HomeMy WebLinkAboutPermit Electrical 2007-10-23
ZON N\llu
INITIALS ~ 'Y'V'-
DATE\O -&,-\ -Cy,
SOURll;Bf\ r~f2-)
Date ..LtJ - ,2.~ -0 '?-
225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ~ z.o~ 7-0/ 5 7 (
1.
--1.f3I) 7 (;)Jfmf/(,) ~7<f.~7
LEGAL DESCRIPTION:
1703Z~31 ()7/00
JOB DESCRIPTION: 17c1t1i/)<:'L 1/ Netf;)
~O/} C"Ie.Cu/~ mostt'l,n'-!!)l.. CcJ)d-lt,~
ft.e.f/N/rtJ J.ishf f'/~(~ "t:.J?~~~r&JAS
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor
s: L o7r':j.<..
FI ~c .r/,;l.-
Address
Po gl')~ lib}
City
A l-/V i~ 0 P--
'117iJ !
Supervisor License Number
Expiration Date
Constr. Contr. Number
Expiration Date
o 7 - 0 '1 - z. 0 09
upervising Electrician
~
y / (~I~hJ.iY1v-l DeveLope fYlertf Co .
~ers Name 2. ;'C l...A-/A j l...,.-v.dA g <tce./'
Address ~()O !AJf?5f /If/., l'9l/e~ E.
City g'1t)B-ile ()L- Phone -"z.?J -1l7,'? I
I 17Lfol.. I
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
3.
A.
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
$117.00
$ 21.00
$55.00
B.
$ 70.00
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
Over 600 Amps or 1000 Volts see "B" above.
D.
$ 55.00
$ 76.00
$110.00
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
10
$ 48.00
$ 4.00
L..(s.n:.
~C~
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
ATTENTJO,qp~t8 WOO rur~s
Phone 5l(I-Lf 19- f9Jf$V' rUle8~W~~RM!). s you, ~o
NOtification ~K ' 'lM~ '~on UtIlity
In OAR 952-001-~ 0 t :fu/es are set forth
Ur -..., 0090. You ~a
I:") ~ ~ <; ~211ing the' .
number for the Drago e... e tel~~ho~e
/ D - 0 (- Z 0 , D Cent4P18"1~aj~'3~rbiablcation
200 Amps or fess ).
~ IS6 D6 L 201 Amps to 400 Amps
401 Amps to 600 Amps
NOTICE:
THiS PERMI~
AUTHORIZED UN~~ti*lmnf€fiiRMIT IS NOT
COMMENCED OR~SOA9~Nee '00
ANY 180 DAY PEF110l1.chnology Fee
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
Limited Energy/Residential $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
?5~
/0'(
~80
C( 'If.:>
log Z..1
Owners Signature:
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01579
ISSUED: 10/22/2007
APPLIED: 10/22/2007
EXPIRES: 04/24/2008
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1807 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703253107100
Springfield
TYPE OF WORK: Plumbing Only
PROJECT DESCRIPTION: Misc plumbing in existing restaurant
TYPE OF USE: Repair
Commercial
Owner: LANGAN ROSE MARIE
Address: PO BOX 1600 ATTN RASH #125-27-136
ROWLETT TX 75030
I CONTRACTOR INFORMATION.
Contractor Type
Electrical
Plumbing
Contractor License
SCOTTY'S ELECTRIC INC 156062
~1riX'+'~VrYMllWGn" tn 49561
follow rules adopted by the G' tJll9llLB~N(i; INFORMATION I
Notification Center. Those rule~ QI '" "C:1l IUI LlI
# of U~its: In OAR 952-001-001 0 thro~gh OAR i~Jries:
Primary occuggOO"'1 ~I~Y obtain caples of the &\P~f Structure:
Secondary occia'<<n".Qg ~gllrmnter. (Note:. ~he tel~ 61JEbf Heat:
. mOBt or me Oregon Utility Notl lOlL
Primary Const UCffO? ~er is 1-800-332-2344). a el'Type:
Secondary ConstructIOn ype: Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building:
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instructio~~~JnCE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
Pa!!:e 1 of 3
Expiration Date
07/09/2009
12/16/2008
Phone
541-382-6142
541-484-3787
n/a
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspoutsillrains:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Fixture
Miscellaneous Plumbing
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01579
ISSUED: 10/22/2007
APPLIED: 10/22/2007
EXPIRES: 04/24/2008
VALUE:
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
~
Amount Paid Date Paid Receipt Number
$8.20 10/22/07 1200700000000001329
$4.10 10/22/07 1200700000000001329
$6.56 10/22/07 1200700000000001329
$32.00 10/22/07 1200700000000001329
$50.00 10/22/07 1200700000000001329
$8.80 10/24/07 3200700000000000706
$4.40 10/24/07 3200700000000000706
$7.04 10/24/07 3200700000000000706
$48.00 10/24/07 3200700000000000706
$40.00 10/24/07 3200700000000000706
$209.10
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.
~eouire~nsnections I
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Pa!!:e 2 of 3
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-01579
ISSUED: 10/22/2007
APPLIED: 10/22/2007
EXPIRES: 04/24/2008
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
Pa!!:e 3 of 3
225 Fifth Street
Springfi~ld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01579
COM2007-01579
COM2007-01579
COM2007-01579
COM2007-01579
Payments:
Type of Payment
Check
cReceint I
RECEIPT #:
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
RlCHLlND DEVELOPMENT
CO
City of Springfield Official Receipt
Development Services Department
Public Works Department
3200700000000000706
Date: 10/24/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
DJB
5329
In Person
Payment Total:
Page I of 1
2:39:27PM
Amount Due
48.00
40,00
4.40
7,04
8,80
$108.24
Amount Paid
$108.24
$108.24
10/24/2007