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Home My WebLink AboutPermit Electrical 2007-10-5 .-;:-~ ~ ZON vY\U{' / ~ INITIALS I\J M ., DATE \0--\0 ~ 0--"1 SOURCE '(Y\;\JS prz... Date \D-S-D\ ~~,' ~....J:...:,~';?I-I'<crl-li1:i"''''''''ij'''~I';.~">~;~''.''_.'~''!-:. ;'"'4;;" .,iT," ~~ ":.; '"....~ ,,~.,: ~...... ,!>4'. ;~~ ,o~::~:~:z.: :"~~J"~'f9R~,$.R~:OIili~lQWE(JON ,;,,: ./':< ~ "", ~,.l.",_1F. ..'t~_~ ...,'<"/I'~,~""-'."c,,~'".'}.~ ,1":rf. ...",_~>-~,'l". "'l'" .J;,.c:~ p. .,l , '" ~ ' "'. .,. E... ~ >:. '... .""", ~.,. ,. ... >' ~ ~ ..., ~ ~ ~. . ~ 225 FIFTH STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICLAL PE~IT APPLIC~TION City Job Numbe~Ltml "' 0\53 l LEGAL DESCRlPTION: \ "l O~ ~S 5 \ o35cs-o JOB DESCRlPTIO~: <.Vf~ ~ ~s.ta\\ u.ir\~~r- ~\ ~~ Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if. work~l Modular~~i~t;tQOn law requIres you to Suspended for 180 days. ~ \j ~ ~ ~\.oJv" Feeder ~~~~~;~~~:~~~~e~h~~~:J~~~~~~~~rh , 2. CONTRACTOR INSTALLATION ONLY B. Servt"OOtfOO~OO-HO~1to.ahoo.~iR..QMQ~2r~l'Jcation: .' '.. 0090. You may obtain copies of the rules by Electrical Contractor KeJ z.~ B~~-tt-:, ~ ~. 200 Amp~a~ the center. (Note: the t~ej6~e 201 Ampsu.tmloerAIi\IP!he. Oregon ulIIny i-.j~tg~'?6tliulI Address ~D ~ \'2..q.~ 401 Amps to 600 ~\,er IS 1.800~332-234'M'38.00 601 Amps to 1000 Amps $180.00 ovnKt~psNOlts $413.00 ReTH1S PE~MIT SHAll EXPIRE IF TIl~#&~K c. ~fljJ:t~~Q~ielhY~ PERMIT IS N()T COMMENCED OR IS-ABANDONED FOR - InsAtVVtip8(}\ID:ftNt~location 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 6.00 ~ps or ~OOO Volts see "!3" above. , ~~' ture of supervising,. .Ele. ctric~an D. Branch Circuits .j~ New Alteration or Extension Per Panel " "ffua6 J<.../J;Y"J)( One Circuit \ (j ,. OJ._ Each Additional Circuit or with I '^ n ,fl_ 1 r _ , ~ice or Feeder Permit OwnersNamel@juvUl1fYlrA OJ ~(Y\eA\5 Addre~t\ q E BI2!Yl ril ^V1~ ~6k~' Miscellaneous (Service/feeder not included) -Each Installation . City~/J ) (1fJ) Phone Pump or irrigation $ 55.00 - I 7' Sign/Outline Lighting $ 55.00 OWNER STALLATION Limited EnergylResidential $ 28.00 The installation is being made on property I own which Limited Energy/Commercial \ $ 50.00 50 . C:() is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 1. LOCATION OF INSTALLATION: \.g4tt A~~e1:. - D~' City ~a\~. tQ. Phone SD~-~\e-D'2Jo" Supervisor License Number ZB4-~ s Expiration Date \t)-\-\D Constr. Contr. Number 2S~~ Expiration Date C~ -'2. Sa - ~ Owners Signature: Inspection Request: 726-3769 3. COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof . $117.00 $ 21.00 $ 55,00 $ 76.00 $110.00 $ 48.00 % .C::O 4. C:() $ 4.00 4. SUBTOTAL OF ABOVE \ D2.r::J::J B. \to \ 0 .'2..\J S.\C 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL \ 2..1ii. "\\0 . Shared Drive(T:)/Building FormslElectIical Permit Application 7-07,doc Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01531 ISSUED: 10/10/2007 APPLIED: 10/10/2007 EXPIRES: 04110/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 644 A ST ASSESSOR'S PARCEL NO.: 1703353103500 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Install receptacleslInstall wiring for lenel system, Fire Alarm System, and circuit on ground floor near stairwell. Owner: THORP PURDY JEWETT ETAL PC Address: 1011 HARLOW RD #300 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor KEIZER ELECTRIC INC License 25359 Expiration Date 06/25/2008 Phone 503-378-0267 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKIN~ Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: , Storm Sewer Available: ", I c,mON: ~mrffW'':X~it:V Special Instruction: follow rules adopte Th Y e rules are set torth Notification Center. os hOAR 952-001- Notes: NOrICE: In OAR 952-001-~g~~~~:~~s ot the rules by TUl(\ n _ 0090. You ma~ _.. ""'ltA' the telephone ~r[m,'HT-5H;\ll ~1inE1F 'M'e-Wt;ltil\ ll'li/ ,,_~L . U.'lit NotdlOlWun AUTHORIZED UNDER THIS PERMI1 ion Descri WBtie for :hel~~~g~~k.~). COMMENCED OR IS ABANDONED fpp . en er Descr~~Xn 180 D~~.Pe~~truction erlt~ql~t Square Footage Value Date Calculated or mu Ip ler or Bid Amount Pa2e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 10% Administrative Fee + 5% Technology Fee + 5% Technology Fee + 8% State Surcharge + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus Minimum/Adjustment Electrical Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01531 ISSUED: 10/10/2007 APPLIED: 10110/2007 EXPIRES: 04/10/2008 VALUE: Total Value of Project ~ Amount Paid Date Paid Receipt Number $5.00 10/1 0/07 1200700000000001297 $10.20 10/10/07 3200700000000000673 $2.50 10/10/07 1200700000000001297 $5.10 10/10/07 3200700000000000673 $4.00 10/10/07 1200700000000001297 $8.16 10/10/07 3200700000000000673 $48.00 10/10/07 3200700000000000673 $48.00 10/10/07 1200700000000001297 $4.00 10/10/07 3200700000000000673 $50.00 10/10/07 3200700000000000673 $2.00 10/10/07 1200700000000001297 $186.96 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. L.JleouiredJnsnections I Rough Electric: Prior to Cover Final Electric: When aU electrical work is complete. Low Voltage: Prior to cover. Pa!!e 2 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01531 ISSUED: 10/10/2007 APPLIED: 10/10/2007 EXPIRES: 04110/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 Paee 3 of 3 225 Fifth.Street Spririgfield,Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0l53 1 COM2007-0l53 1 COM2007-0l53 1 COM2007-0l531 COM2007-0l53 1 COM2007-01531 Payments: Type of Payment Check cReceint I City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3200700000000000673 Date: 10/10/2007 10:01:31AM Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus + 5%'Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 48.00 4.00 50.00 5.10 8.16 10.20 $125.46 Paid By KEIZER ELECTRIC, INC. Item Total: Check Number Authorization .Received By Batch Number Number How Received Amount Paid njm 23352 By Mail Payment Total: $125.46 $125.46 Page 1 of 1 10/1 0/2007