HomeMy WebLinkAboutPermit Electrical 2011-6-14
Electrical Permit Application
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DEPARTMENT US'E,ONLV
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225 Fifth Street. Springfield, OR 97477 .PH(541)726-3753tFAX(541)726-3689
Pennitno, 5//01'117
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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Zoning approval verified? 0 Yes ONo ,-" . " "-'"" : :.t,: "_'_\1', . ':' ';~f !'/'i.. ,:.'-,;" 'Cost' : ' Total"
"Nuniber ofjnspedions"per.iteni' f)-, "", Qty. _,;:;'~,a~~~ .;, ,f.,- c_OSf:-i.
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Residential, per unit, service included:
o Residential I 0 Government T 0 Commercial
~~J_oBiSn1E~INF(jRMATI()Nt;AN(jllIZQC'A TI0N'ii1!'!ii;~{I' 1,000 sq, ft, or less (4) $134,00 $
Job site address: ?7:7rf>' ~~ /~ s/, II' Each additional 500 sq, ft. or portion $ 25,00 $
thereof
City:5M~ I 'State: I ZIP: Limited energy (2) $ 32,00 $
Reference: J7D"]1 Lft{ L I Taxlot,: DZSOD Each manufactured home or modular $ $
dwell)ng service or feeder (2) 63,00
.- .C ,~.. -... . :"'DESCRIRTION OF-WORK',,\;.,,:".'H"1Y;:'iiT"
I&A//~ ~ -f--- .:i: _ ~ ./ Services or feed_~rs.: installation, alteration, relocation
, 200 amps or less (2) 2- $ 81.00 $1<1& Z.
'PROPERTY, OWNER 201 to 400 amps (2) $ 95,00 $
Name: ~G ~ JA-I/~ E,^Je~"o....\ L L 401 to 600 amps (2) $158,00 $
Address: ~ .~^ A. ~1..__/~JvA 601 to 1,000 amps (2) $205,00 $
City: A1G-t:NF I State: ~ I ZIP:'77tfOj' Over 1,000 amps or volts (2) $469,00 $
Phone: - - I Fax: - - Reconnect only (2) $ 63.00 $
E-mail: Temporary services or feeders: installation, alteratio.n, relocation
This installation is being made on residential or farm property 200 amps or less (2) $ 63,00 $
owned by me or a member of my immediate family, This 201 to 400 amps (2) $ 87,00 $
property is not intended for sale, exchange, lease, or rent. OAR
479,540(1) and 479,560(1), 401 to 600 amps (2) $126,00 $
Signature: Over 600 amps or 1,000 volts, see services or feeders section above
C.oNTRACTOR " INSTALL6.T10N, Branch circuits: new, alteration, extension per panel
Business name: CH~4 ./U ~ ~./7e/ C a. Fee for branch circuits with purchase of a service or feeder fee:
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Address: / ?-.:?> Each branch circuit $ 6,00 $
Cityj-- >d'?L- I State: O'tt!! I ZIP: 97;Lu b. Fee for branch circuits without purchase of a s~rvice or feeder fee:
Phone:S- .;I1-'??5~- .?.i'.s'd! 'I Fax: - - First branch circ~it (2) $ 55,00 $
E-mail: /" VI, ~I / M.;;7 ~ AO .L2..o, e.."",_ Each additional branch ci~uit $ 6,00 $
.
CCB license no,: 623 77 r BCD license no,:4> -22/ C Miscellaneous fees: service or feeder ':lot included
Signing supervisor's license no.: 472 IPS Each pump or irrigation circle (2) $ 63,00 $
Print name of signing supervisor:,.-'",.< k"';""'-+'L"~ /-e hi /~h.' ~ Each sign or outline lighting (2) $ 63,00 $
Signature of signing supervisory- --v /? / j/~ Signal circuit or a limited-energy panel, $ 63,00 $
/ alteration, or extension (2)
Each additional inspection: (1) $58,00 $
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(JI;.V-=#- 9-(( -9')1 ''8"~ ~" (A) Enter subtotal of above fees
(Minimum Permit Fee $58.00) $ ((;2-
(B) Enter 12% surcharge (.12 x [A]) $ J1 '!.-t(
\[J \\9 (C) Technology Fee (5% of [A]) $)ff!
TOTAL fees and surcharges (A through C): . .
$ it;'i ~
~
440-2584-J (9/08/COM)
CITY OF SPRINGFIELD
SP.R..........ING. FI.E~
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Building I Residential Permit
PERMIT NO: 811-SPR2011-01417
IVR Number: 811195200914
www.cLspringfield.or.us
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitce nter@cl.springfield.or.us
PROJECT STATUS:
STATUS DATE:
155 ued
06/14/2011
ISSUED:
APPLIED:
06/14/2011
06/14/2011
EXPIRES:
VALUE:
12/10/2011
$0.00
SITE ADDRESS: 3998 FRANKLIN BLVD, SPACE# 14, Eugene, OR 97403
ASSESOR'S PARCEL NO: 1703344202500
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Electrical Only
Repair
Residential
PROJECT DESCRIPTION:
Replace service and feeder
Phone Number:
OWNER:
ADDRESS:
GREEN VALLEY ENDEAVORS LLC
3998 FRANKLIN BLVD
EUGENE OR 97403
CONTRACTOR INFORMATION ~
Contractor Type
Electrical Contractor
Contractor Name
CHRIS MILLERS ELECTRIC lNC
Lic Type
CCB
~
BUILDING INFORMATION
# of Units:
o
# of Stories:
Height of Structure:
Type of Heat:
N 0 I . t Water Type:
ATTENTIO : regon aw reqUires you 0
follow rules adopted by the Oregon UtilityRange Type:
Notification Center. Those rules are set fortltlazmat:
In OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone . . .. .
number for the Oregon Utility Notification Electrical Specialty Code Ed.t.on.
