HomeMy WebLinkAboutPermit Electrical 2007-11-13
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225 FIFllI STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number COM zOO 7- 0 ( to '7
1.
3100 pierce Parkway
LEGAL DESCRIPTION: /70 [.30DO
-.SQrinafip1cl. OR CJ7A27 0(000
JOB DESCRIPTION:
Tl.:::llll:^-'J..ary Service
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor Olsson rnd. Electric
Address P_O. Rmc 7n41"'l
City Eugene
Phone 541-747-8460
Snpervisor License Number
3334S
Expiration Date 10/01/09
Constr. Contr, Number 63473
Expiration Date
01/26/09
Si~:Ele;
I
Owners Name
Oreqon Military Dept.
Address 1776 Mi1itb w",,(p_o_ Rrw 14,<;CO) E.
City Salem, 97309 Phone
OWNER INST ALLA nON
The installation is being made on property] own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Date
11/1,/(17
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
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 70,00
$ 83,00
$138.00
$180.00 180.CO
$413.00
$ 55.00
1
~, rE~il~f:~9'i~~Wi~~re{~86i', ..,
'ol:ow rules adop.ted by the. Oregon ,Utili!)'
~1'1tificatic:m~m?"frM~'UR!!;'!l1~S<.i."M -, e
in OAR 9sroO~W tar~ugh OAR 952-001- $ 55.00
0090. YO(lll1P~lliI'l\OOPi~~f the rules DY $ 76.00
calling l/lfl ~~~o lll\8t~Jbp tel~pho,.,,, $110,00
number for ilie'Oregon utimy Not,ficaliGR
~(l\'lRQll ,MI~~4)ls see "B" above.~
D. LBninch,qr~_~i~^ ", .'.' _
,...,,,/,,,
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48,00
$ 4.00
Pump or irrigation $ 55,00
Sign/Outline Lighting $ 55,00
Li_i~/Residentt! EXP1R~ If "nIl= woom.
Linl1teIBBl~U~~~ THIS_Dt:QM1T lS1Q~~
Min~~~~iliW~~~i~~~~IIB~~:=~.~nrcharges
4. L~~!rpKmJ'!::.::E:...:.:!;:;::;. l~:~
10% Administrative Fee 18.CO
5% Technology Fee 9.CO
TOTAL 221.40
Shared Drive(T:)/Building FormslElectrical 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
CITY OF SPIUl'lt.J1<IELD
Building/Combination Permit
PERMIT NO: COM2007-01809
ISSUED: 12/10/2007
APPLIED: 12/10/2007
EXPIRES: 06/10/2008
VALUE:
SITE ADDRESS: 3100 Pierce Pkwy
ASSESSOR'S PARCEL NO.: 1702300001000
Springfield TYPE OF WORK: Use ]nitials
Commercial
PROJECT DESCRIPTION: Temporary power
TYPE OF USE: New
Owner: STATE OF OREGON MILITARY DEPARTMENT
Address: PO BOX 14350
SALEM OR 97309
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
OLSSON INDUSTR]AL ELECTRIC
License
63473
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
BUILDING ]NFORMATlON I,
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type: oU \0
Ener~vf~l!eS ~ \}\ili\'l
o~' Ol~ ,\~@Gl'llilfijse\ 10(\\\ nla
_~,.,rn . ..I_.....'t,oo ,\....ca( _ ^n'\_
\~il~1N !li'1>);V~B'0~I\?EN~"- -~ RM;~t""(Il',rAr I
'I'CQ\\, ,;., .. ""!
~o\\ \ ~ 00" -V" ' ' Ill' - ' Vii
, Op..\:\ 952- ob\ai(\ CO f)' \ne \e1e?ca,\iOl\
1(\ 'io\.l \IIa~ R"~rl~)>I'f}I&h\~ ~0\\1\
G00C?; \'S \ne C\~~ 'itre'~r~.~~)'
-'''. 101 pI; ...,OJ"
,.\.l,;,\)C\ (\\efl!3'e\J ve Rqd:
ce % of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Expiration Date
01126/2009
Phone
541-747-8460
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
i\\'C. ~O?>.~
tf-?\?>.'C. \~ ~\i \CO ~O
"J''1\~t:,rtT ~~~~;\ "t,",\CO ?~~f''\ to?>'
I "t\-\I';) , 't: c1P;) J;,\: T.~~\J
V ltl\ij\Hi~Im";r~bl1
t.. t,~\:.W.J ~ 'C,I'IU'
$ per()\\~l~~\:l Q~S~uare Footage
or mul~'l{,r or Bid Amount
Description
Tvoe of Construction
Pa2e I of2
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2007-01809
ISSUED: 12/10/2007
APPLIED: 12/10/2007
EXPIRES: 06/10/2008
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 Descriotion
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Perm ServlFdr 601 to 999 amps
Amount Paid
Date Paid
$18.00
$9.00
$14.40
$180.00
12110/07
12/10/07
12/]0/07
12/10/07
Receipt Number
1200700000000001479
1200700000000001479
1200700000000001479
1200700000000001479
Total Amount Paid
$221.40
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 Tnsoections I
11111 I l
Temporary Electric: Approval required prior to Utility Company energizing pole.
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 fnrther 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.
1 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
Pa2e 2 of2
225 Fifth Street
Spripgfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-0 1809
COM2007-0 1809
COM2007 -0 \ 809
COM2007 -01809
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
,::,"'HOF'BLO, ~,,:,
~,J~ 1!ilIJ .."
...,.,- ;
~ - .
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200700000000001479
Date: 12/10/2007
Description
Perm ServlFdr 601 to 999 amps
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
OLSSON INDUSTRIAL
ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 47849 In Person
Payment Total:
Page I of I
2:14:47PM
Amount Due
180,00
9,00
14.40
18,00
$221.40
Amount Paid
$221.40
$221.40
1211 012007