HomeMy WebLinkAboutPermit Electrical 2003-11-19
.,
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . F~'{RiJl~l-A~~B!t'lt as sUbmitte~ has the following
ELECTRICAL PERMIT APPLICATION /; ~ zoning, and does nol require ,specific land use
approval.
City Job Number CC>>I1zoo3 ~O/JL{l- Date /1 13 Os Zoning "PlO,
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1. i~EO€ATIONOF!INSTAEI.IAirrg,lf!1irJll~'l
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LEGAL DESCRIPTION
/7033341.(
JOB DESCRIPTION"
C.,"',A K..--t ]c')b i-/Z.k +-= S ll/C
PermitS are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,' ,
02600
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*C@NTRAeTORiINSTA:EEAJ10NONE.&l
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Electrical Contractor O1ris tenson ElectriC:
Address
1298 Bet"F'l Orivp
City Eugene
Phone 541-688-6121
Supervisor License Number
3759 S
Expiration Date 10/01/04
Conslt. Conlt, Number 26- 34C
Expiration Date 10/01/04
Si~e of Su rSing Elec~ /"- 0
'tIfC-, - T~ ,y~n
Owners Name 0 Dc) 'I
Address 3S-S- GU2JT<)L csT
City sAt... t-wr M... Pbone
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OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or renl.
Owners Signature:
Inspeetion Request: 726-3769
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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
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B. t.'Ser,~iji:eS:J)rJFeeile.r,~,f'liist:illatio'!,~Altera tions;.Qr.~Reloe:itioit:.,1';t.'
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63
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsIVollS
Reconnect Only
I
$ 63,00
$ 75,00
$125,00
$163,00
$375,00
$ 50,00
C ~t':f':lA#-""~:n:~~:?Sf,..~"Xtl'j:'.if':~';f~E~d-..~.tfi~~~~~. ~~.m1~~
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, .-r.n=I"TIOI\I'Oreaon laW requires you" '
InstaUation, Alteration or~loca\\onOregon Utility
'nllow rules aao!J1 U uy .. - _ -"t fon '
200 A'riips or less Center, Those rules arS 50:uO
201 "RJ1~fR~~'6o ~ps001 0 through OAP$%'9?oCj'v,
~ UA ;:::I'O':=:'- v' . at th'" "1.)Og ~
40i Amps t'f600,AmpsJbtain 'coptes $100,00 '
OU~V'. uU.,':~' .' ,. (Nn!.o;,tt1e telephone ,
ov.er 60021,\inp. s or<i 000 'Y. o.llS see ,B, ,a!:>Oy,e"H{i"" '~. '
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New Alteration or Extension Per Panel
One Circuit $ 43,00
Each Additional Circuit or with
Service or Feeder Permit $ 3,00
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E. 1J.oMiS.iie "~~~fJ;:e)f~d~~nollinclliiled)f;;:EaCii"'ilistallatiOn';j;
"~'f't:: ' CCEXP1~fJ' ".<"""...~,.,..-""",=",,~i!
Flt~hllii~ UNDER THIS PE'~r1~E, ~I
Si ~W.\QihlililR IS ABANDONED ro~~6! 0
Linuld ~Q,.~J\5ruGllD. $"25,00
Limited Energy/Commercial $ 45,00
Minimum Eleetrie Permit Inspeetion Fee is $45.00 + Sureharges
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4.'"1SUJJTOTAr;"OFABOVE~' !!,tlij'lJ:!W,"\i,;s.
~~~'fy.,~~"t~\o:"'~":A,.""....~~~,~J - _;:;:." ,;$>1, -i,_,. .,.
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63
L./ If I
b30
73 ?!.
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:YBuilding FonnslElectricl1l Permit Applic:l.tion l-03.doc
.
.
