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Home My WebLink AboutPermit Electrical 2005-10-26 City Job Number 1. LOCATION OFINSTALLATION 3. 38'f Q C;-\. . 5 pr\~~Q\cO, a( LEGAL DESCRIPTION /70'3 UZC{ . 65700 ""t"1!?\E'l'O~U""~\O^ "-t""Pt"' ~II.A-\-\o"- JOB DESCRIPTION S el COlMlM.. -h'TIi!^ I "'- .A- t<~ - 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor CJ COi\lVfo.~~oA1-.l:"c. Address tDq~ ~t-.\ ~iJ,. S\-o Su'i~ \\0 City jlPClU"'\"~"- Phone (ra3) "0-/9..2.:.1. Supervisor License Number 9Cf'l L~ A Expiration Date O-\... ~os:t Expiration Date \ \ -, Ce> 'S'"~ 10 /J /O~ . . Constr. Contr. Number Signature of Supervising Electrician y. L _ /COc.H-- Owners Name tJ A-fs eM... 4r ~ ~ -s LLL F,4( rVV~ VI8ft I 2s7S- City /__-v... G- EN~ Address Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. New Residential- Single or Multi-Family per dwelling unit. 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 Dwelling Service or $50.QQ~. Feeder UO.l 'CE- ft~ \, lK~ ~GPI\( n · "1. Ll txP\n~ . ~~Ql B. Serviceslr\15JafiiM~hs ~'l\-\\e-~\iiw;t~ cation: AU1HOR\1E.O BANDON~O fQ 200 Amps ote'MME.NCEO OR \5 A $ 63.00 201 Amps to AtwAtlO DA'1 p~R,uD. $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 C. Temporary Services or Feegers uires yOU to NIION: Oregon \aW req re on Utility Insfun1&on, ~~~gVJian\ Rel~ftn~n gre set torth 20d~: ra ~~enter. Ihose ru.~es a ~(l~@- 2d)1~~~~~~tnfi)01? thrO~~;' ~~rtill$Ol>Y 40bMW~~'OB~ltl~flbta\n ~~~e: f;w tP\p'p~O Over ~~s~ (HJ66~W&cffi~~lt'Slfu)w\hcatlon D. Br~WcIDfsthe. ..1.800-332.-2.344). center IS New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Lf r: 00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE q $",00 3. J \ " I:"i" Y 50 )- ~ . 'tJJ <)2 {,s- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application l-03.doc CITY OF SPRINGFIELD Building/Combination :rer~t " Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2005-01517 ISSUED: 10/26/2005 APPLIED: 10/26/2005 EXPIRES: 04/26/2006 VALUE: SITE ADDRESS: 384 Q St ASSESSOR'S PARCEL NO.: 1703262405700 Springfield TYPE OF Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: low voltage for telcom termination w Owner: WATSON-ALBERTSLLC Address: 875 FAIRWAY VIEW DR EUGENE OR 97401 Phone Number: 541- I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor License Expiration Date Phone C3 COMMUNICATIONS INC 117658 10/01/2007 503-643-1922 -;' G INF "H~ WOR" U\S P S PERM\" \5 NOl 1 n llWiDijNDER lH\ ONEO FOR Lot Size: AU . Ne\!!l OR \5 AS AND Sq Ft 1st Floor: CO II tfMtfl\\\QO. Sq Ft 2nd Floor: AN, ."Type: Sq Ft Basement: Range Typ~: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Yrimary Construction Type Secondary Construction # of Bedrooms: I DEVELOPMENT INFORMATION' REQUIRED PARKING Overlay Dist: Total: # Street Trees Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: to \aW requires yoU, . ---, 111("\"" nreQon , 8 r~u"n Utility IPUBLIC IMPROVEMi,N.isMuleg adopteTC1ho'YS~'~ules. are set tort~ ~, ~nter. 0 OAR 952-00 ,- NotifIcation d~19 \f)rp~h \ by . OAR 952- T- . ies o1\he ru eS 1~090. \'oLl r&.~tpO\\.~~~~~ tele,~ho~e \ling the center. ( Ut'llity Notification ca h Oregon number for t e. 1_800-332-2344). Center IS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated 1 of 2 Status: Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01517 ISSUED: 10/26/2005 APPLIED: 10/26/2005 EXPIRES: 04/26/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax "541-726-3769 Inspection Line Total Value of Project Uees Paid-t Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid $4.50 $3.15 $45.00 10/26/05 10/26/05 10/26/05 Receipt Number 1200500000000001612 1200500000000001612 1200500000000001612 Total Amount $52.65 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. . 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 certity 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 of any structure without permission of the Community Services Division, Building Safety. I further certity 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. Owner or Contractors Signature Date 2 of 2 ( , 22.5 Fifth Street 'Springfield, Oregon 97477 541-726-3759 Phone .> '-- Job/Journal Number COM2005-01517 COM2005-01517 COM2005-01517 , Payments: T.~e of Payment Check Change Jnb/Journal Number c;pM2005-01517 COM2005-01517 COM2005-0 1517 \ .l~ . Payments: Type of Payment Check Change '.~ . ,?,. r; ,;(, ...... " ~ '.~ . . <' 10/26/2005 RECEIPT #: ~!t.if.-.' ....',....'.i.... lair,!,,'! .............ti.... ...,j - i _, t~' .. j _"",. ..~v.' ._'" -. ." . -' -oty of Springfield Official Receipt <~velopment Services Department Public Works Department 1200500000000001612 Date: 10/26/2005 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Paid By COMMUNICA nONS INC COMMUNICA nONS INC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 20568 In Person djb In Person Payment Total: Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Paid By COMMUNICATIONS INC COMMUNICA nONS INC Item Total: CheCK Number Au th on zatlOn Received By Batch Number Number . How Received djb 20568 In Person djb In Person Payment Total: 1 of 1 11:35:05AM Amount Due 3.15 4.50 45.00 $52.65 Amount Paid $52.97 ($0.32) $52.65 " Amount Due 3.15 '4.50 45.00 $52.65 Amount Paid $52.97 ($0.32) $52.65