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Home My WebLink AboutPermit Electrical 2004-3-2 . FAX: ,'P:\<l \~iOOmoject as submiUed has the following \!'on\~b~1!lf'cr~6es not require specific land use approval. t9 :3 0 I 0 L( Zoning ID(2. "",',',....,.N'-""~,. ".,' ,,,,,,,,PJl).':::"'~J_,,.._,,_,~,,-,,~:~o,lf,?~,, "~,' 3. ~,COMPEETErFEE',<;:m-TF.nrJT.E'RProw,r-",iti'c'",'~ 'iIc)ii;",; ."""",,,,,,...,,,,,,"""'.ili.,,,,,.T\il1Tlilmaa1i:>IlJ09.1Olir'" "","I"-.,~, ..".","",.l"" 225 FIFfH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PERMIT APPLICATION City Job Number LDM'ZD04 -OOl33 Date 1. 'f!ftiJOCATION!OR-iNST'Ar.T!A'jroN':'!'#i'~ :Z:;~'W.iill".4.~",.0;:l\:..':.'"it~~Ao.;.~Ji"""';t:::;-J.t;;'Ii"'ill\"f~%t'.. }~~ <6/1 IZI" E-tL. Ic.......~ tI LEGAL DESCRIPTION 170"323lf3 JOB DESCRIPTION" II.')c:'O leU "bl~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. W, ,r.CO~Tit4croR,~~iNs,iAE~o:&1ONEy/t 2. ~~~~;r,...}<,~~ -;";'7g..,..r.~;~'<'f,:~i;;;,. ....,';~",...'-:d Electrical Contractor llil Qx~ ; C,;, d..f:;:leckM: c.S Address P \) (2,7>)<.... '-f 0 S c.f? City ~ddA., C,7<-/D<! Phone L/'l,-/-q()7r; Supervisor License Number ~ 5\- Co 3, L 6 A- Expiration Date I 0 ) ( loS Constr. Contr. Number 1<14 (nP' 5 Expiration Date 6:J / ()...~ / /)1.{ Signature of Supervising Electrician ~<.\-iV~..........-I' ~ / ~'^ -k,. .e.l:- ~ Address ?o gOt<7Lf 2 '5:' ./-h IYI t:S Owners Name City t::lA.~E Phone OWNER INSTALLATION The installation is being made on y' ~Y-';J I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A i:t~~N-'"'~~~;b-;~r~~t"'~I:;>-~~S- -"j~~I~V&-~~I--::~I'ti~E~'~riiil'~?,=-*j,;-:K~j~d~I'lif(;i;1~~;' ..~, eW\J.,-eslucn In .~. ffia c;oril"_ u - ~a "per, ,,"'e na. umt.~~j-t ~l...~.:;;~~-)J~~~,~"",.!:.~,,:,,;;- ",......-,.~--,~,...~~~~'li_,;<!.~t.~ Service Included 1000 sq, ft or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19.00 $50.00 p "_ -k~~~ 'lo?;''l~;'':;';:;1.e~q.~~-<,-~'',-,~~~7:'-'i'1;~J~,''-':&~~ B. ~~~~~9ttf<<~[~~Nt~~~J:~~tl;,~~~~~Ii~~~t~-~~~ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN oilS Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 '["+""~'r4"r.:J~"'" i~.;.!'~l'~Vf",,~J...,,;,,".mr.~' ';~"'~J;;',,-;r,.; "1fr,..i!fj~-- . J ~~:-:'-fJ c. :.:Temnorarvt.Ser:vlces orjFeeiler~~~.~>~~!;..",iK:t:~~"", '.Ai;!... '~4.'l';j./~:J, c::.~K,.r^~.-,:-,J'-.l.*"""........t,...,,.~-~, . ~:!;;,:. -...... '-'i~"~"" . Installation, Alteration or Relocation 200 Amps or less $ 50,00 20 I Amps to 400 Amps $ 69,00 401 Amps to 600 Amps' _,,..es'S'f/JQ'aQ, "Ia'l'l ,~..,. \Jtlllt, o~zr,=I1~~Q9,~;V:::~~~:;~~',< ",,' , " D. itB~CIfCIrC'ilt.i--"ln"'~"lt., , "'iII:a~\~,t\i"j~"~"i"'" j - '-o~';3~~.;~Y;f. - " ..(\",\;'ef~I-~~ .;<"",",__~,..,:'1 NeJ terat\On10r'E'ilension.peflPanelol,"e r\llaS ~e'\lI""" O,.vv'- '95 \" e One 5cuit; 952-0 obtain COpl ,~~ ",\$1~~1!i6' - Eacii'k~~tion8lIG:rrffi'it or,/lf.itlil'lO\'=', 'I"\~ l'lotilicatv.. SeJ'V1~\(;r liee~etlRemft{" . ~Of' uti \., 4$)3,00 ca\IIiT'" ' n1:.\n9 ore" ",,_,'\?'2.:~--: ~ . '~ tk:~'-;.'r":~~fP'\h~~!:;'%<iJ'~~~~-'~- _~- .~/~"' l..<o..!~li'~'''-~~~"':;.''~ E. (~Mi!S.~1l~!'!9J1S.;l~~Q'i{i1f€e]eJ;:.!1.?!,~clu2~d)2i:~~~,~Jptt~!!