HomeMy WebLinkAboutPermit Electrical 2006-1-11
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. ~ .: '. ClTY OF"SPRINGFIELD, OREGON /'
,~
225 FIFTH STREET . SPRINGFIELD, O'R 97477 . PH:(54I)726-3753 . FAX: (541~\~1ql#,'0 '\ '/
ELECTRICAL P,ppMIT APPUCATION ~0"i\<'~~00~ <,0 /
City Job Number ,-,\.O .f'CC:A~ Dale ~\'C~~~,0~ /'" /
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Service Included
200 Amps or less $ 63,00
201 Amps to 400 Amps $ 75,00
40 I Amps to 600 Amps $125.00
601 Amps to 1000 Amps $163.00
Over 1000 Amps/Volts $375,00
Reconnect Only $ 50,00
AT. .TENTION: Oregor I~." f^-",.,--,.^..'.h
Supervisor License Number 3'-19 Q.r61):Jw rules adoptbld la~:'S,~~~~tlF..~d~~r.w.$~~1
c- f I Notiiication Center, Those rules ;re set forth
~ Expiration Dale I () I 2tXJ:::+in OAR 952-001-001 0 ~'1F~'tl~~~1\~~5~t_ie~r! Relocation
~ 0090. You may obtainWrAmp~p~II~~ules by $ 50.00
. Constr. Contr. Num. be~ d [') - 3.;J.,~"1Iino the r.enter. (79Jtb."!P!!..Jt~,,4Q~~mPJ $ 69.00
. I I 1- number for the Oreg@:1l~''''Pf !<!&gg~P!!l $100,00
~'l;I('r:::lI ExpirationDate ::r \ WO<p r.pntpris 1.8r,,;!''''''60-0~A-''\ 1000 V It "B" b
vv~ . _ vver. . mpsor 0 ssee a Qve.
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Signature of Supervising Electrician D. 1Il,,~c~.lGIr~Ults.,*$~~ """*8!..."'<m:....'i\\,>;.<:w~
,-A. Q~ New Alte~atioa or Extension Per Panel
'" ~ ...;:-yA' One CirCUIt $ 43,00
.~ ,'~ "-m '''~.I.L '" l C.w.;~~do~~~:~~~~~~tor with \ $ 3.00 ~ pU
'Cll- OwnersName \UJ\L. \~!,l.l\_ ,f\ Ul.'\IIU
- Address l>r1 LW If) 1 ..- E. lM~~~,;1~ryl~.tit~~r~~~I!~1~!{ff~1l!tl~~
City ~~ Phone J.a.a2J.o1OO
OWNER INST ALLA nON
O'l.C\OO
JOB DESCRIPTION
~C), ~th.l')
Permits are non-transferable a
not started within 180 days ofis
Suspended for 180 days.
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CO " CTOR"INSE' , > TIONiONL~
2. . ',' -<. . . , .,. ~ ..,......
Electrical Contractor .La nt:e.EJu_tn'(,
Address :3J-l's3' -\-\W~ F1 'Z
City~W\e--;~ Phone -=t2f.,OG.'5[
The installation is being made on property I own which
is not intended for sale, lease or rent
o~Td~~ature:
THIS PERMIT SHALL EXPIRE IF THE WORK
6IITi-jmmm mln~o TUI~ o:o,WT I~ tJOT
SOMMENCED OR IS ABANDONED~~~O\
,~IV'R nAVD~ '1\\
Inspectlonf)ReqUest:.f?~'dl3~ ~ ~ ~!\)\tJ
~~~
1000 sq, ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Maoufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$19.00
$50.00
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidentiaI $ 25,00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
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. ~~lf'2:b,":"r.""~1".....~.... f'C:!~ot6}' ~
~Io State Surcharge 1'L.fQ..
10% Administrative Fee \() .ldJ
"'11.W
TOTAL
Shared Drive(T:YBuilding FormslElectrical Permit Application 1.()3.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00043
ISSUED: 01/11/2006
APPLIED: 01/11/2006
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
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 INFORMATION I
Contractor Type
Electrical
Contractor
LANTZ ELECTRIC
License
84679
Expiration Date
07114n006
Phone
541-726-0659
, BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rimary 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'
Front yard Setback:
Side I Setback:
Side 2 Setback:
. Rearyard Setback:
Solar Sethacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
IPUBLIC IMPROVEMENTSI
Street
Storm Sewer Available:
Special Instrnctlon:
Sidewalk Type:
DownspoutslDrains
Notes:
I Valuation Descrintion I
DescriDtion ,
Tvpe of Construction
$ perSq Ft
or multipUer
Square Footage
or Bid Amount
Value
Date Calculated
I of 2
.
. CITYOFSr,l~.l1,GFIELD
Building/Combination Permit
PERMIT NO: COM2006-00043
ISSUED: 01/1112006
APPLIED: 01/11/2006
EXPIRES: 07/1112006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
.
~.:: Fee Description
+ 10%Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
$6.60
$5.28
$3.00
$63.00
1/11/06
1/11/06
1/11/06
1/11/06
Receipt Number
2200600000000000048
2200600000000000048
2200600000000000048
2200600000000000048
Total Amount
$77.88
I Plan 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.
IRi'1i'1J~
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 certiJy 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 certiJy 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 ..located at the front ofthe property, and the approved set of plans wiD remain on the site
at all times during construction.
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
Sr.,rjngfield, Oregon 97477
5:11-726-3759 Phone
.
~
~ty of Springfield Official Receipt
_evelopment Services Department
Public Works Department
'"
Job/Journal Number
COM2006-00043
COM2006-00043
COM2006-00043
COM2006-00043
Payments:
Type of Payment
CreditCard
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1/11/2006
RECEIPT #:
2200600000000000048
Date: 01/11/2006
Descrlpdon
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
LANTZ ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
lIh 01213B Phone
Payment Total:
Page I of I
11:37:47AM
Amount Due
63.00
3.00
5.28
6.60
$77.88
Amount Paid
$77.88
$77.88