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Home My WebLink AboutPermit Electrical 2006-1-24 'I , r \0\,0 13 SPRIN~0 0 ~. ~. ~ R . ~ ~ c. ..... I ~ .:\.~\ :'- ~ ...., ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ,~~~1",$~)<~,-" ..-"':t:.:;.': ELECTRICAL PERMIT APPLICATION .' <0\0\,0\ ,e \'Jf.' City Job Number CC>","" 'Z. 0 t;> b - DO 0 Y J Dat",\o.,.\<'t #'2. ") ~ . 0\0' ~? ~ ~ ..('<\ .n., _,:~../ ,,- 1. 1/:c;o611ioNpF IN$TALLATJ:6IY-i~.,'i;1 3. ~COMPfJtf.itftI{$.e.!!@Wo<EjiE~ X;,,'i~::::':It:.. .~ 6/10 ~t2(:l,f,\(CI f'\ R,Ll1iJ v' ~,:O.<,"'\~'''' LEGAL DESCRIPTION A. r:'N~:-vResid;'liiihl,::':Single>~r ~lullf-Fhmih;p~rd"CiIin'g unit'l '/ 70:S "3 '( l( 2. C> 2 5> 0 0 Service Included \,y . JOB DESCRIPTION *cJ~ S CIVc...'-'.-:h::. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 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 $50.00 2. f!f:9~~go~iiyS!.0LJA!J:ON.;'Qft.Lt] B. R~.~rvi~~JiliF,@~ers:;'I~At;li~iiO".;.A'iI~r"itoIls,!,{~eloc~t10:;':,.::.] ElectricalContractor QCtmO c...(t-cLE-I~(-trit:.1 200Am~sorl;ss. .. . l.'.c':.~;;,;,/~'~~~bo J ....l""J ~ .'J.' L~ 201 Ampsto"400Amps '1 'l.Jse r[l."s ~;" ~~ 75.00, Address \-1). r: )('))t 4 \~ ()D 401LA'inpsOt'i,c6001Amps10 through OAR q'$'125',OO 6o?~'1ntf'lci i05b' xlnlis'n copies of the r~iI6;:OO ovJi.<Wio61ArnpWciiiSr. (Note: the teleph$375.00 Rtcb'IriJt'c'f()nlythe Oregon Utilitv Notific;$:5WlO Center is 1-800-332-23441. c.I~:r~";pOr~f,y~1$~r,~ice.<()r:F~~~ers'l'_.-: q \~:'. ~''c' ";} ~'j.',. t .,:. r.. NOT~:iY. Alteration or Extension Per panel/ TH M<:lrCUlt $ 43.00 IS m&MI:\tliSI>fllILf.iJ .tb . L T'" . AUTH@ftYl'ro'lfflm;;(lfrl~ THE VlMql( $ 3.00 . ( 'Z.. J.~ COMMEt:l~tr.. . ~ PEI1M1LlS-N9r . ". . Address YO f.l () ~ 7D "7 0 ANY1fBo~~~~&d~O;QQJI\11cluded)r:E:'iCIi hl~tall:itlonl City MLG-QVf!' Phone b <fZ _brOO Pump or irrigation $ 50.00 . Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1':SUBTqTAIoFA:BOvE:~- ", ~;;. :/ -j S ..;- . rI.. . .," . " ~ .. ._.. _~ ,_ , . . !.'.. .J {!!iu;, State Surcharge t.{ '( 0 10% Administrative Fee S ~ TOTAL bl.( ~ City tiuy'ne. ~ Phone '4 In -I L\ 1J Supervisor License Number ~O.:J.. ~ ~ Expiration Date \ 0 I 0 \ (0-' Constr. Contr. Number lto ~ ~ ,I Expiration Date No \ r> '1 \ 1...Co, Signature of Supervising ElectriCian t/",,~ ~ Owners Name 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 Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. [~r_a~~~' ~-i-~~uJ~~R:,~.~\.'t,_:-~:.':':'\. .'.r:::' ~,~.~ $ 50.00 $ 69.00 $100.00 ,I"" ... .,. ,.'d . ,\"11 ~.' _. . '1' "'. ~ ;.' 4) Shared Drive(T:)lBuilding Forms/Electrical Permit Application 1-03.doc . . \.-11 i' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00043 ISSUED: 01111/2006 APPLIED: 01111/2006 EXPIRES: 07/11/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3770 Franklin Blvd Bus Stop ASSESSOR'S PARCEL NO.: 1703344202900 Eugene TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Electrical Service and One Circuit to Bus Stop Commercial Owner: LANE TRANSIT DISTRICT Address: PO BOX 7070 EUGENE OR 97401 Phone Number: 541-682-6100 Contractor Type Electrical Contractor LANTZ ELECTRIC , CONTRACTORINFORM~TlON.lrequires you to fol:ow rules adolil~d bv the OE''l00.n Lt'\ilitvD t Notification Centet'I~~,"W8 rule" ~mr"~}~lIl,, a e .n "',0 Q~') M<,,~467~Mn"nh n^001!1,4/~0~6 BUlLDINGJINFORMAl'IONlcopies of the rules by calling me center. (I'Jole: the telephone # of Stories:,r for the Oregon Utility N.!JottSize:n Height of StrycJu[$r is 1-800-332~234,S,q Ft 1 st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: 'Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Phone 541-726-0659 .# of Un Us: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I REQUIRED PARKING , Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: Pave&l0l~tlt\d: Compact: % ofll<tIS:~~ SHALL EXPIRE IF THE WORI( . AUTHORIZED UNDER TH1S PERMIT IS NOT ~. ..,..." "" 'J!~ ." !OJ "o':';~~;:;14[[l f~F; I PUBLIC L'~~'~~'~IOD. Sidewalk Type: DownspoutslDrains: ,. Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descrintion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Palle I of2 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 . Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid t t . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00043 ISSUED: 01/11/2006 APPLIED: 01/11/2006 EXPIRES: 07/11/2006 VALUE: Total Value of Project L.Ff>f>~ P.llid I Amount Paid Date Paid Receipt Number $6.60 1/11106 2200600000000000048 $5.28 1/11106 2200600000000000048 $3.00 1/11106 2200600000000000048 $63.00 1/11106 2200600000000000048 $5.50 1/23/06 3200600000000000027 $4.40 1/23/06 3200600000000000027 $43.00 1123/06 3200600000000000027 $12.00 1/23/06 3200600000000000027 $142.78 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. " '~f>~ 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 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 1 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 Date Pal!e 2 of2 , . 225 FiftQ;,Street . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00043 COM2006-00043 COM2006-00043 COM2006-00043 Payments: Type of Payment CreditCard 'I 4 '1 :; Ii .1 1/23/2006 . RECEIPT #: 3200600000000000027 Description + 8% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By CAMP CREEK ELECTRIC Received By djb Check Number Batcb Number Page I of I lIIIIIliiiity of Springfield Official Receipt .velopment Services Department Public Works Department Date: 01123/2006 Item Total: Autbortzatlon Number How Received 279927 In Person Payment Total: 11:49:56AM Amount Due 4.40 5.50 43.00 12.00 $64.90 , Amount Paid , I $64.90. . $64.90