~!jil.!!.ti Pump or irrigation Sign/Outline Lighting Limited Energy/Residential $ 50,00 $ 50,00 $ 25.00 2) / Limiw\h~.;commerciaIF:l" i\~~V Min~um_ ~l'\ffr~!mM\1t RH~1~~ 1S'w~l\arges 4. ~~l}Uf;\", ,..Q ,B B.,\t~'J~,k, '''W;,,'?'iii','~!!~f:OR I J )- V~-~" ~~'Q~~loI~~t.~~,,_J!~;"'i:~it'~~~')I.~ -, H~ 11ln DAY Pt~IUU. /'j \t:.. 7% S tl!rl! 'b'url:Ilil'rge .:>. to } 4~ 1 5ib' 10% Administrative Fee TOTAL Shared Dlive(T:)/Building FonnslElectrical Permit Application 1.03.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00233 ISSUED: 03/01/2004 APPLIED: 03/01/2004 EXPIRES: 09/01/2004 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 81 I River Knoll Way ASSESSOR'S PARCEL NO.: 1703234311500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Low voltage '. Owner: FUTURE B INC Address: PO BOX 7425 EUGENE OR 97401 Phone Number: 541-744-2660 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DIVERSIFIED ELECTRONICS INC License 144685 Expiration Date 06/23/2004 Phone 541-484-9078 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 SETBACKS I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: aU to # Street Trees Rqd: n laW reQHa~lj;~ap'nfl!:1 P d D' R d ",.Qrego C"-J"C,,n "n " ave rIve q: E.1'.rnQ,~. db" the ,,-ompact:t tort ~TT dopte' \ s are se % of Lot Cov~'(~WS:.N ru\e'h~nter. ,hose r\eO~f\ 952-00' "otilicati,:~ "n1-00~ 0 thro~:~" 01 the ru\lls_ t I PUBLIC IMPROVEMt~T-S;~ maY obta\l ~~~;:e', the te\et,~;~;t\~n - ! . the r.enter. I jt\li\V No \ calling Sidewalk>!rYpe: 2 2344) ber lortll" ~ ~ - sinn-33 . ' num ~ _ .oowiispoutslDrains: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction I iJllTICE: Valuation Descrintioo:.1jjs PERMIT SHALL EXPIRE IF THE WORK $ Per Sq Ft SquarJilJ!IiQ~IZED UNDER THIS PERMIT IS NOT or multiplier or Bid 1iQ.MM~NCED OR f.gIMlANDON!IDl&G:lalculated ANY 180 DAY PERIOD, Total Value of Project Paeelof2 . . CITY 01< ~nUl~ljN~L1J Building/Combination Permit PERMIT NO: COM2004-00233 ISSUED: 03/0112004 APPLIED: 03/0112004 EXPIRES: 09/0112004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L.Ff'f'S P,llirlJ Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Residential Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $4.50 $3.15 $25.00 $20.00 3/1104 3/1104 3/1104 3/1104 1200400000000000257 1200400000000000257 1200400000000000257 1200400000000000257 Total Amount Paid $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. ~f'rl Tnsof'rtinnsJ I 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 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 constructio.n. Owner or Contractors Signature Date Pa!!e 2 of2 225 Fifth Street -; Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00233 COM2004-00233 COM2004-00233 COM2004-00233 Payments: Type or Payment CreditCard ""~"""~""-""",", ..1., WiE" ; i i:""' ... . j . ,oj, ..."......' ..... Receipt #: 1200400000000000257 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Residential Minimum! Adjustment Electrical Received By djb L'heck Number Batch Number Authorization Number Paid By ALLAN WOOSTER 000310 001343 City of Springfield Official Receipt>' Development Services Department Public Works Department Date: 03/01/2004 1:08:27PM Amount Paid 3.15 4.50 25.00 20.00 $52.65 Item Total: How Received In Person Payment Total: Amount Paid $52,65 $52.65 . .