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Home My WebLink AboutPermit Electrical 2006-1-11 (2) ,~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (.O......'G.OOb -Dc>04'{ Date ].' rtoc,il.trpiv dF. i1Y.s:rALM,!ioW.;r.;:-J:~~~ ~ s: S-o FrA-""-ls:II....... LEGAL DESCRIPTION 170"15 Y S 2. 00((:)( JOB DESCRIPTION Add. s:- c ( r c..vl-: +-s 3. ~tQMPif1rtH'F;r{s.C#E.putE BELQW' 7.t", , . ......1. . '~- ....' , A. f:;N;~<<i~i,d;~~jaF~ ~i'I~gie:QF 1\'i,u)t!~-faJri.ih~per-id'ye)!ii1g I_~.',i!t';',~:d Service ]ncluded 1000 sq. I\. or less Each additional 500 sq. ft, or portion thereof S106.00 S 19.00 Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days ofissuauce or if work is Modular Dwellirg Se,!i,c.~,\'.'in law reqUires Y'S50,OO Suspended for ]80 days. Feeder, d b '.u~.e Y tne uregon Utility 2. ~f!{iff~qq~.,py~~f~0Pq~~_~iixq B. tB?~~~;\~'(~~~~~JH~(~~lt~!I~~Q~~}:~lt~~~i~~~~~e~6~1l:t~-~;i~ '::'1 , -.-.........--.....""..... ......."..........::::I!',.......,..;"J.Jt:.-VVI- Electrical Contractor ~ CU'fo..O (yt;(,IC fJa:f:y\c.1 200'=Ai%~stFi~~'SIaY obtain copies of the SI63WO)Y \ . LLc... 201 AinplJIRf'400?Ani'p"Ster, (Nole: the tele1S115~00 Address %. fux. L.\ 1'1l'lO, 401 A"r\ij;'21i\f600IXlrippregon utility Notifin:isfOO 601 Amps to f608t,.(:;,Ws 1.800-30<::-<::J44j. SI63,OO Ci~(v1t ~qlt.\D~hone '"""'\ L\ ID-\t11\ Over 1000 Amps/Volts S375.00 I Reconnect Only S 50.00 Supervisor License Number "30'.,;) ~ S Expiration Date I'D I Cll I 01 ConSlT, Contr: Number \ \:0 1.\ ~ II Expiration Date \)\0\ CA \ 'L.DO 1- Signature of Supervising Electrician ~>- ,:> ~ Address LTh ?o IS o~ 7070 t:'VJ.rtrNt! Phone b '62-&:,(00 Owners Name City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 c. ~\;te)~P~r-a.r.y:'~'c~~.ic~',o'r\F~e4crs ..~ 7'. '; -l.,~'.~.. ')..';'1". ri , ;,,1 " ";J Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, D. ~~~~~a~~~h_-:(:'ii.~_~its~.fi~f~i:~;~:~;',:;:~:,.~;.::h:1:;,I~::~f~\" ~i~~<:' ;.', l~L, S 50.00 S 69.00 SIOO.OO .'.'..',.j , ,,,. '''\l . ",":-i'.''-,-~ New Alteration or Extension Per Panel '13 0001tlMtt . ~ _~' .. $,43...00 . m51 ... i ill SII\I\iiJkn9Ui1IRE Ir I JVUHl\ ~_~~R THIS p!:QMI IS$>I(j).'ijo I Z /1'mflM"'l~l,rH~~f)Neo.7EQ~..'. "i '" j 'E. ~~Ays~~edef;i!~t"incl~ded).:;:E,:idl In'syillatiOli. Pump or irrigation S 50.00 Sign/Outline Lighting S 50.00 Limited EnergylResidential S 25,00 Limited Energy/Commercial S 45.00 Minimum Electric Permit Inspectio'n Fee is S45.00 + Surcharges Iv. ..,'. " ". '..' -, . ,. "" 4_ 'SUBTOTAL OP.A.BOVE,.'.", ~... -,'. ',",., . '.:' - " .,.. ...". "'". ,-"___',,+,,,, ,c.'.... ',... 1 .' ~ - . , ,,' . ' , ~ ~" sS- 4l{O rSO b Lf "13- 7% State Surcharge 10% Administrative Fee TOTAL Shi.red Drive(T:)lBuilding FormsfElectricnl Permit Application ~.o3,doc . . CITYOFSPRIr\iut<IELD Building/Combination Permit PERMIT NO: COM2006-00044 ISSUED: 01/11/2006 APPLIED: 01/11/2006 EXPIRES: 07/1112006 VALUE: Status: Issued '. 