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Home My WebLink AboutPermit Electrical 2004-8-6 . . q~ ",. (~? ~ 6. ~O',{) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(541)726-3753 . FAX: (541)':'6-3689' OOs'% </ ~ ~ '" "I ELECTRICAL PERMIT APPLICATION "% ~""'^ "01 ~"'''''' /_ <70'/ '/~ <.Y ....6) ~ City Job Number~ Zo:::::'l ~oO 9 D) Date 0 'f 10'1 sO" 9",~ ~i!: U},.... ~ \90- I. 'LOCA.Tii/rloIUNSTALuiiON .~~r .;~ 3.'coM~iEliFEi SCHED;;~'tlE """~sC}::",~ .' 4Cj} 2 Fyn~k\'fn' tihld ..~" '-'""", '. .... ~ .~>~"~~~~ LEGAL DESCRIPTION A. '..N~,,: !tJs!~~nti.al- Singh~or J\,lulti.Famil) 'dh 'unit." I '60 -:> 0:' (l( 0 ZOO ( Service Included 200 Amps or less $ 63.00 20 I Amps to 400 Amps $ 75.00 40 I Amps to 600 Amps _ $ I 25 .00 NOTIC~OI Amps to 1000 MIP'F THE Wefl*-- $163.00 4 ~5- CA~~ PE~.J.l;rISbb\~I.t~~1Ii\S- RMIT IS NUT $375.00 AUTHO~li)1h1t<lD:lid1yTHIS PE $ 50.00 COMMEtiC,EQ OH IS t\B~~DqNED!O~." .... ___,. _ ,,_, ~.~. ANY 1180 lJMhi19A4i@~i'n'kes or,F~eders ',,;."':;_~I." > i,',i.' :'~';'t~~:o: JOB DESCRIPTION I ()IIC' ( 11' +"""" Permits are non.transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. '?"f.-.- /~;'-".."" :(.'.' '..;- "L ".'--~: .., -: .,..,. '" '_' . CONTRACTORINSTALLATlON ONLY 2. ......'l'}..ri'i::,1:.~:'..:.:-....'.:~......, .~-':\ .'~, .<....l-.~. ~ . 'L' Electrical Contractor ,Rll,'ldfYS . []ec+r,'c. InC City ICJS Mac/,.<)Qr) ~):len( Address Phone u Supervisor License Number 3:J.Cj 0 - S Expiration Date lOr I - 04 Constr, Contr. Number 4 'Jq I 0 Expiration Date Z:Z:;;;:'~;dOO Owners Name ~~a>_14) / IJ J," \ d 1:'\ h Address .4; 70 (2 OK 71.( Z. ~ . City ~ -c..--rt' ~ . Phone l .... OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~~^' ~~ 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $ 19,00 $50.00 Y" ,.., l" .., ",," B.'~Ser,vices or Feeders':' Installation',.A!t~.~ations or. Relocaiion:, \ . .' 'r" : ..., . _ .'. _", . "~ ,'".. . ..,.,. '. . Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B'" above. ::'.......",... .,' ',"" . ._.....~;.'.~~. ~'1 .";: .\~.. D, Branch CircUits" .l': ). ,.; ,1. ,,: .. 'r'.:", ... New Alteration or Extension Per P,mel 4 3 One Circuit _~~ 43,00 --- -~~~~~--~ilV 10- _____ i61i"~fijIQs~fttfibYU.~re Jfi'OO .1...:.3 N'IW~Genter. ThQSl.t ,. ntoA~~~. .., .. EinO(j~~~~(ll)1iilnle1ai1m.'"'rl~~lfr'UliWEncII Install~tioIl' YoU maY C)btain .~. ,I,.., of pg~;'~r t~l~ (Note: u.tJ~P~..50.00 Si~;rfdr~~on UtIIl"iJ;~o.oo Limtled E~~-23l..o)o $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fe, is $45.00 + Surcharges ;:'. . ........-,, ,;, 4. . SUBTOTAL OF ABOYE'-' ....., .. hi '-fl.' blO 7(37 .' - ,. .;'~ .... 7% Slate Surchnrge IOtJ.Io Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Eleclricnl Pcrmit Applicalion I.03.doc . CITY OF ~rK11~uJ:'1ELU. Building/Combination Permit PERMIT NO: COM2004-00965 ISSUED: 08/04/2004 APPLIED: 08/04/2004 EXPIRES: 02/04/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4912 FRANKLIN BLVD ASSESSOR'S PARCEL NO.: 1803031402001 Eugene TYPE OF WORK: Electrical Work Only Total: Handicapped: Compact: ~'\)~'4- ,'r.