HomeMy WebLinkAboutPermit Electrical 2007-11-16
SPRINGPIBLD iiiI ZON t..~
, " l,!& - INITIALS N f'1\
~ .AI.. DATE \\ ,-\fA '\\-'1
225 J'1J'Jd STREET 0 SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~." S?URCE~:q=-\,-:1)
ELECTRlCALPERMIT APPliCATION 1///2 ..,
City Job Number COW\ z...OC7 -6 I b ? J Date /'l/t{)?"
1. LOCATION OF .INSTALLATION: 3. COMPLETE FEE SCHEDULE BELOW'
3375 6{LUwCU1 sJ-. . ,
LEGAL DESCRIPTION: 17:6 S Z'Z. z.O 00 ?O( A. New Residential- Single or Multi~FaDljly per dwelling unit.
('~CJYl - J '^- Ck:HJ~ Fa 0 d/;. Service Included .
JOB DESCRIPTION: COt1n-ecJ- ~VI..J!)(JY 10oosq.ft.orless $117.00
" " - L ' ..Lr.. " ..1.: ~ n _ _ L _ ' AEach additional 500 sq. ft. or
U I ~S ~ Ot}0.s J u 0)(1 s, llU1 t:M.UYlCClfportion thereof $ 21.00
,.' ," Ji, ~;~'/,,' P,:l''1~i:.:j\~''ID!;:C'D;D~INTbr'IE?,T;;:K,~{:?\b'C'~i::'''r(:T;:::~:'',,"~ :""," :',
. ~~'J'" ,....~t~L~ '<t4,,?1''( .\2Jl' _ tD:t:i.~l'- :L,.,\:J.it: GJG'td ;~U:I~,U\:1t~;'f'" ~ .>'J' . tj"
~. ,..:, ~":'. :,1;).' r~ ~t>' ~'r'~~4~~.. i ~. ..' ~'~r.~\E?\:; ~"'.<'!' ~ r~1:I:31i"~T;~ :l/'r, f;."'} t~.: :'''''' .,:r:: '.i: :'u,,,', ~ r ~. \"\..~'~'\.~'-~, ::~,
Each Manufact'd Home or
Modular Dwelling SeIVice or $55.00
Feeder
ATTENTION: Ore
2. CONTRAl.:J. vR .INSTALLATION ONLY Nfo'~~ r&I~~a8p1:f8ragyA~ mogurr~o.lf6rations or Relocation:
, . Ottf/cat;on Cemer e regon Utility
Electrical Contractor C.A.S ~ $.{~ f- N ~R296~~ .qJ&tJ~~se rules are, set ,fOJ:th $ 70.00
0090. YQlI~~~~9h OAR 952-001. $ 83.00
Address Po B OX 7~<':' g cal/in4bth~;;;lt4mn.!es ofthe rures by $138.00
numb~iiM~':r~ n~. ''rol'e; the telepnooe
. . ut;'. ~nl'~@Q<<D&i1h'lmity Notifi~' $180.00
City S~t'V\1 O'Y\.Phone 503 -378'-OOJL ov~ B6dUj1)O~2~2344). CG:&IUQ $413.00
C)7303 Reconnect Only $ 55.00
foSCf - S/G
(OJo~
Constr. Contr. Number ftJ LfLf/ b
03)O~
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended fot: 180 days.
Supervisor License Number
Expiration Date
Expiration Date
Signatrne of Supervising Electrician
/' ~K ~
(~r!:/;;,~~1: f;~::;.,t~L))
Address 70/J 5,4,-{L~ /Iv Alt:- E.
City AI ~ A^~ Phone
(
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signatrne:
Inspection Request: 726~3769
C. Tempora,ry Services or Feeders
Installation, Alteration or Relocation
200 Amp,s or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
$ 55,00
$ 76.00
$110.00
D. N:iQT!,lf:;~~"" lI1E WO~~
One1M ~ nRal,NDE.R TH\S PERMi4~~ _
EacIAUt1i i'e'I\A ',cp; ~BANDONEU FO~
ServOOMM liln $ 4.00
. ANY 180 DAY PER\OD.
Miscellaneous (Service/feeder not included) -Each Installation
Pwnp or irrigation $ 55.00
Sign/Outline Lighting 4 $ 55.00 6220. 00
Limited EnergylResidential $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
4. SUBTOTAL OF ABOVE
8% State Surcharge
10% Administrative Fee
5% Teclmology Fee
". "'0
,J.;l. . w
1'.00
Z7D 60
TOTAL
Shared Drive(T:)/Building Fotms/Electrical Permit Application 7-07.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3375 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 1703222000901
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01693
ISSUED: 11/16/2007
APPLIED: 11/16/2007
EXPIRES: 05/16/2008
VALUE:
Springfield TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Sign electrical
TYPE OF USE: New
Commercial
Owner: R2M PROPERTIES LLC
Address: 3015 SALEM AVE E
ALBANY OR 97321
Contractor Type
Electrical
I CONTRACTOR INFORMATION I
Contractor
KINNEE SIGNS INC
BUILDING INFORMATION I
License
64416
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: ATTENTION: OregdVP~iqtJiges you.t~
follow rules adoptea~G8g61h~ditV n/a
~o~AAa~2' . '. n~~I~;;;:~ON
0090. You may 0 n
calling the center. Note: th" telephone
number for the Or /ifl8ft!lijsNotifi~ft
center 18 1 ~qd.
aved Drive Rqd:
% of Lot Coverage:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
. Storm Sewer Available:
Special Instruction:
Notes:
Description
I PUBLIC IMPROVEMENTS'
Expiration Date
03/17/2008
Phone
503-378-0012
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:
Sidewalk Type:
DownspoutslDrains:
NOTICE: SHAll EXPIRE 'f THE WORK
l~~H~~~~~ U_NY~ THIS P~R~ITJ:~SRNOT
CO I'ab:::~' 'J" I., AO.\HC _~L f\
ANY :tiOiWoo...i tion
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Pa2e 1 of2
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01693
ISSUED: 11/16/2007
APPLIED: 11/16/2007
EXPIRES: 05/16/2008
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
Sign - Outline Lighting Each
Amount Paid
Date Paid
Receipt Number
$22.00
$11.00
$17.60
$220.00
11/16/07
11/16/07
11/16/07
11/16/07
2200700000000001715
2200700000000001715
2200700000000001715
2200700000000001715
Total Amount Paid
$270.60
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.
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 ofthe 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 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-0 1693
COM2007-01693
COM2007-01693
COM2007-01693
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Sign - Outline Lighting Each
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
KINNEE SIGNS INC
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001715
Date: 11/16/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
27914
In Person
Payment Total:
Page I of 1
2:08:11PM
Amount Due
220.00
11.00
17.60
22.00
$270.60
Amount Paid
$270.60
$270.60
11/16/2007