225 Flfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax ._ 541-726-3769 Inspection Line SITE ADDRESS: 3550 Franklin Blvd Bus Stop Eugene TYPE OF ASSESSOR'S PARCEL NO.: 1703343200101 f.TTENTION: Oregon law requirEtyp'EtOF USE: PROJECT DESCRIPTION: Electrical\Servicel!'nd,One',Circuit:t6' BliS'Stop Utility "'~t:l~;~;i~'n C~nt~r, Those rules are set lorth , ~ ^ 9 952.001-0010 tnrougll UMn ""~-vv . ~;:::s: :O~~~~SIT DlS~~~ You may obtain copies 01 the rules by EUGENE OR 97401 calling the center, (Note: tile telephone . ,_ ~I-.~ Il..,.....,..m I Itilihl NotifIcation Electrical Work Only New Commercial Phone Number: 541-682-6100 ........,...,..... .- ~_ <4 ;:;"" 1)I)':L'J'ld4\ I CONTRACTOR INFORMATION I " Contractor Type . Electrical Contractor LANTZ ELECTRIC License 84679 Expiration Date 07/14/2006 Phone 541-726-0659 , BUILDING INFORMATIONI # of Units: Primary Occupancy Group: Secondary Occupancy P'rlmary ConstructIon Type Secondary Construction # of Bedrooms: # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla 'DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: . Solar Setbacks: Overlay Dist: # Street Trees Paved DrIve Rqd: % of Lot Coverage: REQUIRED PARKING Total: HandIcapped: Compact: , Street Storm Sewer Available: Speciallnstruction: IPUBLIC IMPROVEMENTS I E~~~~~~'6 ~~~~~ ~~~~~~~~i,~~~~ COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: DownspoutsIDrains Notes: I Valuaf1]on Descriotion I Description Tvpe of Construction $ Per Sq Ft or multipUer Square Footage or Bid Amount Value Date Calcnlated 1 of 2 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 1 Fee Description .., + 10% Administrative Fee " + 8% State Surcharge Add, Alter, Extend Clrc Ea Add Perm ServlFdr 200 amps or less + 10% AdmInIstrative Fee + 8% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add Total Amount . . CITY OF SPRINGFIELD Building/Combination Permit PERl\fiT NO: COM2006-00044 ISSUED: 01111/2006 APPLIED: 01111/2006 EXPIRES: 07/11/2006 VALUE: Total Value of Project ~ Amount Paid Date Paid Receipt Number $6.60 1111/06 2200600000000000047 $5.28 1/11106 2200600000000000047 $3.00 1/11106 2200600000000000047 $63.00 1/11106 2200600000000000047 $5.50 2/3/06 1200600000000000108 $4.40 2/3/06 1200600000000000108 $43.00 2/3/06 1200600000000000108 $12.00 2/3/06 1200600000000000108 $142.78 I PIan Reviews I To Request an inspection caD 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. wiD be made the following . work day. 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 1 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 wiD 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 . 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 wiD remain on the site : at all times during constructiolL Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-.726-3759 Phone ..~ JiJ..ty of Springfield Official Receipt .veIopment Services Department Public Works Department JOb/Journal Number COM2006-00044 COM2006-00044 C\)M2006-00044 COM2006-00044 Payments: T)'Pe of Payment CreditCard :l ,. 1)1' '( :, :C ;r , :\ .', . t.~. '( ;, :C ,!' :1 ;i ., q '( 2/3/2006 RECEIPT #: 1200600000000000108 Date: 0210312006 Description + 8% Stale Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By CAMP CREEK EKECTRlC Received By djb I of I Item Total: Lheck Number AuUlor1zaUon Balcb Number Number How Received 596048 In Person Payment Total: 1l:41:59AM Amount Due. 4.40 5,50 43,00 12,00 $64.90 Amount Paid $64,90 $64.90