Center' is 1-800-332-2344). Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
# of Bedrooms: Municipal f Development Code:
Sprinkled Building:
Fire Alarms:
Energy Path:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
Site Information
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Springfield Building Permit
6/14f2011 8:32:05AM
Lie No
62377
Lie Exp
12f2112012
Phone
541-895-3660
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other: 0
Occupancy Load:
2011
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Page 1 of 3
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~ OREGON
www.ci.sprillgfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2011-01417
IVR Number: 811195200914
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
pe rmitcenter@Ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
06/14/2011
ISSUED:
APPLIED:
06/14/2011
06/14/2011
EXPIRES:
VALUE:
12/10/2011
$0.00
SITE ADDRESS: 3998 FRANKLIN BLVD, SPACE# 14, Eugene, OR 97403
ASSESOR'S PARCEL NO: 1703344202500
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Electrical Only
Repair
Residential
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Replace s~rvice and feeder
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PROJECT DESCRIPTION:
PUBLIC IMPROVEMENTS
I
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Description
Tvoe of Construction
Unit Amount Unit Tvpe
Unit Cost
Value
FEES PAID
~
DescriDtion
State of Oregon Surcharge (12% of applicable .!ees)
~~r~i::~s ~E_,~.r:nEs.~~,:-~_ __ ~_ _.____.._.._____.__
!~_hnology!:~ (5Q/~~~~~~ tot,al)
Total Amount Paid
Amount Paid Date Paid
$19.44 06/14/2011
$162.00 06/14/2011
-.- ----..-.-...------.'---
$8.10 06/14/2011
$189.54
ReciDt #
2011001595
2011001595
2011001595
Springfield Building Permit
6/14/2011 B:32:05AM
Page 2 of3
CITY OF SPRINGFIELD
SP~~~G..,:E~
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~OREGON
Building I Residential Permit
PERMIT NO: 811-SPR2011-01417
IVR Number: 811195200914
www.ci.sprlogfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
perm itcenter@ci,springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
06/14/2011
ISSUED:
APPLIED:
06/14/2011
06/14/2011
EXPIRES:
VALUE:
12/10/2011
$0.00
SITE ADDRESS: 3998 FRANKLIN BLVD, SPACE# 14, Eugene, OR 97403
ASSESOR'S PARCEL NO: 1703344202500
SCOPE:
WORK INVOLVED:
TYPE OF STRUCTURE:
Electrical Only
Repair
Residential
PROJECT DESCRIPTION:
Replace service and feeder
Plan Review
~
Oeoartment
Application Acceptance
Received Due Date
06/14/2011 06/14/2011
Comoleted
06/14/2011
Result
Over the Counter
fPerriiif,lssuance :?~::-:--,._.'_06/14/2011:.:06/14/2011 .
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Electrical Review 06114/2011 06/14/2011
Comments: Over the counter permit
06Ti4noh
Reviewer
Chris Carpenter
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';" '.:"'" >,;,,, no' .. " . I
^
"'-''>-'-
06/14/2011
Not Required
Chris Carpenter'
Initial'Review
Co-mments:
':06/14/2011' 061.14/2011. O,6/1~/2011
Over uie ,counter permit
""'-, .~
. _.Overthe.Coul)ter
INSPECTIONS REQUIRED'
Inspections
4225 Service or Feeder
Chris Carpenter
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 or 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. 1 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 Contractor Signature
Date
Springfield Building Permit
6/14/2011 8:32:05AM
Page 3 of 3
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 5t
Springfield,OR 97477
541~726.3753
www.ci.springfield.or.us
811-SPR2011-01417
3998 FRANKLIN BLVD. SPACE 14
permitce nter@ci,springfield.or.us
RECORD NO: 811-SPR2011-01417 DATE: 06/14/2011
""f;':'+~ ''''''''"iY:.I.'"f''', ._~,t\(;C-O(jN'cCODE: -' ~:e:,~cAMOUNT:D"UE ," -"-
224-00000-426102 162,00
821-00000-215004 19A4
100-00000-425605 8,10
- --------
TOTAL DUE: 189.54
t::;.~AY.fIiI~~iLD'eg;,. ","'-'PAy'OR-:;'CASHniR:J:CARPENTERt.-""1tL'_<;:_QM:rI!E&f$~;. ",.-'Cl,.:;ANlOUNT MID, '_
Credit Card Chriistopher Miller 189.54
02444C
RECEIPT NO: 2011001595
[DESCRIf1.IION "o"'.:;,;"jJ' > . ,
Services 200 amps or less
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
.' ----.J
TOTAL PAID:
189.54