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Home My WebLink AboutPermit Electrical 2007-11-8 _/ SPRINGFIEI.D ZON (\ ~ INITIALS'Th ., DATE ~'~:.rl SOURCE ~ ~~ Date II... ff-tJ 7 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATIO)V City Job Number CO~ ZOO 7- C) I b Jb $ 63.00 $ 75.00 $125.00 $163.00 -. $375.00 -"-~. $'50.00-50:.00 ~ c. 'C~ . "'~:-1Il!uIres ~1lI Instafht_~tGf.~' Oregon UtI,,,, 200 ~jJ_:Of<<JfO~lI.~ Constr. Contr. Number /03'-170 201 A~<!9W-~~88atJben~~ Expiration Date 3 -/~-ZOtf 401~~DSo,.;g~~the~p ()~eT6~o~m~tI01~~ Signature of Supervising Electrician D. i Branch Circuits ~(/J /)../' _ New Alteration or Extension Per Panel >? J~ K~ t..D One Circuit - ( ~ ! ~ f Each Additional Circuit or with /_A .A ./t 1.1 ~.::;::LcServiceorFeederPermit Owners Name lYr n., vnA.f ..-,(1.. "-J Address 110 'W/Y C(~ bILE. Miscellaneous (Service/feeder not included) -Each Installation City C~ tV J olf Phone Pump or irrigation $ 50.00 Sign/Outline Lighting / $ 50.00 Limited EnergyIResidential $ 25.00 ~onG.~ Energy/Commercial $ 45.00 Mhll~~IIfMWSPf~'t'X~Rf!1' Yn!~fWt+ Surcharges AtWT~mAIJDmMSJPERMIT 'S NOr r ) ~NOvMMo~M~OCDftl~ABANDONED FOR tfl/cJ MM)~~OC;ee rS'"'~ 5% Technology Fee 27,r - 67br 1. LOCATION OF INSTALLATION: 3. ~ ~1J-lL, ~I j-~ ~.fi~b LEGAL DESCRIPTION: A. /70S zzoa 02..300 JOB DESCRIPTION: ~(j~ L,(1.5rf,v'td. $6;/11 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ., 1\.. , CONTRACTOR INSTALLATI0NONLyh 2. Electrical Contractor E.s f 19 ~1tIS' Address /2J 0 ~I?d. City ~~If}~ Phone 'Ie.s= S' ~ tf (0 Supervisor License Number . SIt.{, ~iS; _ ' Expiration Date . ?- /-Zo08 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: i}d~~ Inspection Request: 726-3769 COMPLETE FEE SCHEDULE BELOW New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manllfact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B.Servlcesr~r Feedets..;;i"IhstalIation;'1\lterations or Relocation: .-~~_.. ... ~~--~..~._-- 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only ... $ 43.00 $ 3.00 ~L. TOTAL Shared Orive(T:)lBuilding Forms/Electrical Permit Application 8-06.doc Status Issued CITY OF SPRINLl1lELD Building/Combination Per.mit , PERMIT NO: COM2007-01656 ISSUED: 11/08/2007 APPLIED: 11/08/2007 EXPIRES: 05/08/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3000 GA TEW A Y ST SPACE 206 ASSESSOR'S PARCEL NO.: 1703220002300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Sign lighting for Activate AT&T Wireless Owner: GA TEW A Y MALL P ARTNERS- Address: 110 N WACKER DR BSC 3-04 ATTN PROP TAX ADMIN CHICAGO IL 60606 Contractor Type Electrical ATTE follow rules adopted by the Oregon Utility Contractof.1otification Center. Those rules arelsbttmfiil E S & A SIW't1A~~B2-001-0010through OAR ~00)1. 0090. y s OJ callin e number for t~e OJe.99n Utility Notification Cent q~ ~t.!ff~-~32-2344). eight of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 03/16/2009 Phone 541-485-5546 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: I\~J'tft:Coverage: --. T~!S PERMIT .~"M', ~{r/~;- PU VR~Q . - -d ISr~~~~~%"ORK ANy 180 DAY PERIO ABANDOliJl!lJ~~~l D. Downspouts/Drains: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01656 ISSUED: 11/08/2007 APPLIED: 11/08/2007 EXPIRES: 05/0812008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Sign - Outline Lighting Each Amount Paid Date Paid Receipt Number $5.50 11/8/07 2200700000000001689 $2.75 11/8/07 2200700000000001689 $4.40 11/8/07 2200700000000001689 $55.00 11/8/07 2200700000000001689 Total Amount Paid $67.65 Plan Reviews' 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. I Reouired Insoections I Sign Electrical: After connection is made but prior to energizing 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. d~f--641flu CLt I/G~f- YJ 7 Ow';;r or contract;:;~nature Date Paee 2 of 2 225 Fifth Street Springfie,ld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01656 COM2007-01656 COM2007-01656 COM2007-01656 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: Description Sign - Outline Lighting Each + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By E S AND A City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001689 Date: 11/08/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 008937 In Person Payment Total: Page I of I 11 :56: 11AM Amount Due 55.00 2.75 4.40 5,50 $67.65 Amount Paid $67,65 $67.65 11/8/2007