .~.,: ..ii1....<.'~' Q,.i~",,,,,,,,,",.,,,,,,.,.,,~,,",,,,,,,,,,.,,,,,,,,,,.-
E. i'\1fic'dta'rle6W.-E!:i,,;'," , . ~~iit.'iRd\i'did~:aar'l'ii~r;tillii$
~~~\e1rJ\Qo~'""""'''-':"'.<'~;~~~:.'''~'''"-'~''.''<
isil!hiQ'?;tline Lighting $ 50.00
Limited EnergylResidentia\ $ 25,00,
Limited Energy/Commercial S 45.00
Minimum Electric Permit Inspection Fee is $45,00 + Surchar_g~
"1~~"'-('"i1~:;;~2i!.:Iu:~~t~I~~~''''::'1.''~::-l'm':cli'::'!lU'C'.li.!r.~...'!'.w\r-;'~~\1I.'!o'll;;'''
4.'~';D;';~M;{OFi.Ifir(jl'd:1':"~'~/o;t:.T~~;.1~.1'fi: " I \" ;.;:
ti.:;~i-f1t~;;~~;'~~~~~SB:~g41fJ.~~\~~~~~~-~ ""1'
t'.9D
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lt7lf.~
7% State Sun:harge
10% Administrative Fee
TOTAL
Slu:1rai Drive(T:)l8uilding FonnslElectrie:a1 Penrut .A.pplic::lrlon ~ ..Q,3.d.oe
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PAID IN FULL
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CHERRY CITY ELECTRIC
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. \...11 f OF ~rt<Jl'oi\..o1<lJi.LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2003-00984
ISSUED: 10/0312003
APPLIED: 09/30/2003
EXPIRES: 04/03/2004
VALUE:
225 Fifth Street, Springfield, OR
54t-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspeetion Line
SITE ADDRESS: 3001 Franklin Blvd
ASSESSOR'S PARCEL NO,: 1703334402600
Eugene
TYPE OF WORK: Eleetrical Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Service to construetion trailer
Owner: OREGON DEPT OF TRANS HWY COMMISSION
Address: 355 CAPITOL ST RM 119 SALEM OR 97310
Owner: STATE LAND BOARD
Address: 355 CAPITOL ST RM 119 SALEM OR 97310
I CONTRACTOR INFORMATION I
Contractor Type
Electrieal
SETBACKS
Contractor License E.\wration Date
MORROW MEADOWS CORP 91668 _."S 'lO~.\~\{lf/2012005
BUILDING INFORMAp~lb~aC60~ ;e\\~'
aQ,u" \'(\'" s e\a 1O'l.N"
# of St fi!'$iP\ ~aO 'O'l sa \\)\0 O~ g \-,9t18Iz\:
~~tit\1~trt~re-<;'(\0 ~o\)~'(\ 0' \'(\0~'f\~~t Floor:
1'-':r:h!f'Or'Hett;.~~O'\ 0 \~ 0~\0'" 0 \e\'S:l!l~\l Floor:
,tWf1tCJ.\~';bO'\' 'X)\1,).fI C O\a', \~ ~cSli'Ft Basement:
NcJ\i>>l~ 'l)yPe~e'l 0 ~0\' ~ ~ u\\\\1~'Ft Garage/Carport
\~~Y-!biih: 0 C0f1 O\0~0 :?,':Jrz.- Sq Ft Other:
009 .~\~~ \~ ~ \'(\0 ,\,'000 Impervious Surfaee Area:
..a: ..\0 .~\'"
-)'- -,\~'"
I DEVELOPMENT INFORMATION I
REQUI~D PARKING
, '~\IJ?\
Overlay Dist: \'i- ,\1'Ot8 :N.IJ'
# Street Trees Rqd: 'i:.'/..?\~'i:. ~~tf\lI.'iIicaPPed:
Paved Drive Rq<<!:.~., <;\\~\.\. ,,<\\\S?t: 'c~ij1p'il'tt:
!lo.\('i\ \v" ~\'" f:J'i:.~ \ ""f:JIJ~'c '
% of Lot Coverl!g~:I:.\\ "I;) \J~ S ~'O~\~
,\\'''' , (;)\\\1':t. IJ~ ~
.'I\~ ,..,r,<e.\l jOI('l'i) ,
I PUBLIC IMPROVEMEN;;&.~ ~\>.~ \ .:
""~ '
... Sidewalk Type:
Phone
503-399-7609
# of Buildings:
Primary Oeeupaney Group:
Seeondary Occupancy Group:
Primary Construction Type
Seeondary Construction Type:
# of Bedrooms:
Front yard Sethack:
Side I Setback:
Side 2 Setbaek:
Rearyard Setbaek:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
DownspoutslDrains:
Notes:
Pa2e I of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Type of Construction
Fee Deseription
+ 10% Administrative Fee
+ 7% State Sureharge
Add, Alter, Extend Cire Ea Add
Perm ServlFdr 200 amps or less
Perm Serv/Fdr 201 to 400 amps
Total Amount Paid
.
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
. CITY OF ~rK11~GFIELD
Building/Combination Permit
PERMIT NO: COM2003-00984
ISSUED: 10/03/2003
APPLIED: 09/30/2003
EXPIRES: 04/03/2004
VALUE:
Value
Date Caleulated
Total Value of Projeet
l.Fee~ Pfclid .
Amount Paid Date Paid Receipt Number
$14.10 10/3/03 1200200000000002267
$9,87 10/3/03 1200200000000002267
$3.00 10/3/03 1200200000000002267
$63.00 10/3/03 1200200000000002267
$75.00 10/3/03 1200200000000002267
$164,97
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.
l.Renuired In~nection~ I
1 Rough Electrie: Prior to Cover
'2 Final Eleetrie: When all eleetrieal work Is complete.
3 Electrle Servlee: Approval required prior to utility eompany energizing serviee,
By signature, I state and agree, that I have earefully examined the eompleted applieation and do hereby eertify that all
information bereon is true and eorreet, and I further eertify that any and all work performed shall be done in aeeordanee with
the Ordinanees of the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and
tbat NO OCCUPANCY will be made of any structure without permission of the Community Serviees Division, Building Safety.
,I further eertify that only eontraetors 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 eard is loeated at the front of the property, and the approved set of plans will remaIn on the site at all
times during construetion.
Owner or Contractors Signature
Paee 2 of2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
COM2003.00984
COM2003.00984
COM2003-00984
COM2003-00984
COM2003.00984
Payments:
Type of Payment
Cheek
-~. CI!""'" "
Wir'" """-."""'= .._,..'..,.1
,- . ..... "
'>.," 'r :1
'- 1_1
".;.~=""".,"",........_' "'""-.-
Receipt #: 1200200000000002267
Description
Perm ServlFdr 200 amps or less
Perm ServlFdr 201 to 400 amps
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
MORROW MEADOWS
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department-'
Public Works Department.
Date: 10/03/2003
11:21:12AM
Amount Paid
Item Total:
63.00
75,00
3,00
9.87
14.10
$164,97
How Received
In Person
Payment Total:
Amount Paid
$164.97
$164,97
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