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Home My WebLink AboutPermit Electrical 2005-8-15 (2) un:C SPRIN . _, '-"'---'. atur~_ :8!TS!",,9.~i ' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 t~t;1~,'~~ ",'';'''Ji.;j~l ' ELECTRICAL PERMIT APPLICATION ""'f"Yta:.pS, '" City Job Numbk..nYJ }Irf'6 - nil (')() Date EJ>? II "?:>j n f=) -', >f e~ 1. ~'LOcA1WN.'OKiNSTAL'.51TidN;!':-~'t'~ 3, trCOMPLETEFEESCHEmTh~EiOlV&~';~~;"~~'j>;'~~:lJ?\ ~~,'''''_ .,,_......-t~,-""'.<,......u.,'*t .~'......-. .....:i'~.i~,...}..:J\11l ~"';"'~""'_'<-~._'-- .~ ."."',-..../..-::.;:.~..i....~,..I,,--..~.2.:i,j~.. "~ .,'$:~~~,at:l:L)(rlr ...~:~ 41 n;h i=?O-t1JtY1l{ 11~rv1 ~...JLi;;L, A, ~j;t~JI1fc~~j,;,Y~iN~~'Jl~l:;i~t~~1i~~f,,~'m~~~it~t;l LEGAL DESCRIPTION Iii","",", ",," --"",,,,~i""',"~,~ ,... - '-"-,,,,,,,,,...~=.,,,""'''''''''''' """'''''',~ \-"[03 34 "t:ArrD q~ .....UIII/lbl JOB DESCRIPTION .... (\.QW ~ J2-VcUL , Permits are non-transferable and expire if work is ,. not started within 180 days of issuance or if work is Suspended for 180 days. ~~~~.~?itl,f1'JM3ZJ':i1~,,,.Pi"'~"''''F;,;;r...,n.-,''!'.'1,~ 2. ~9&I~~~9~t~~v~~712NW~.yl~!i Electrical Contractor (r) N fS E/~'t,€:l(_ ..1"( Address 95') f)OIt~It)(,i. I+.x... City" 1I",..\':u.o PhonC'Q Supervisor License Number ~~7 Y <:;;. Expiration Date ID - 0 7 Constr, Contr, Number / c:,,;;) \ q i Expiration Date IJ-19-o(P Service Included 1000 sq,.t'f~\"'~DN: Oregon laWJ:onlllr- yo\1Q6-00 Each addm~p~Lfgg g'llJpRrd by thE! Oregon Utility portIOn thereof Th I .t HHlO :OUlIcallon Center. ose f'J IlS af..- Set TOren Each ManufaCt~~eI091 0 throU~lh OAR 952.001. Modl!.I~~1J;l~Ui.ngrS\l]'til!.I!Din copie~ oft~e fu!ffiJ,9~ Feeder calling the center. (Nota. "'" ,d,...J..one ,""llznumblanrORltl-elClre~' ,\jtl\i_'Notification~~."".\,\~ 'I B. ,Ser.,Ylce,s:or- eders;~l.n lti.oJl;l/ honsorJ,RelocatJ,on:n,' ;",; . ""'.;-:""-+c......~I. _ter..lS~l: u.~.. ".~.....'~ ,". - 'j'. _. (TO 200 Amps or less $ 63.00 (03 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps $163,00 Over.IOOO AmpslVolts $375,00 l" II I k' ~ r . - ... - . Reconn,ectt?i1IYIT SHALL EXPIR~ I~ THF \$'50:00 THI:i ~r~LI,;D.G~~~,) ,~etN\i~~\~,Ti<"'f"f"~I" C. .:remporaryiSer.vlceS',orJFeeders'; l.,f!t'!i~;;. -. _;'I,,'\.~~~j~1>:"-"4.\j.,J H:1t.."f-'i Urvil~ltl;~ft'Itl"'\"" ,,' l~"'1l:,; '" --" "lI!' ."".<ac[")WD.FRIOD . Installahon,JAlterahon 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. ~~I'iQ?~o~"''-.rHi~~:r;~~~~I",;~tt'#;''::\}' J~Y'::~.1,.:-ni-':'t~:'?': \, _ "LJi;'-':t~~ D. ,,~.nm.c~~ ",' ~~~,j.,'/7;;5i'4~:~'~.~~:(;1.~,!-,:,~:?~'0~"~,~,~~~~-i"'\)1 $ 50.00 $ 69,00 $100,00 New Alteration or Extension Per )>anel One Circuit $ 43.00 owne~ami f fit k()J ~.p ~achi~do~i~~~~~;;:~~~r with $ 3.00 . ;~;6 ~~_C;;~:::,[iflr~~C~:~:~'i~"<!9'~ c02.. q7~(JCf Sign/Outline Lighting $ 50.00 OWNER INST ALLA TlON Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45.00 The instanation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Minimum Electric Permit-lnspection Fee is $45.00 + Surcharges rr't """"'"~Yn'~'-""'''''''-'''-''''-'''-'J''''~'~<-'.' -'"-l"'''-''''''-'';.' '..... _.~u,.", .~ 00 FJ' ~... .... _....~,..t.,.,.,...._...."."._.....,,-'.. ,~,..',.", '\!,;,._.'l.'......