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Home My WebLink AboutPermit Electrical 2004-7-14 , . . ~ ~PRINGFIELD ~dill" ~~~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: ![~Z26-3689 0- ELECTRICAL PERMIT APPLICATION G-0o",. ~~-? City Job NumberO:>U\~- eo~ ~~ Date ' 7.... r:l ,..... {)L! ~\90' ~ & ~9 1. ~':tlfi@, Inn"',,,. 8RS ~~ers~ 3. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 LEGAL DESCRIPTION l'l 0 ~~"S l \ 00 t <::> C , JOB DESCRIPTION :C'^~~ l \. ~~W IN\e.-J...er Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. i B. Electrical Contractor SlX\Se. -t r=Cec--\-.f'Z<... ~ Address <;G(iCCo SeCI(Y'fl" Lf p/ City Lu) €Y1e Phone 31._) -'--Ilr3 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only / $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 jp 3 I!!!!- Supervisor License Number <I) rt?o\; '\-\)~~'\ c. , ~<v ~ ~\) Expiration Date / () - oL( ~ ~ '\ ..\'\ {;:> ~ Installation, Alteration or Relocation iS~v'X<v"(-..'&,~ ~~ 200 Amps or less Constr. Contr. Number /~f;.r!J\~S ~<J~ 201 Amps to 400 Amps ".,5".. ~6. CO ~<v"(-.. ~~'?-~ 401 Amps to 600 Amps Expiration Date .c.~~~\~ _ \S "'_ ~..- x:.", "<.,.'V \)'0 ':-..C\:)\)' Over 600 Amps or 1000 Volts ,\~. .. G~ D IWlS an~v . ..: ~ ~~. ~\) <v '____- New ~Ite~ation ~~-a~~~~~1'~~, \..s.eo~e ~ _ ____ One C1rcUJh~'O o~,e '\.'(\o~ o~Cb~ \~<::t~ $00' L/~ Each A~'t,'d~~r~t o~\\Ut~ R,e? [(\~:'" o~,c, Owners Name 0'E.~ uJ 'B~~c{l se~~~~~~6~~~~~ c,0 0\'1~'~,\ ~ D.~.3.00 OJA-O -l-\:G--9'( O$~ ~ E. . t:;? 1\ /1' ( '") ^ 1-. .("'V""':'I . 0 ~O '\(\e [(\e \' City I;:--vG..J7ftL PhoneV\ L.- -U(O~ Pump~&1gati\l~ 'o'\~ ~\c;, S'gnJO N. -~~tm'\ ^,e t ul1m~t10,.,---g0e\' Limited Ene$lResidential Limited Energy/Commercial ~1, ,qp Address OWNER INST ALLA TlON $ 50.00 $ 50.00 $ 25.00 $ 45.00 The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: 4. 7% State Surcharge 10% Administrative Fee o ~ .Ef2> Li- . <o""L \ ro.f,O ~ .., l .. -Z "Z-- Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03,doc Status Issued CITY OF SPRINGFIELD' Building/Combination Perinit PERMIT NO: COM2004-00880 ISSUED: 07/14/2004 APPLIED: 07/14/2004 EXPIRES: 01114/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 885 ANDERSON LN ASSESSOR'S PARCEL NO.: 1703331100701 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Install new meter. Owner: VERN W BENSON Address: 940 HWY 99 N EUGENE OR 97402 Phone Number: 541-912-0600 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor SUNSET ELECTRIC INC License 158859 Expiration Date 02/27/2006 Phone 541-915-4883 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stor~: , Lot Size: Heig~t\9't'st.[ucture Sq Ft 1st Floor: T~ bf ~t: Sq Ft 2nd Floor: ~Wa~er,,!~-{l.e: Sq Ft Basement: ~x, ~~~ l)'pe: Sq Ft Garage/Carport ~ ~ ~~~y Path: Sq Ft Other: ~\., 0. ",,'?- ~rinkled Building: n/a. Occup~\~ad: rY\ -(..'\' . <?- 'oJ. d~ .'<' ~,~~~$ ~ ~~~l~~LOPMENT INFORMATION I #qj~o~_~';'O~'>" ~ "'-,~ c.. ~<<; o.~<<; c'J \SoW' ~\~ O\~ ~~~~~D PARKING ~?,W~~, ~~~~~0 '<..: ':0'\'(,' ~ 0..... 'J~ Overlay Dist: o~ ~ ~ \~ O\T~F. ~o~. Q~ ~ \.)~:...CO~ # Street Trees Rqd: O\0~ 00'0 Q?0 ~~ (jIr.~~J})~: \) ~ Paved Drive Rqd: O~. oo~~ '\~ ~o R,,0? ~;'aa~l~ ~ % of Lot Coverage: ~~ ~ ~ ~0\'~...'>. ~ cP ~0' .~'I\:\ ~~. ~~ \.s0~v0~...~ ~\.~ ~o ~'0~ a;~ ~ -:~ .',{'i ~ \ 0 q.... A9, O,Oj I PUBLIC IMPROVEMJl}~~ ~~~ ~'<> v0~~ O",<Q~co\j.J "L _ Ut':.. ~O 'is'0 ~ .~ .~ ~'>' .~e~1k~pe: ~G ~ ~ 'IQ~ . (:I :o..)-~n~outS/Drains: ~ R-3 VN Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2004-00880 ISSUED: 07/14/2004 APPLIED: 07/14/2004 EXPIRES: 01114/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line ~Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $6.60 $4.62 $3.00 $63.00 7/14/04 7/14/04 7/14/04 7/14/04 Receipt Number 2200400000000000927 2200400000000000927 2200400000000000927 2200400000000000927 Total Amount Paid $77.22 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. I Reouired Insoections , Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I stat~ 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 c~ny that ntractors and employees who are in compliance with ORS 701.005 will be used on this project. I further,'gre 0 en re th 1 required inspections are requested at the proper time, that each address is readable from the street, tlia~Jlie p it ca s'located at the front of the prop.erty, and the approved set of plans will remain on the site at all times dJrin ru ./ );. //1 1j-(?(-oL( O~~C~iSig~ature Date Paee 2 of2 . 225 Fifth Street Springfield, Oregon 97477 541~726-3759 Phone Job/Journal Number COM2004-00880 COM2004-00880 COM2004-00880 COM2004-00880 Payments: Type of Payment Check 7/14/2004 RECEIPT #: ""~ty of Springfield Official Receipt ~velopment Services Department Public Works Department 2200400000000000927 Date: 07/14/2004 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + lO% Administrative Fee Paid By SUNSET ELECTRIC, INC. Item Total: Check Number Authorization Received By Batch Number Number How Received Jmp 1028 In Person Payment Total: Page 1 of 1 2:05:23PM Amount Due 63.00 3.00 4.62 6.60 $77.22 Amount Paid $77.22 $77.22