CITY OF SPRirlitJI'lELD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2003-01142
ISSUED: 11114/2003
APPLIED: 11113/2003
EXPIRES: 05/14/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspeetion Line
SITE ADDRESS: 3001 Franklin Blvd
ASSESSOR'S PARCEL NO,: 1703334402600
Eugene
TYPE OF WORK: Eleetrieal Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Connect job trailer to serviee
Owner: OREGON DEPT OF TRANS HWY COMMISSION
Address: 355 CAPITOL ST RM 119 SALEM OR 97310 '
I CONTRACTOR INFORMATION I
Contractor Type
Eleetrical
Contractor
CHRISTENSON ELECTRIC INC
License
458
Expiration Date
05/01/2007
Phone
541-688-6121
BUILDING INFORMA TlON I
SETBACKS
# of Stories: Lot Size:oU \0
Height of Strueture \ ..1 (eSi{F!'!s!, FJcl~~~'
'" a~'1 .....l...OI)' ",...r\
Type of Heat: 'Otago" \\'IeSq Ftj~d.;I:loo::
Water Typ.e:r:...(\\O~'''o,,\aO ~'! t,SqlFfBasement9
~\~\..... u t" sa..... r:t""\~....- \
Range Type: ... t,,\aS a \at ,\'10 "S!! Ft. Garage/(;;ilrport
.' n..... C l' ' ....to......' ,"g .~'
Energy P.iith: \',Ol' a 00'\ 0 \\. .sq,Ft10tlier:,ol'a
'fca 0'\' o?'" ,<>u'
\0\' , <>95'2..0 ,,\ail' c Impe..vlous\Surfaoo Area:
t""\t.l.n '."" Qu '....\n\e. \" ...\n\\ \\.I~_. .
I DEVELOPMEN;r'INFORM:Af[ION':';~90l' ~\'~~hAA).
c".... - \Ol II'..., '.'000....:3- REQUIRED PARKING
utflOat <,"" ,e, '\
Overlay Dist';' r ~
# Street Trees Rqd:
Paved Drive Rqd:'
Total:
Handieapped:
Compaet:
# of Buildings:
Primary Oeeupancy Group:
Seeondary Oeeupaney Group:
Primary Construetion Type
Secondary Construetion Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setbaek:
Rearyard Setbaek:
Solar Setbaeks:
% of Lot Coverage: E WORK
~~1\~~~M\1 SHf>,LL E~~~~~~~~1lS NOl
I PUBLIC IMPROVEM~NTS'P,\It.O U~~~; ~Bf>,NOONEO FOR
COMMHlCme.~aI\\GllPe:
"'I H~O O~~~ rt:
f>,,, DownspoutslDrains:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
\,
I Valuation DescriDtion I
Deseription
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Projeet
Paee 1 of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01142
ISSUED: 11/14/2003
APPLIED: 11/13/2003
EXPIRES: 05/14/2004
VALUE:
Status
Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Deseription
+ 10% Administrative Fee
+ 7% State Sureharge
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6,30
$4,41
$63,00
11/14/03
11/14/03
11/14/03
2200200000000001765
2200200000000001765
2200200000000001765
Total Amount Paid
$73,71
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.
I Remlired Tnsnections I
1 Eleetrie Serviee: Approval required prior to utility company energizing serviee.
By signature, I state and agree, that I have earefully examined the eompleted applieation and do hereby eertify that all
information hereon is true and eorrect, and I further eertify that any and all work performed shall be done in aeeordanee with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Scrviees 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 eaeh 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 eonstruetion.
Owner or Contraetors Signature
Date
Paee 2 of2
225 Fifth Street .
Springfield, Oregon 97477
541-726-3759 Phone
JoblJournal Number
COM2003.01142
COM2003.01142
COM2003-01142
Payments:
Type of Payment
CreditCard
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Receipt #: 2200200000000001765
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Perm Serv/Fdr 200 amps or less
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
CHRISTENSON ELECTRIC
000221 051771
'City of Springfield Official Receipt
Development Services Department
.
Public Works Department
Date: 11/14/2003 11:50:37AM
Amount Paid
Item Total:
4.41
6.30
63,00
$73.71
How Received
In Person
Payment Total:
Amount Paid
$73.71
$73.71
.
.