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Home My WebLink AboutPermit Electrical 2005-8-15 , ~, CITY OF ~IR[NGFIELD, OREGON '..: r,I' - SPRINQ~I"L~ :';;;:;'';u~';.==Lr=~ """'"".,.,,, .,"" """,..,.., ~'4.l City Job Num~m.2 (J() S - 0/0 95 Date ~ ::;;~~e~:'(a \!f \I' e\ a:~ - \~e ';Iy I.w6\"---ll~--."-'~1 3. "'COMPLETE ~~""""~~~~EWW- ~---] e~~-'~~~ ._~~e.",_~.. LEGAL DESCRJPTION IJ.) 0 l!.o\ - A Ne-;; R!Si~g;'1 =-s~bl~~r ~~Jl ~~i,:..J / /' IJ '5 ;):1 0 0 0 0 76?J Service Included ale ~,,~~;;;- ;;;.::; k'^.:..... v o.S\'::I JOB DESCRJPTION I:A 1(}.oVI" 1000 sq. It or 1085"0,,,0,,"0 $106.00 Each additional 500 sq. It or T~ SbeutGC portion thereof $19.00 PermitJ are non-transferable and expire if work is not started within 180 days ofissuance or if work is Suspended for 180 days. __."., ._..._ _ - - ---- --- ~1 2. CONTRACTORINST~TlONONLY: Electrical Contnlctor L, t{. !fA,1HI.Il, ~ E:~ Address 4X":z, Sfletlu;..., (,;if. ~ City <; """" Phone l4'1-C>~ /I Supervisor License Number ,3 znJ(" ~ Expiration Date /11- /-07 olf"bf:' (.,- ((-en Constr. Contr. Number Expiration Date Signature of Sb?;" Electrician -A~ ~c.~ r?_ Wa. _ Owners;;'_ ~~~ Address ro '.gnx /479 Ci~" ~ne OWNER INSTALLATI~l7'7'O The installation is being made on y__y_'" I own which is not intended for sale, lease or rent Owners Sjgnature: Inspection Request: 726-3769 , Each Manufact'd Home or ModUhir' Ih'J,\m,"g: SJiv!ClftIl law requires yo I ' " ' '$ 00 F~JW rules adopted by tho 1;;, "'!jUII Jtl ttY "c,'Hf'calto. n 600 t,e~ -Those'!lJfe~-Mat~t-- - -"'-~-l B. 'IrSef!lces o~ Feede"'ii Installation Ij! Iln elocation: 1 '. v. .11, v.....o:;..,-vUT~uu U ulrougn tI i! 10' _. . J 0090. You may obtain copies of the """" h>1 200.f..mp,sotless . .",,~.llU' 20hdm~s(j.,t~c~enter. (Note:.tll"''''ljP~ 401 AIriue~ r t e l5'regon Utl"'y "UUIlI'~Ir>...- ps ~ n p, 8Oll-a32-'. , ~uu 601 Amps to 1000 ~~ '~lo $163.00 Over 1000 AmpsIVolts $375.00 R~___t Only $ 50.00 C. Tem~rary.Services. or F~den .-.. ,- - 1 Installation, Alteration or Relocation 200 Amps or less I $ 50.00 201 Amps iO 400 Amps $ 69.00 401 Amps to 600 J'UD.jiU EXPIRE It T"~ ~$IOO.OO ."1 r.I,I_:, 11 ..... -,,,'" .. "'~ VUKK ~er600~~~~OOO:V~ltsS!"'tllB.~.Y~S Mil..- D. ,,~~a,n~~ ~1~its~~_IS_ '~(}t\tWONEOFOR /o,.r Iou 11>\, PI;f1liln New Alteration or E:r.unsloD Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 f)lJ ~ ~-'-, ! , '. ,.'. ',j E. ,~s~~~a,~~~~ (~rvicel!~~.~?t.!".c1u~~.;-:~~.m~~~~~d Pump or irrigation Sign/Outline Lighting Limited EnergylResidentiaI Limited Energy/CommerciaI $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is 545.00 + Surcharges ._"'__~__........,--._'~__'_ ____.'__,~_.. u_ .__-, 4. SUBTOTAL OF ABOVE f,')~ d30 2 f>O srO b~ bO 7% State Surcharge ]001'0 A"'",,;n;m:ative Fee TOTAL Sbarod Drivc(T:)'Building FonasIEIcctrical Pcmnl Application t-03.doc . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-01095 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 541-726-3769 Inspection Line SITE ADDRESS: 3333 RiverBeod Dr ASSESSOR'S PARCEL NO.: 1703220000700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: use initials Commercial PROJECT DESCRIPTION: Temporary Service for Video Camera - East of Colonial Drive by Chain in Driveway Owner: PEACEHEAL TH Address: PO BOX 1479 EUGENE OR 97440 I, CONTRACTOR INFORMATION I Contractor Type Electrical Contractor L H MORRIS ELECTRIC License 01838 BUILum" INFORMATION I # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction TYPlllTTENT/. Water Type: Secondary Construction 'Eype: ON.Oregon l.8.ange-jT.ype: # of Bedrooms: I v:'~W rules adopted byE!~~rlg~;,fii:YOu 'u Notification Center. Th <S' ~iokleJ~(;i1'di~;':Y nla In OAR q!i?_orl< "". _ ,ov,P, Ult:'" are SAt tt, U090. You may ol'tDEVEL(jrMENT INFORMATION I Calling the center (N '''v 'Ult:'" L number for the O' ote:the te/~Phone . C . regon to)l~.~I"y.<R/~lt tin" enter IS 1-800-3#,Street Trees'Ttqd: I..; <-\."...,.4'"1 Paved Drive Rqd: % of Lot Coverage: Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: n----.~ (\IUlllIt: T ' I PUBLIC IMPROVEMENTS' HIS PERMIT Sr,nLL LM fne lr I nt VVUKK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Expiration Date 06/08/2007 Phone 541-747-0811 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspoutsffirains: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal!e I of2 Value Date Calculated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01095 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 541-726-3769 Inspection Line Total Value of Project F.....~ Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid $5.00 $3.50 $50.00 8/15/05 8/15/05 8/15/05 Receipt Number 3200500000000000491 3200500000000000491 3200500000000000491 Total Amount Paid $58.50 I Plan Reviews , 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. , R..llllirpt! In.np..tinn. . "~ Electric Service: Approval required prior to utility company energizing service. 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 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 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 Pal!e 2 of2 225 Fifth Street i.{Spriit'gfield, Oregon 97477 541-726-3759 Phone ," Job/Journal Number COM2005-0 I 095 COM2005-0 I 095 COM2005-0 1095 Payments: Type of Payment Check '/ 8/15/2005 . RECEIPT #: G~~"'''''!.I'1.'!!-l!.".",.,:. ~" . :^~ "I '4!!IlIJ' , 0.....,.......- -.' ,Rty of Springfield Official Receipt .velopment Services Department Public Works Department 3200500000000000491 Description Temp Power 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By L.H. MORRlS Date: 08/15/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received njm I 16396 In Person Payment Total: Page 1 of 1 9:17:5IAM Amount Due 50.00 3.50 5.00 $58.50 Amount Paid $58.50 $58.50