>&\~,-:. '1$ ~ ~ 4, SUBTOTA:D'OF;ABOl!E,~IJi,,"~', ,r",~" :<\1&; , /' A -;V-./.~~""<G _~~;jj..~~.il.T~'i~~;;,;-~:."t:'~!l.~~i..~i$-J.~~f . 7% State Surcharge q , 41 10% Administrative Fee Co _ ?,o ~76.71 TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03.doc . , ' CITY OF SPRINGFIELD he, Bl!ildI_~bination Permit PrOIl~1 d?~~ 8.s;<""" PERMIT NO: COM~ti~o.elo ISSUED: 08/15/2005 Ie lana :~""in9 APPLIED: 08/15/2005 e EXPIRES: 02/15/2006 VALUE: , Status Issued 225 Fifth Street, Springfield, OR , 541-726-3753 Phone .. 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 4102 FRANKLIN BLVD ASSESSOR'S PARCEL NO,: 1703344200400 Eugene TYPE OF WORK: EI"ctrical Work Only, ATTENTION: Oregon law reqUIrE;'; Y" ',..') fawP.EIOF;USEi1pte~diiftiliW Oregon lCli~merclal N~tification Center. Those rules are sellorlll in OAR 952-001-0010 through ~A.R 95~-~?_1: 0090, You may OOla111 \.oVI'''''' ~, ...- ,-.-- -, calling the center. (Note: the telephone number for the Oregon Utility Notllicatlon ('on,p,;.. 1-800-332-2344). PROJECT DESCRIPTION: New Service - Owner: UNITED PIPE & SUPPLY CO INC Address: 7600 SE JOHNSON CREEK BLVD PORTLAND OR 97206 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor MNB ELECTRIC INC License 162191 Expiration Date 11/1912006 Phone 541-726-8601 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION I # of Stories: ;~i.s;~i~i\\\T S\1Jot'S~~,P~R~~F THE WOR~ Height of Structure AU1HClRiZtD UI!?iIl.f.t lstlFloor:qM1T IS NO Type of Heat: ViENCED C~!I\Eqi!d,F.loii'i::ED FOR Water Type: CONIII Sq,Ft'Basement: Range Type: ANY 180 DP8 FSq'iltGarage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: I DEVELOPMENT INFORMATION I Frontyard Setback: .. Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01I00 ISSUED: 08/15/2005 APPLIED: 08/15/2005 EXPIRES: 02/15/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fpp~ Pllid I Fee Description + 100/0 Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $6,30 $4.41 $63.00 8115/05 8115/05 8/15/05 Receipt Number 2200500000000001096 2200500000000001096 2200500000000001096 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,ffi. will be made the following work day, , fPl\ll,jrpd Tnsnpdion,. Electric Service: Approval required prior to utility company energizing service. By signature, T state and agree, that T 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 ofany 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 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. f:1-~r,~' ThO'f'JU OrZ~ ~/ Islos N~ Owner or Contractors Signature Date Paee 2 of2 275 Fifth Street Springfidil, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-0 I 100 COM2005-0 1 100 COM2005-01100 Payments: Type of Payment CreditCard '\ :r " f " If" 8/15/2005 . RECEIPT #: ."~RI_N_a_F1~'",.,. - i. WiL, . '.' I ~_, ,. ..~:r . ~ty of Springfield Official Receipt .veIopmcnt Services Department Public Works Department 2200500000000001096 Date: 08/15/2005 Description Perm ServlFdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By MICHAEL K GOINS Item Total: Check Number Authorization Received By Batch Number Number How Received njm 015579 In Person Payment Total: Page 1 of 1 2:51:36PM Amount Due 63.00 4.41 6.30 $73.71 Amount Paid $73,71 $73.71