HomeMy WebLinkAboutPermit Electrical 2006-4-12
.,
CITY OF~PRINGFIELD, OREGON '\--,
I' net
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPUCATION
City Job Number (!t)h1;z.OOb -DOt..f4? Date L../ -10 7()h
t. ::'LpC4ITQil)lt~~A~r~!~~.!!~~
~O do (ih-L--........, r mr
LEGAL DESCRIPTION d
\""10 3> ':l~~ Dba 3.S6D
JOB DESCRIPTION 1000 sq. ft. or less
I") Each additional 500 sq. ft. or
ILlCJ..J2.. ~1: pJ~.,p portion thereof
Permits are non-transferable and expire If work Is Each Manufact'd Home or
not started within 180 days of Issuance or If work Is Modular Dwelling Service or , $50.00
Suspended for 180 days. F~~::::~'TION: O-eoon law re",,,, vO yvv tu
2 ,coNiiiAefORr~sT;f,~~.r.TIOJjO~ B. I>~,' ~,.~,~,iIe',' '~'!'l!!~lftr~iiWiI' ~'," ~o..;~~~k.ri~:"~,l',1
. l ",,,,,,.. . .;1A"'K ,. i\~I..O~ .~l~f~__...-=- IJ ~I'rf~~_",...,",",;,,_
fl )- -, ..,..... . r' 0......, 'In.'' f'r"~ 0 ttlrr.t1ol't OAr, 0:"?0.111.
ElectricalContracto Va.,. Au, .Q..t-"~J_~,200Amps:Orless u", "" ". ,$63.00
.- --~26j"Am~~!io466'~~If' CLl~,CJ U' 11;~ ,ui$~5.00
40f;Amsio'i;OiF~ IS (:' :'[,: "'." ~:..,Q$l'25.00
PI" P - 1,1 ," orl
' , . 1.. 0" I.L.'I'.....'.I
60 I Ampsro 100.0 Amps ",' . $163.00
L..t'. . .... . 'I
Over 1000 AmpsNolts
Reconnect Only
3. "CdMRizi.<<iF.il'E.!t~t:I.i::.e'h";'~t.; t":
1Iil..."'" ._.,~ _--, ..,., /"" ." ..,:;
A. lI!if~lrD~",d~iiXiWslli'.;i~'~M"'uiI!-~-e'f!d>"eih~"uDitT,;
~..,,", ~~.&"_b...........,? ~p. ~.<",...",gl_. _ ._~~
Service Included
$106.00
$19.00
AddreSS~O Rn~ ~!l/
c;~~. ~
~t.l2. ((~
$375.00
$ 50.00
Supervisor License Number I.~ k4 . "\
c. .'r.~1k~~~tf'~~~r{~<'i
Expiration Date
10 - I - 0"7
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
,Ov~~6,QO.Amps or 1000 Volts see "B" above.
~ ",' . ..", "" ' . """"",,, ,'j
Di neb (3lr ul ,,,,:,"\~'~ .
T Ml,) CIVil 11f"'\L..L.. L/' ".....' ,.. .
NewhAlteratlonlor,Extenslon:Per~l'aner IS NOT ~ ~~
}-\u I unlLLU UI'4UL.I' 111lV I ..., ...". _
(q~~I~!f~\\\tEQ O,R IS ABANDO~lm rln~$43.00 ll,
Each i\:ddlllonal C~rcUlt or WIth "'-
'St\lv.1~!'F-l'-\dV ~ Hll.lU $ 300
j ervlce.Q:' ee er ermlt . .
$ 50.00
$ 69.00
$100.00
Constr, Contr. Numbe~ {lti I S I ~
Expiration Date
q -elL{ -~
SiglU'ture of Supervising Electrician
] .J;A/t'lAO__/ C1 f~, / '
Owners Name I~ t'!lf~':1 ~ JL.o,
Address ,..~r'l.~f)--r~ "~ ~ E.
City ~IU.AJ~I ~ Phone ~
OWNER INSTALLATION
MIS~ii:=r-' ~~~Wr~~;" 11~'blcl:.r~'!!"Eakb~I.i;fall~ti~'nI
> . ,. " ..,' '......, ' .,....~ < .;u
The installation is being made on property I own which
is not intended for sale, lease or rent.
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee Is 545.00 + Surcharges
Owners Signature:
4.
8% State Surcharge
10% Administrative Fee
\..t"\ ()'D
....3 ~-o
J-SO
5~1D
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FonnslElectrical Pennit Application 1-06.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00443
ISSUED: 04/13/2006
APPLIED: 04/13/2006
EXPIRES: 10/13/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3030 GA TEW A Y LP
ASSESSOR'S PARCEL NO.: 1703222003500
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alteration
Commercial
PROJECT DESCRIPTION: Electrical for Heat Pump.
..-.. ~-
Owner: FOOD IND CREDIT UNION INC
Address: PO BOX 7245
EUGENE OR 97401
", ''-'" '......,.. ............;::1....." .-.. . -.,-.' -- J
follow rules adopted by the Oregon Utility
Notification Center. Those ru:es are sat forth
in OAR P'~;>.OQ1.0010th'OlI~h O/\R gS;>-OG1
Contractor Type
Electrical
Contractor
OREGON ELECTRIC SERVICE
V"'.", ~"T r~il~' C::J:f'UrJ (.,--':,....;::) C. t'~c fU ....~ ; '.'
, CONTRACTOR INFORMATION. .~, Ii' ,;', r ',' ;' ",,:r
r 1.' I . 1~...I . , I , ' ,
License,.~, ,.Expiration;Date Phone
161518 09/28/2006 541-343-1681
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
_ ,.r....~
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMA'I:lON '.
I1LJ' "''','lfD -'.. .LL EXPIRE IF l~~QIf~R"D PARKING
lun' UNDER THIS ' ,m
Overlay Dist'::J1VIJ\1ENCED OR IS ABA PERfllrr'bf.il:NOT
# Street T.rees,Rqd:'! : :.:y DER NDONEfuaodjcapped:
Paved Dnve Rqd: ,100. Compact:
% of Lot Coverage:
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 1 of 2
.
. CITY OF ~rK1r~\.oNJ<,LD
Building/Combination Permit
PERMIT NO: COM2006-00443
ISSUED: 04/13/2006
APPLIED: 04/13/2006
EXPIRES: 10/13/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fpps ~
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Amount Paid
Date Paid
$4.50
$3.60
$43.00
$2.00
4/13/06
4/13/06
4/13/06
4/13/06
Receipt Number
2200600000000000459
2200600000000000459
2200600000000000459
2200600000000000459
Total Amount Paid
$53.10
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.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 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
Paee 2 of2
225 Fi'fth Street
Sll'ringfield, Oregon 97477
541-726-3759 Phone
.
~,,-,,'
~
Caof Springfield Official Receipt
_Iopment Services Department
Public Works Department
Job/Journal Number
COM2006-00443
COM2006-00443
COM2006-00443
COM2006-00443
Payments:
Type of Payment
Check
cReceint!
RECEIPT #:
2200600000000000459
Date: 04/13/2006
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
OREGON ELECTRIC SERVICE ddk
19605
In Person
Payment Total:
Page I of I
8:36:36AM
Amount Due
43.00
2.00
3.60
4.50
$53.1 0
Amount Paid
$53.10
$53.10
4/J 3/2006