HomeMy WebLinkAboutPermit Electrical 2004-1-9 (2)
~:' " n' . '. C~rY OF S'l-~~GFiELD, ORE001~{ ;... . .::
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~225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 b 'tted has the following
Th followmg project as su ml
ELECTRICAL PERMIT APPLICATION zo~ing. and does not require specific land use
City Job Numbcr CO~zc>o4' -0001 J Date (- ') - o 1...( approval.. ~L-..-- .
'~~';;Ti~::~~~~ir; .~ '(X)M!LE,.r~d:;:~=.''''''' '-"-,::J-.:
LEGAL DESCRIPTION A. [r.:~~~:~~id~~tia~=Singl". O~~U'I~i:F;;;;i1~p':r dw~;iing~l;it~_;
0033 L(Lf l OZLfOO
JOB DESCRIPTION 3'1'79 r/f4Nk't'/N
Z06 A-Wlf' s (!..o{'- c.MHrIG€:
1)1..1/t> <}:Nl C-'i!i?" -::J.f;X 5
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY j
Electrical Contractor ~NNP.t(J1 S:PIfAt:;:ut:""
. \
Address I.fo 'o?o ~~ r:-t'n.L. &et:k' l{p
City -;;;;Au. f'-Jf~ Phone 137'1-,3!:O
Supcrvisor License Number S ? b "l 0
/0 J 0 / / ~ 'f
Id~ 4fo Cf
()S/Ifo / ;)00 t
. f
Expiration Date
Constr. Contr. Number
. Expiration Date
Signature of Supervising Electrician
o(D~~~
Owners Namc \M. ~ vI ~ -H ~ IivI t? <:; e tJ
Address 31 Cj f( F i!i1t:lk'u 'vv .
, .
Phone ~-'I/ ld1 73dJ
City
O~~ERINSTALLAT10N
The installation is being made on propcrty 1 own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwclling Service or
Feeder
$50.00
B. f Services or Feeders - Installation, Alterations or Relocation:
---- -
200 Amps or less I $ 63.00 I:, 3
201 Amps to 400 Amps. $ 75.0~O
401 Amps to 600 Amps E.~,llte$r48~~l:'
60 I Amps to I 000 ~~legon \a~'e Or&99!l;~R~G'n
Ovcr 1~~1>9o~oP\ed\:l'l -'''''BSe.~~OJ!.QO
Rcconnc\\~/llYJ\eS o\er. \l\O"- <leI' OPS'sml&.4 ,
10.. \ion ce ..0010\h1u. ~ the r
c.l!e;;\~\\'\c;s~PR1 "~r90?'~":~\e\i?n~e n
-\.eJ~ "--- 'Tl'e.-J-IJ~-I~O\6'.\\.!......"'IO\i'ica\\O
~090. ""oU center. \ \J\\li\'l'"
Install~1I0ea-l\lN11~n~I\'eI0lIll'8i1?&?>?_2'344)'
200AmpSO'll~er;~~.~.,~ ~.l"('\' $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Ovcr 600 Amps or 1000 Volts see "B" above.
D. I Branch Circuits
New Alter~tl'{YC~~tension Per paX~\ll,E IF 1HE WORK
One Circui ~~ERM\1 SH/l.LL E H\S rE~M\qo,S NO. .
Each Additi i[~eQ\'titllOEK 1 mt:OR
Scrvice or F ~OMMrneED OR IS (>R/l.NOctl!l-.'\lO'
,"~ 'nr.Y'PERIOO .
E. I MisceUanfdl\Y (sAA,ft'~/feeder not included) -Each Installation I
Pump or irrigation
Sign/Outline Lighting
Limited EnergyIResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.1 SUBTOTAL OF ABOVE
6>
'ft(/
b70
7% State Surcharge
10% Administrativc Fee
TOTAL
'I 7s 11-
Shared Drivc(T:)/Building Fonns/Elcctrical Pcnnit Application I-OJ.doc
.
.1 CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00013
ISSUED: 01/05/2004
APPLIED: 01/05/2004
EXPIRES: 07/05/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3998 FRANKLIN BLVD SPACE 2 Eugene
ASSESSOR'S PARCEL NO.: 1703344202400
TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Replace 200 amp service
Owner: MAVIS HANSON
Address: 3998 FRANKLIN BLVD 25 EUGENE OR 97403
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
KENNETH CLAIRE SPRAGUE
License
122469
Expiration Date
05/1 6/2004
Phone
541-937-4250
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement: 1
~'ldW~llll~'fgbl,. 0
ATTENilON:Orego W\\1i!l\i)lIegon UtIlity
folloW r.~\~~~~~;~~\m~r1Jl~~~~:
I DEVELOPMENT 1NF.B~~aiQNlltl,i~P~~ ~~ro~~~;i the rules \
'J090. You may Ob~~tn N~te: ~q~~i\RKING
Overlay Dist: call1ng the cen~r~~on UtilitlJJtlotlflcatlon
# Street Trees Rqllurnber tor the. 1_MO-33~I~pped:
Paved Drive Rqd: r,........,..r Ie:.. Compact:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
R-3
SETBACKS
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
% of Lot Coverage:
I,PUBLIC IMPROVEMENTS I
Street Improvements: .
Storm Sewer Available:
Special Instruction:
CESidewalk Type:
~~~lpE~,~ll"m\'.tlt!l[I&)\rn$lE IF THE WORK.
AUTHORIZED UNDER THIS PERMIT IS NOT
. COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
'.,
Total Value of Project
Paee I on
.
fi) CITY 0.. I)rK11~u"'J!,L1J
Building/Combination Permit
PERMIT NO: COM2004-00013
ISSUED: 01/05/2004
APPLIED: 01/05/2004
EXPIRES: 07/05/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6.30
$4.41
$63.00
1/5/04
1/5/04
1/5/04
1200400000000000007
1200400000000000007
1200400000000000007
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 ReolJired Insnections I
I Electric Service: Approval required prior to utility company energizing service.
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 1 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 madc 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 inspcctions are requested at the proper time, that each address is readable from the
..' strcet, 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
Paee 2 of2
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