HomeMy WebLinkAboutPermit Electrical 2007-11-1
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225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number C.Ot..-V\ z..c~ (- 0 I h 2 gr
1.
CQte 7::l??m t :5 5'/0
LEGAL DESCRIPTION:
17 OJ 2'2- 2-0
ralewa'1- Sf
,
61700
JOB DESCRIPTION:
~:;;:..~ ::n~!:r:'b;':;~~~:
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor )e [' ure kth / Son,'fro/
Address ,;..&c; f€rn4;/! Loo,lfJ
City s;" r " fit" 1: e lel.. Phone So? / - ;;;8 J' 7
tI
Supervisor License Number '5 (fC;s LEA
Expiration Date Jojo/ /;; [)Of
I S 6~ I g
Constr, Contr. Number -:l 1;) if?/; cL /3.
Expiration Date '% / <l / () q
I F
Signature of Supervising Electrician
~~d
Owners Name j( C5h &-eI h-u:l h
Address h ;;8 6 Feri,,- / / {.DO/J
City ~jJr,"",~ p, e/J Phone S-,) I ~;28f7
,
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Date NOli \)"'1mJ\
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.
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN oIts
Reconnect Only
$ 70.00
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
C'ii
Notification C ' ed by the 0 u 0
in ~~8!t~e;~~erlilia8roJtAt4~OOJltility
OO~QcY%\'Ii' ;-2 ~ through OAR 9 set fO.rth $ 55.00
ca '.l"~umam co . fi2-00~
nu m~~~t}fi trroB~~es of the rufe~ '* $ 76.00
40 r'1Rt~ ~_fJiif~~yeNte/~Phone $11 0.00
C8ffler IS 1-80/'L!;l.0 otlTlc~ti
Over 600 Am s or-ro~ "B Rn,ve.
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
E.
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
NO Limited Energy/Residential $ 28.00
I TI~:ted Energy/Commercial / $ 50.00 5' 0
A~t~i~~&M1tI~ r . i n Fee is $50.00 + Surcharges
C~ ~o
ANY 1 &l[or{) e l(
10~J S'
'7f"O
6 u;?-
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application 7-07,doc
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01628
ISSUED: 11/01/2007
APPLIED: 11/01/2007
EXPIRES: 05/0112008
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3340 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 1703222001900
SPRINGFIE TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Low voltage security alarm system
TYPE OF USE: New
Commercial
Overlay Dist:
# Street Tree,s Rqd:
Paved Drive Rqd:
% of Lot Coverage:
,'_' ~r.. _. tr,Q~ \f 1\\t ~?l~~
NU' iU~_' , _.~ ~' ;;i~l)\\) \Ii....
\\\6 p~f\wnLIU !IE-No'!' OR
\U1\\OR\7.t.\J uOo \S ~B~\\\ U\''le Sidewalk Type:
I\nE\\\CEO n
COWh'l' . ~'{ PER\O\).
AN\{ ;80 \) ,
Owner: 3346 GA TEW A Y LLC
Address: 840 BEL TLINE RD STE 202
SPRINGFIELD OR 97477
Contractor Type
Low Voltage Electrical
I CONTRACTOR INFORMATION I
quireS you to
Contra~WENTION: Oregon law hre Oregon UtM~ense
SECU~\f8*ful~dopte.9 ~~~ r~llo~ are set ilStitu8
NotificatIon ~ I t'\L. - - . ~n I'~
. OAR 952- - VlN~1I1W91R ~Q
In btam COpl~;:' v ·
0090. You may 0 . the telephone
calling the centt!rof~~~~.. '~otiiication
number tor the. QI~~?_ ~~\')~:
Center ,sry~ ~ .
Water Type:
Range Type:
Energy Path:
Sprinkled Building: '
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
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
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Paee 1 of2
Expiration Date
08/0812009
Phone
541-521-2837
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Downspouts/Drains:
Value
Date Calculated
CITY OF SPRINGFIELD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-01628
ISSUED: 11/01/2007
APPLIED: 11/0112007
EXPIRES: 05/01/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
Date Paid
Receipt Number
$5.00
$2.50
$4.00
$50.00
11/1/07
11/1/07
11/1/07
11/1/07
2200700000000001656
2200700000000001656
2200700000000001656
2200700000000001656
Total Amount Paid
$61.50
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.
Reouired Insnections 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 construction.
Owner or Contractors Signature
Date
Pal!e 2 of 2
225 Fifth Street
Springfidd, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-0l628
COM2007-0 1628
COM2007-0l628
COM2007-0 1628
Payments:
Type of Payment
CreditCard
cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200700000000001656
Date: 1110112007
8:39:20AM
Description
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Amount Due
50.00
2.50
4.00
5.00
$61.50
Paid By
SECURETECH INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 001705 In Person
Payment Total:
$61.50
$61.50
Amount Paid
Page I of I
11/1/2007