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Home My WebLink AboutPermit Electrical 2005-2-15 I .' .A ,-. ~ ~. , 225 FIFTH STREET. SPRINGFIELD, OR 97477 . 1'11:(541)726-3753 . FAX: (541)~6-36R1ho ~ % <;il ~"'Z. ELECTRICAL PERMIT APPLICA TION \ '; ~ ~o- ~ CityJobNumber CCW\'"t.--~-o$'"-OO ,g1 Date 2-/5'-0) ~ ~ <6~. <ll ~,~ <ll 0- ~ -:;.9- 3. COMl'LEl'EHm SCHE'ijp , ;1,O~ ~<l' ~ <ll~ 'C. ~,~ .... ~ '?:. c:<> <ll~, A. New Residential.,.. Singleor'M\ti~ 'am yper~~lingunit. %.~ Service Included c> ~ ~<ll 1000 sq, ft, or less ' 106.~~ Each additional 500 sq, ft, or \ <:(j, ~, portion thereof ~ f\) ~ Each Manufact'd Home or Modular Dwelling Service or $50,00 Feeder >;i\)....lt ~~;'~1 Tit 1. ,tOCA'110N OFl~Sl'ALLA.TION b'31 IvJ. LeV' +-cY'..... ~.,.<1-1 LEGAL DESCRIPTION 1703 'Z7Lf3 OS-KOS- JOB DESCRIPTION e&L-/t-CA= 5C1Lvl c..t!' Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. CONTRAf.il uR iNSTALLATION ONLY 2. ;" ".' ,''''i'',,,,.,,;'''' ''';' ',' ' ", ' Electrical Contractor &J\' \ clefS 6 t~-t riC 11l( 8. Services or Feeders -Installation, Alterations or Relocation: 200 Amps or less I $ 63.00 201 Amps to 400 Amps $ 75.00 Address ,g 5 MQChs () f\ 401 Amps to GOO Amps $125,00 , . A ~@ENJ;\Q~: \Q~~g..91'iP!,aW requires you ~ 163,00 Phone 485 - 09 Z~ fol~rp.@@'O)~~PY the Ore'gon Ud"t~tn5.oo NotJl..~tia~tCGmjer. Those rules are S81 fo~o,oo in OAR 952-001-0010 through OAR 952-001- Oggo.1'MwVi1I8lI).VQI1ot&leefi:OpiaQdli\he rules by calling the center. (Note: the telephone n~IVit9Mf1f~ntt~tvm~ro~litl}tM4ltification 200 A~~tees$1-800-332-2344). $ 50.00 20 I Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100,00 OveT 600 Amps or 1000 Volts see "B" above. D. Branch Circuits b] City lSVCj€ tie Supervisor License Number 3;1 Cf 0 .. S Expiration Date J 0 - /- 0") Constr. ContI'. Number 4;;;r::t (p Expiration Date I) - I 0 - D"I pervising Electrician L ), /' ____ New Alteration or Extension Per Panel -, One Circuit Each Additional Circuit or with ,,' '/ il ~l1lijrw~ ~rq;eeder Pennit $ 3.00 Owners Name Cc~tcr..-..'^.~( ShtYj,l"'-. CJjC ;" p lSRMI1SHALL EXPIRE IF THE WORK Address '/ g'''J I Se- s7'A(L. k:::... ) S~~ (OJ E. A~Htl~fl~~ rn~Dt~e/IfFMr P~fRMIQ~~r1ich InstnUation City ~(.e.-+t1tvL.- cL Phone 'PG.Q~Jh~~~~~ OR IS ABANDONED $ 50,00 S1k~tiifihb Dfg){t~~RIOD. $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 $ 43.00 OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fcc is $45.00 + Surcharges bY> lfL(( b'JO 737L 4. SUBl'Ol'AL OF ABOVE Owners Signature: 7% State Surcharge 10% Administrative Fee TOTAL Inspection Request: 726-3769 Shared Drive(T:)/Building Fonns/Eleetrieal Permit Application I-03,doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00183 ISSUED: 02/16/2005 APPLIED: 02/15/2005 EXPIRES: 08/16/2005 VALUE: 225 Fifth Street; Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 631 W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703274305805 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Replace service Owner: Address: CENTENNIAL SHOPPING CNTR LLC 7831 SE STARK ST STE 103 PORTLAND OR 97215 ' Contractor Type Electrical I CONTRACTOR INFORMAllUl~ I 'res you to ' , ATTENTIOf:l: ure\:jUII 1(;4 requ~ pn \Jtiliti . Contractor follow ~ule$ adcfpree\B'e th~~lR/~~tWR>Nflte Phone BUILDERS ELECTRIC INC "I()tific_atl~~ C~~~~~~~~~...Jf. ";^ ~~t. 541-485-0922 BUlLDIJll'6.fNF~kfI&~ copies of the rules by ou~u. lUU ......1 II te' the telephone # of Stod&Yng the center. (~~ Utility ~~on Height pt)Sbf.uij'tf9~ the, Creg o-332-2~.t lstFloor: Type of Heat: Center IS 1-80 ~-Sq 'I?t 2nd Floor: Water Type: Sq Ft Basement: Range Type: , Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION. REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: %i~mo.t3fp'yerage: , EXPIRE IF1HE WORK _ . , lH\S PER~\~ ~~~~~IHIS PERM\1IS NOl ' I PUBLICfyMi~OVEUEN;i~ ~ ABANDONtU run - ()~. .'XlIl""'V., , \ .,:::.~ ANY"180 DAY PERIOD. Sidewalk Type: Downspouts/Drains: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instr,u~tion: , Notes: I Valuation Descriotion I Description . Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page l'of 2 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 + 7% State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid 'Total Value of Project L.,Fees Paid I Amount Paid Date Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00183 ISSUED: 02/16/2005 APPLIED: 02/15/2005 EXPIRES: 08/16/2005 VALUE: Receipt Number 1200500000000000205 1200500000000000205 1200500000000000205 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. $6.30 $4.41 $63.00 2/16/05 2/16/05 2/16/05 ElectricService: Approval required prior to utility company energizing service. $73.71 I Plan Reviews, LReouired Insoections I , , 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 th~ 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 ~ ,1 ' Pa2e 2 of2 Date " ' 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt lelopment Services Department Public Works Department Job/Journal Number COM2005-00 183 COM2005-00183 COM2005-00 183 Payments: Type of Payment CreditCard 2/1612005 RECEIPT #: 1200500000000000205 Date: 02/16/2005 Description + 7% State Surcharge + 10% Administrative Fee Perm ServlFdr 200 amps or less Paid By VIRGIL LOV ALL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 069157 In Person Payment Total: Page I of I 7:48:14AM Amount Due 4.41 6.30 63.00 $73.71 Amount Paid $73.71 $73.71