HomeMy WebLinkAboutPermit Electrical 2007-10-1
. EC 0063
.. Job Number~-o1J ff.1?
ELECTRICAL PERMIT - CONTR~R
INSPECTION LINE: 726-3769
City of Springfield
225 Fifth Street
Springfield, OR 97477
[I Job Addre..'+7 ( Jt
ownersName:Lf')(' MS3ibL-r Date:e'-30~~
Description of Work: :z.. -lJea-lf'A L't/l.cLiJ"\
"'
Fax Line
Electrical Inspector
General information
541-726-3676
541-726-3663
541-726,3759
COMMERCIAL CI RESIOENTIAL CI INDUSTRIAL CI PUBliC CI
~ Electrical Contractor: -~)i~~ ,-
Supervising Electrician Signature: t , ~ ~ u/,. L
Supervisors License#: ~qt)- S EXPires:/t?~/- C> 7
Construction Contractors Board #: 12.91 fJ Expires: ~r?-. J(j{'f}
THIS PERMIT IS NOT VALID UNTIL SECTIONS I & 2 ABOVE HAVE
BEEN COMPLETED AND SIGNED BY THE SUPERVISING
ELECTRICIAN PRIOR TO AN INSPECTION BEING REQUESTED
I INSPECTION TVPE
I TEMPORARY
I UNDERGROUND
UNOERSLAB
ROUGH
I SERVICE
I LOW VOLTAGE
I MANUF HOME SERVICE
1 MANUF HOME CONNECTION
1 SIGN
I
I
I FINAL
ApPROVAL DATE
INSPECTOR
_e.
.
.' CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01l88
ISSUED: 09/20/2005
APPLIED: 08/31/2005
EXPIRES: 03/20/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 421 A ST
ASSESSOR'S PARCEL NO.: 1703353105400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
Commercial
PROJECT DESCRIPTION: Add two Circuits
Owner: MCKENZIE RIVER MOTORS INC
Address: PO BOX 640
PLEASANT HILL OR 97455
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
BUILDERS ELECTRIC INC
License
4296
Expiration Date
12/10/2007
Phone
541-485-0922
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 GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
SDlar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
Description
Type of Construction
I PUBLIC IMPROVEMENTS I
ATTENTIO/Sidewalk Type:
" uregon law requires YD t
follow ruJe~ DliwnspoutsJDrains: U 0
"JoFf/cation Cent~~ - Th ~ Y ,..", ,VI egon Utility
~~~R~952'O_01-001O t~r~~~uh e~:~e9~~_60o~~
. ou may obtarn copies of the rules b
caltJ'1f'" thp f"'ont,.--.. '" I _ . .. y
. ' - .~. .. '.... lCIC'l-Jllune
I "u.. '-," for the Oregon U . . . .
Valuation Descrintion Ct. tlllty NotlflcatiDn
en er IS 1-800-332-2344),
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
Street Improvements:, ,.
:-cu dL.::
Storm Sewer A.':~il.:!~lfRi,'i1T SHALL EXP:RE IF THE WORK
SpeciallnstrucAl~~:rlORiZEO Ui~GtR THIS PERMIT IS NOT
CO,YIi,iENCED OR IS ABANDONED FOR
Ai;'Y 180 DAY PERIOD,
Notes:
~~,
Paee 1 of2
; I
.
. \.-11 l' OF ~t'KlNGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01188
ISSUED: 09/20/2005
APPLIED: 08/31/2005
EXPIRES: 03/20/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fp.p.~ P,llid J
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$4.60
$3.22
$43.00
$3.00
9/20/05
9/20/05
9/20/05
9/20/05
Receipt Number
2200500000000001301
2200500000000001301
2200500000000001301
2200500000000001301
Total Amount Paid
$53.82
I Plan Reviews I
To Request an inspection caU the 24 hour recording at 726-3769. AU 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.
l.Rp.I1nirp.d ~
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 2 of2
225,Fifth Street
" .
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-0 1188
COM2005-01188
COM2005-0 1188
COM2005-0 1188
Payments:
Type of Payment
Check
".
9/2012005
.
RECEIPT #:
.~
1IliL,
2200500000000001301
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
BUILDERS ELECTRIC
Received By
lIh
Page 1 of1
J;,j.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Date: 09/20/2005
Item Total:
(;heck Number Authorization
Batch Number Number How Received
92394 By Mail
Payment Total:
3:08:04PM
Amount Due
43,00
3,00
3,22
4.60
$53.82
Amount Paid
$53,82
$53.82