(. ~r ,~~ ,s ~'\)' I PUBLIC IMPROVEM~.N:.TS~ ~\>.\.\. \.l'~\~ ?\~~~~\) {'\)\'\ ..,,,,,- :'i S ~\.m..~a\" ,,,v c. ,?'(.'i" " ~ a~p"l!: ,\'1'\;) ,?-\L't.'v Q. '\ ':0'\'1'0 \;\C,'t.IJ&\v{!.~~tsmrains: IX '0\h\h'l:: IJ~ '?"'" " C;" \'O'V \>.~, TYPE OF USE: PROJECT DESCRIPTION: Add 7 circuits Owner: WILDISH IND DEV CORP Address: PO BOX 7428 EUGENE OR 97401 I CONTRACTOR INF~TION I Ui~e'O '-\l\\\\\'f Contractor _~e,-:l ~a~\a~O(\ !I. \o\\U.icense BUILDERS EL.E~~~e e. a~a :~".()~~296 .-6~\V\'~qy)i\hED~@NiOR~'l'IO~ I '" ,- ft~e'O ,I I "'(I ". I II f' ~()"ll \~ C/)(\'" :$)\I'" 'as 0' .' ~a9'(\u':' (\ # of Units: ~~c~~O(\ ~o:\~o cSRlrj...~e \0 !I.\\\Ca.\\O' Primary Occupancy Group: ~O O~ gr;,~ ~~ 0'15 e~\V(~lt'P't't~~ Secondary Occupancy Group: ~..cl\.'{~ iii C "~J;r.~'2.tt~A Primary Construction Type $\I~~\\(\~ ~ I ~e ~{inl:r~pe: Secondary Construction Type: - ..n'Oet \0 I\"et ~ange Type: # of Bedrooms: \\U"-- ce Energy Path: Sprinkled Building: Contractor Type Electrical 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: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Pal!elof2 Addition Commercial Expiration Date 12/ 10/2007 Phone 541-485-0922 n/a Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Value Date Calculated . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00965 ISSUED: 08/04/2004 APPLIED: 08/04/2004 EXPIRES: 02/04/2005 VALUE: Status Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F....~. P~W Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Rec"ipt Number $6.10 $4.27 $43.00 $18.00 8/4/04 8/4/04 8/4/04 8/4/04 1200400000000001186 1200400000000001186 1200400000000001186 1200400000000001186 Total Amount Paid $71.37 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 R..onir..d \lw1..ctions I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I bave carefully examined the completed application and do hereby certify tbat all information hereon Is true and correct, and I further certify that any and all work performed sholl be done in accordance witb tbe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described berein, 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 ead, 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 tbe site at all times during construction. Owner or Contractors Signature Date Page 2 of2 [I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00965 COM2004-00965 COM2004.00965 COM2004-00965 Payments: Type of Payment CreditCard 8/4/2004 . RECEIPT #: G~ ~ Jiii)' of Springfield Official Receipt .elopment Services Department Public Works Department 1200400000000001186 DescrIption Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BUILDERS ELECTRIC Received By djb Page 1 of 1 Date: 08104/2004 Item Total: Check Number Authorization Batch Number Number How Received 000462 020798 In Person Payment Total: 2:19:04PM Amount Due 43,00 18,00 4,27 6.10 $71.37 Amount Paid $71.37 $71.37