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Home My WebLink AboutPermit Electrical 2007-12-12 Date ZON mLtC/ INITIALS N;J\ DATE \,_,1'1-,0" I SOURCE 0' (l5f?42/ 12.//7.-/07 ! i 225 FIFI1I STREET. SPRINGFIELD, OR 97477 . PH:(541)726~3753 . FAX: (541)726~3689 ELECTRICAL PERMIT APPLICATION City Job NumberCn/Y7) KV -; ,- 0/ d 20 l. ~ It>~J!2!!Ot~~H.4.TI01'!.: I / fI ;tloLw& ~ I"J LEGAL DESCRIPTION: tlb3;;.>S 33 1'1000 C:;o[.j)~ CJv JOB DESCRIPTION: #<P-r~ 1:, ',rt::'~', 1 l7"'. ~v..-o<f''-< , Permits are Don~transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor UHuilol.e (( EnAl,:~.... Address _90 I AJ~JQ<T ~ City Q-rJ5 (J4-5s (').r- Phone <:;'{/-t./-1C, /5'i7 , Supervisor License Number 53<j{.S Expiration Date /0 - or ' L-o(O Constr. Contr~ Number L(0 if;' 7..-1 Expiration Date 7-2.--0'1 Signature of Supervising Electrician L1Ii O~ Owners Na~~h 97::tN;/ ~ Address ro 80 X 7 OS <<; -; Ci0~o.~ Phone d~ 9~'l'O I OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. A. Service Included 1000 sq~ ft~ or less $117.00 Each additional 500 sq~ ft. or portion thereof $ 21.00 ~t.....,,_.,.........na-~ 91 JB1U80 ~ Each Manufact <l........e<6l<' u~68JO 84t JOJ JeqWftU Modulall..,w.-..{.g~JuII!A>~ ) 'J8~eo 84t &!l@9.00 Feeder 8U04d818t 841 .8\ON iUlA '0600 B.l~et;_;~&<<iI~I~I~ati~~.:.l.. ~uln^~n68JO 84t ^q patdOPll lalnJ MOIIOJ 200 AmptllOJ' ~ nbeJ MIll uo6eJO 'NOilNmlll 201 Am~~ Mps $ 83.00 401 Amps to 600 Amps $138~00 601 Amps to 1000 Amps $180~00 Over 1000 AmpsNolts $413~00 Reconnect Only $ 55~00 C. Te~mpo~~~~~:~(fs"AltI'EXPIRE IF THE WORK InstallatiJ,Ullt'.Qrl~6~Q~f.\ib~IS PERMIT IS NOT 200 Amps ~q~~]ENCED OR IS ABANDO~.f)gR 201 AmPs1~\td ~P.Ay PERIOIi, $ 76.00 401 Amps to 600 Amps $1l0~00 Over 600 D. New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit $ 48~00 $ 4.00 ~5 E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55~00 Limited Energy/Residential $ 28.00 Limited Energy/Commercial $ 50~00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges l)O 4. SO. d.S0 Cf . eJ1::> r-,-.6?} 8% State Surcharge I 0% Administrative Fee 5% Technology Fee Jt. So TOTAL i. ((J I ~ Shared Drive(T:)/Building FormslElectrical Pe t Application 7-07.doc 225 Fifth ~treet Springfield, Oregon 97477 541-726-3759 Phone ~..[l:Q~~:ii" '..'...'... 1Ii:~; . .~-~. .t . ~ --' " ~,".-".--._,.,...,-_.-.-' '.,', - City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007 -01820 COM2007 -01820 COM2007-0 1820 COM2007-01820 COM2007 -01820 Payments: Type of Payment Check cReceintl RECEIPT #: Date: 12/12/2007 2200700000000001818 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DOUBLE R PRODUCTS Item Total: Check Number Authorization Received By Batch Number Number How Received njm 5004 In Person Payment Total: Page 1 of 1 8:34:08AM Amount Due 48,00 2,00 2~50 4~00 5~00 $61.50 Amount Paid $61.50 $61.50 12/12/2007 -~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01820 ISSUED: 12/12/2007 APPLIED: 12/12/2007 EXPIRES: 06/12/2008 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1111 MOHAWK BLVD ASSESSOR'S PARCEL NO.: 1703253317000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Extend circnit on canopy Owner: Address: THABET INVESTMENTS-1111 MOHAWK LLC PO BOX 70567 EUGENE OR 97401 I. CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DOUBLE R PRODUCTS License 40432 Expiration Date 09/0212009 Phone 541-476-1387 BUILDING INFORMATION I # of Units: Primary Occnpancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type:. .,_. Sq Ft Garage/Carport Energy Path: . c/.. Sq Ft Olh~r Sprinkled, BbiliillfgMIT SHAl,llaEXPIR'Otc~'iI~t\tQfd~ ..,'..;-~~ :~~~Z[~ I_I~~~~D TtJlC' DeDI\.IT Ie:. I\lnT 1 DEVELOPMEN!I\iINJj'()~Alm~BANDONED FOR ANY 180 DAY PERIOD. REQUIRED PARKING Overlay Disl: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: 1 PUBLIC IMPROVEMENTS I . (PtSJ!!<mJ!!'" T><pe: UO/lao/jllO ^ ,'UO~ I SI JelueO eU04d;',e~~r"'"Ib\l\l~m1lll:JOj Jeqwnu Aq se/nJ e41 jO seldooN) Jelueo e41 5UHl130 -100~<:S6 8'rfO 45i-1O Ulelqo Aew nOA '0600 41JOj les eJe se/nJ e:041 0:00-:00-<:96 8'rfO u/ All/Un U05el(' "'," (., 4.l. ~eluao UOlleOllllOM ": '''1 saJlnbeJ Mel ;~fi VI-'; '>"/nJ MOl/Oj I Valuation Descriotion aJO .NOIlN3lJ.'1 Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculaled Pa2e I of 2 --rj;~;"8'i WIL. · Status Issued CITY OF SPRIN\.Jl'u,LD Building/Combination Permit PERMIT NO: COM2007-01820 ISSUED: 12/1212007 APPLIED: 12/12/2007 EXPIRES: 06/1212008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fee~ P~irl I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Ore Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $5.00 $2.50 $4.00 $48.00 $2.00 12/12/07 12/12/07 12/12/07 12'12/07 12/12/07 2200700000000001818 2200700000000001818 2200700000000001818 2200700000000001818 2200700000000001818 Total Amount Paid $61.50 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 ,~,~,?uirerl 1 nsnections I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 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 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. 1 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 Paee 2 of 2