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Home My WebLink AboutPermit Electrical 2003-10-3 o : CITY OF CUNGFIELD, OREGON 0' ) 1 225 FIFTH STREET' SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:~eijF6-3689 I owmg ProjEtct a b ELECTRICAL PERMIT APPLICATION zoning, and does not ~:qUUi~med has the fOllowing . I, 7 approval. e specific land City Job Number COM =03 -00'7 <; Z Date 10,....0 f - 0 ~ ..... Use j Zoning, C 1';:' I. LOCAl'lONOFINSTALLATION. 3. COMPLEl'EFE/!rsCHEnn7 ~[!gLOW IO-03-0'lS Lf 'i? f{'! ~M \::./,::;: 15/ V j Authonzed Signature - ex,;)- LEGAL DESORIPTION A. New Residential - Single or Mul\i-FamiIy per dwelling u~ l~()~1 (D'5i'i : 0200 (:) City <; M.!"-bFf'F.L0. Phone I)'q/- 751)-<191'3 Supervisor Lilnse Number 7271 {' FA , i / Expiration Date (; / nl/ Installation, Alteration or ReIocati,,,, t 1 _~o i 200 Amps or ie&'bn laIN reqU\ ~'Jm'J $ 50.00 Constr. Contr.'Number _ ~ 9 9 <f <-l AneOU1),Q,~Yorr~~d"!J'p~ne oregar, setf"rI $ 69.00 I . / to\\Ov4(}.u~~'ip.Ot1rowa rU~8~:;~S2,.(\O $100,00 Expiration Dare _1"1 </ () 1-+()" '~otitic~~P~i'Q9J\~.~~ir0f@~~Sdf'in€:"rlilil}G"t .. Signature of S,upervising Electrician \ Og. 't'!atwll)CU\lliiitS' ~~t8: th8 tale,p'\'IO~e n ~. (),L )09.N 8ftera'fi'Jt8J' Q'lt QjIilh."'rt~ql~fA~P.\IO . /J . call1fltj Or:;~ ~ 44' : ,C/ --""-'-- _ nulfilDl1JclftUU1ei q~loO-33Z-Z3 I. $ 43,00 c::..--r Each 1'\{!d]llOha~ CIrCUIt or WIth ~ W' -( I \ --:-... /. ,'] Service or Feeder Permit Owners Name l dl ~ L--- D c-V _ ~~ Address ?c) I5o", '74 z l? I City {::lA C--!.-1If r:! , JOB DESCRIPTION I _ <;FCUR;in S'f<:fl"M Permits are nbnwtransferable and expire if work is not started wi'thin 180 days of issuance or if work is 1 Suspended fOf 180 days. I . CONTRACTOR INSTALLATION ONLY 2. I Electrical Contractor .Alli . (' Fc.uf$.tl.1 I Address 41L:1J. j MAIIJ <T~O Phone OWNER INST ALLA nON The installatiJn is being made On property I own which is not intended for sale, lease or rent. I Owners Signa1ture: I I Inspection Rkquest: I I I i 726-3769 Service Included 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 . . - . -. -- - -]1- -- --,- - .. B. Services or Feeders - Installation, Alterations or Relocation: J[ 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63,00 $ 75,00 $125.00 $163.00 $375,00 $ 50.00 c. . 'Te';'porary Se;vices ~rFe~de-rs 11 , . _ _ _ ,l $ 3.00 E. ' Miscellaneous (Service/feeder not included) -Each Installation ". - I~. . Pump or irrigation $ 50.00 S~&llil1.; Li~h%~p.,ll EXPIREJF THE vroI3'60 Lili\ilSJ ~~fiW;R'(jwem~11H\S PJRM\11S$ti'Sl.1io LiMJ~d1E\a~tf?cf'CJV{~i~BAND..cI~ FO~45.00 #(/<;",01> MinimuRPEI~~ij 61ff'11t!milt}tion Fe" is $45.00 + Surcharges , ANY 'f . . , 4. SUBTOTAL OF ABOVE Ji L.f ) 7% State Surcharge ]1 J- 10% Administrative Fee '-t -,0 TOTAL 52 bS Shared Drivc(T:)lBuiJding Fonns/EI.xtrical Permit Application 1-03.doc 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~rKlNGFIELD Building/Combination Permit PERMIT NO: 'COM2003-00992 ISSUED: 10/0112003 APPLIED: 10/0112003 EXPIRES: 04/0112004 VALUE: SITE ADDRESS: 4884 FRANKLIN BLVD ASSESSOR'S PARCEL NO.: 1803031402000 Eugene TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: security system Owner: W1LDISH IND DEV CORP Address: PO BOX 7428 EUGENE OR 97401 Contractor Type Electrical , CONTRACTOR INFORMATION I Contractor ADT SECURITY SERVICES lNC Phone 541-736-4973 # of Buildings: Primary Occupancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction License 59944 Expiration Date 05/11712005 BUILDING INFORMATION I # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Fl 2nd Floor: Water Type: Sq Fl Basement: Range Type: Sq Ft Garage/Carport Energy Path: as ,/oU to Sq F1 Other: fI la'/ll 1aqUI1 00 Ut\liW Impervious Surface Area: _. \''''''00 . . r"lrea . ..... IhniVkto~Mmr<IN~O~'IlION_:.l;S"~~O ." ... \ I} ~ 101lv" C l\l~l.' gf\ VC''' \ 'nca\iOO a _nO~otn10U 01 tna 1ule& '-lotI f\ 99ie'i\Il~"Dgtaif\ caples te\epMoe \0 o~ 'iMtrelii 'fi!e~~ ~\l!l;te: tna Noti1\catiOfl 009 .,,\f&8W DF~\'1<!ldilfl Ut"\t'/ nA4) ca + t \na 011>;,1 332-Z"'" . flu~bt<< Oi!Lot c%~riigl!}- cefl\efl REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I CE Sidewalk TY~: NMI : w ~ THIS PERMIT SHAll EXP\RDb~X~~rgs ffins: ~~~3~~CE~O U~~~: ;~~~66~~6 F~R ANY 1BO DAY PERIOD. I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Vallue Date Calculated Total Value of Project Page 1 of2 -i*.. . . CITY OF ~noNGFIELD Building/Combination Permit Status Issued PERMIT NO: iCOM2003-00992 ISSUED: 10/01/2003 APPLIED: 10/01/2003 EXPIRES: M/01/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I FI'I'~ tiWU Fee Description + 10% Administrative Fee + 7% State Surcharge Low V oItage - Commercial Indus Amount Paid Date Paid Recdpt Number $4.50 $3.15 $45.00 1011/03 10/1103 10/1103 22'~0200000000001610 22~0200000000001610 22~0200000000001610 Total Amount Paid $52.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection ,'equested 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. ~ Reouired InsoectionsJ 1 Low Voltage: Prior to cover. 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 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 readahle 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. Owner or Contractors Signature Date Pal!e 2 of2 225 Fifth Street c' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00992 COM2003-00992 COM2003-00992 Payments: Type of Payment Check Paid By ADT -irM--- C WI.".' "_..... ....,-'..~ - ". ,. I ". . -",H'C__ - . ~ ! -~ . ,;.) """"','. ...,' Receipt #: 2200200000000001610 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt. Development Services Department Public Works Department' . Date: 10/0112003 2:39:42PM Amount Paid Item Total: 3.15 4.50 45.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65 . .