HomeMy WebLinkAboutPermit Electrical 2006-5-26
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225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689
ELECTRICLjf PERMIT APPLICATION
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LEGAL DESCRIPTION /763 dS J'it 070'0 d-..A",;~e~v. ~~sj~~,~~il.lJi;:-S,j;'lgleor~lpltit~,a.'I1il):per ~wemn~ul!~i6~ .~',.
l (-?CX-) {,G""~ -rY~U1Az rJu)fJ. Service In_cl~d:d:. '"'!"c~on law reo.u~es Y~i;i~\
JOB DESCRIPTION 1000,sq: ft. or less" ~"-S0 by the Or ",gon. ~ M )l?rOO
Each additional SOb sq/ft.orIOS8 rules are ~I; 00"'\-
portion thereof-, j::,;Hsr. ~\hrounh OAR 952$ 1~.00
-':')',01,001 .- ottherules 'J
Each MaIlutacr.anJ{~~~.\9ra.in CO?I~S telephone
Modtjlar. Dwellmg Serv.lC&\?r (1'1 Ole. the t'f. e~ct:tktr\n.o
F d - ," :11' tIle eel \l I ..;I.hl No III "ll:Jt1:U
ee er Co;.<I" ;.j Oregon v''''''
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B. ';S~iviCes' or.~e:aer.sP~nstanation;Alteratio.nfor Reloc'atio'n:
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor ~{A X2.A--r-t <;=;1 b-.~
Address 2Lt7,4':;:::'E WoL.(9)~ BuJO,
City (? o<Z.---rL.~ tf) Phone 'Q)") ~V b 7 161
Supervisor License Number ~ ~ ~ c:::;.l. ~
Expiration Date
70"Sba:::.... L-.S lV(...-~T.
Constr. Contr. Number ILL &::P1 <::..,c:.-g
Expiration Date
Signature of Supervising Electrician
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Own'" N"" rz/IA . r ~ c;;;)l/71
Address 0 &JL LjtJ fnl
C~blkalJ~ Phone
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OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
llf?X' \~':Gf1 jO\ '1.-010
m,c:;:x:;"qcl, 726,3769
5/:2& { ~lJo~
Date
200 Amps or less $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps $125.00
601 Amps to 1000 Amps $163.00
Over iooo AmpsNolts $375.00
, nIl
Reconnect Only _ -rue: '3lJD_O:OQ
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, \;~\1~6~\L~D U~~~. ~6~NDa\'klJ run,
Installation~OOt.e. F.Mion or.\R-elocation
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200 Af\f'S' ordess) r. \
.20 I Amps to 400 Amps
. 40 I Amps to 600 Amps
Over 600
D.
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$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
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E. '2M:lscellatie~ti.s(~el:vice/f ee~'er 110'fincluded fi EachIJlstaiI~ti6n'..
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Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$50.00 50. GU
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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r 50. 00
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~inistrative Fee
TOTAL
Shared Drive(T:)/Building Fonns/Electrical Permit Application I-06.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00640
ISSUED: OS/26/2006
APPLIED: OS/26/2006
EXPIRES: 11/26/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1600 CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703253404402
Springfield TYPE OF WORK: Electrical Work Only
ATTENTION: Oregon law requires you to
follow rules cTX'f-Es0.lDtlSIiJ.; Or~:::Jd9;i.ti,g~lity Commercial
Notification Center. Those rules are set forth
in OAR 952-001-0010 throuah OAR ~!)?-()()1_
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notifieation
("r\......+,...... :...... -4 nr.r\ 1"\"""'" ............ A A\
PROJECT DESCRIPTION: Sign Lighting
Owner: WELLS FARGO BANK #92471 INC
Address: PO BOX 4900
SCOTTSDALE AZ 85261
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I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
SECURITY SIGNS INC
License
122809
Expiration Date
03/30/2010
Phone
503-232-4172
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: ,\.Jnl'f!:: Lot Size:
Height ofSt~uAmr~ERIVIIT SHALL EXI~I~{ftl~s~~loOV~ORK
Type of Heat: Sq ~t2ntlIEioor:
Water Type:.l\UTHORIZED UNDER TH~q Ff.~~~elnk?f:JOT
Range Type:COMMENCED OR IS ABfs'qEF~~Ca~Q8arport
Energy Path!\NY 180 DAY PERIOD. Sq Ft Other:
Sprinkled Building: nla Occupant Load:
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:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Description'
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: COM2006-00640
ISSUED: OS/26/2006
APPLIED: OS/26/2006
EXPIRES: 11/26/2006
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'
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
I Plan Reviews I
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.
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.
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Owner or Contractors Signature
Date
Pae:e 2 of2
225 Fifth Street
Spri~gfield, Oregon 97477
541-726-3759 Phone
C::~i;",of Springfield Official Receipt
Bf"ll;elopment Services Department
Public Works Department
Job/Journal Number
COM2006-00640
COM2006-00640
COM2006-00640
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
1200600000000000716
Date: OS/26/2006
Description
Sign - Outline Lighting Each
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
8FL INe. CONSTRUCTION
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm 116214 In Person
Payment Total:
Page 1 of 1
9:51 :38AM
Amount Due
50.00
4.00
5.00
$59.00
Amount Paid
$59.00
$59.00
5/26/2006