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Home My WebLink AboutPermit Electrical 2011-6-14 Electrical Permit Application ':;,1,' ,-. "'--j DEPARTMENT US'E,ONLV '~""':'..'. . 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. , 1"; ,-...., "-;130CAL;'GOVE~NMENT ':ARPJ{QvAu)~Y"i,'S';()JC1,,\'f p,;Fi;}<:,~~~,~;t~_~~}11g1YlifJ:.J;'~.S~H'i:J)OJ]E:~1t~ytJ7,;~~ft~~I;:f~~~~ Zoning approval verified? 0 Yes ONo ,-" . " "-'"" : :.t,: "_'_\1', . ':' ';~f !'/'i.. ,:.'-,;" 'Cost' : ' Total" "Nuniber ofjnspedions"per.iteni' f)-, "", Qty. _,;:;'~,a~~~ .;, ,f.,- c_OSf:-i. {~ ~~;l~f:0~, :U,CATEGORYJCOI; ;'CONS1'l~,UCTIONi<~' ""i."'" . " . _.~ :;-, . ,'" ". . ;".': ...:,....~"'.. ;,! ,':,,/ -'~'i;' -..' ;.I,~:":'~, ',c' _'L', 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: :5':?.?;;?g- /,,)L/U.tJ , "c?/ 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 $ CWU ) 'lr~S~Jil!;;).j"'11":"'f{,ifARPi1iCAN:j;"tJSE\"<':il"~"':!ri,fcl,,,,wo'-' Ni\'\__..d''''', ...r.S11 ,,;,il;;,~1:tt~_);;., "':..,_ '_, ", ,,' :f'r' ,;;i1!,'l,:lt:?~.i~!i~f~ !;{f$,~';'i0~!_~7:< (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~ .1'1; ""-" ..... .. ~:;;v ';;:"'1'~_\ OREGOt-l 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 '((p,'P~' ~Y1Ilm1-ll ~! .~e1I'fa8 u'611W3\~~.'5;;~: ("::,:'.':J :1:-~5'a;o ;8lfl'~O} Jaq~~fJ a1:IGI ,'(i'~)e:' (;~!;) ;e;<;j>J) '.IZ,;118:l e'Lll BUJlIe:J Afj 9&;lli elli jQ gq:;loo U!BNO I\\1W_ ~o--^ .'9~q~ "fiJiNJ96 !1'jO bj6noJlJI 0 WOo ~O()'(l~6li\t9 ~! lijJ&j las gill ~lllnJ as041 'Ja1U00 UO!leD!~!I~t'l .,.....- .......;:<..,.-=> ...,. (,.. '''''''''~I''\r''\e C~"H"'.I MnllnJ 'lrR5K~iJ~~b~-JM;;I-\jor:iaJ6 :Noij,t~>i.Jiv 'OOI\:l3d AVO DB l ANV tJO:l 03NOONV8V SI tJO 03JN3l11JlIIJOJ ION SIIIlllJtJ3d SIHI tJ30Nn 03ZltJOHInV )ltJOM 3HI :II 3tJldX3 llVHS IllllJtJ3d SIHI :33110N Page 1 of 3 s~~~~~ ~~ ~ 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~ ~~ ~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 . t~~_,,~' ..'Y:' :~:"'T~":',>", -"~.~r~t~_-..," ': Electrical Review 06114/2011 06/14/2011 Comments: Over the counter permit 06Ti4noh Reviewer Chris Carpenter C'_"_ ...,......'~"" "...~. , ....."t."'1J'.-.-~'~~'-----., ,,;I~~~~d"'~Li';,':,~<~'.," ..~Ch_n~,qar~e~!~r ',.' ~,'<~". 1 ';" '.:"'" >,;,,, 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