HomeMy WebLinkAboutPermit Electrical 2007-12-26
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225 FIfTH STREET. SPRlNGmLD. OR 97477 . PH (541)716-3753 . FAX (541)7Z6-J689
ELECI'RICAL PERMIT APPLICATION
-
CIIy Job Number ~ () j,04^ 'Z...O'o 7- c I 9 l... ~ Date
I LOCATION OF INSTALLATION:
17;2(; xl Il ~ /I' C
};-EGAL DESCRIPTION 17 O.J~ b! T 9f>t:t:> CA. New Resident",) - Smgle or MultJ..Faml1y per dwelling umt
Ift~A)1Ji/' Iu/}~?. f(,-.CZt'1' Service Included
JOB DESCRIPTION 1000 sq f\. or less $11700
Each addltJonal 500 sq ft or
portIOn Ihereof
3.
COMPLErEFEESLnIDJULE BELOW
ADT Job II: .::2.f3 - {}41,ff - /
$2100
Permits are ODD-transferable and expire d'work IS
not started wrtbm 180 days oflssuance or of work IS
Suspeoded for 180 days
Each Manufuct'd Home or
Modular Dwelling Service or
Feeder
$55 00
2
CONTRACTOR INSTALLATION ONLY
B. Sen-lce5 or Feeders -Installation, <\IteratIOns or RelocatIOn
Electrical Contractor ADT Secul!itv
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsIV oils
Reconnect Only
$ 70 00
$ 83 00
$13800
$18000
$413 00
$ 55 00
Address 2815 SW 153rd Dr
CtIy Beaverton OR Phone503-469-7100
SupervISor License Number LEA389
C. Temporary ServIces or Feeders
ExplTatlon Date 10/1/08
ConslT ConlT Number
59944
Installation, Alteration or Relocation
/ -- too 1J1Ip1f'9f-less $ 55 00
, 201 AmP;' Io-AolP~~' srequlres '''' $ 76 00
'C-f I '1.0 ~I.IU 10
I'll 401 A.!'l~JP 6Op, '"" Oregon Ut. $11000
'''''1I1:o1't'-Il(1. Ii 'USif;f.i(/t> IlIly
"OS c: 1'cft3v,9fa600rAlnPs<IlfGlTgh ~~~llflfClllillve
call1l'Q.lh!}r~.(JPblIraUltlp,es of Ih 952'001.
nUmber t.w. ".._nYer !NoJq, e rU'~~jlll
. J, /. C:e."w'Jat~M1J(l.fistIilll:JfJlfOlfiJTl
11/6/'tI? OO!EitI/iult-800-3::l~,lty NOI'hC8I1Q/'J $ 48 00
, Each Additional CiTCtl'i?~)Ih
ServIce or Feeder Pernllt $ 400
ExpIration Date
5/7 /08
SIgnature ofSupervlSmg ElectriCian
.P~ ~hJ
Owners Name iL .t+A~t,v
Address ::r'o /$01< If J '-J
E. Mtseellaneous (Service/feeder not mcloded) -Each InstallatIOn
CIty
9A
Phone
Pump or lITIgatiOn $ 55 00
SlgnlOuthne Llghtmg $ 55 00
OWNER INSTALLATION L,mited Energy/ReSldentlal $ 28 00
The mslallatlon IS bemg made on property I own Wh";'lVO~'I',.I,-lmlted Energy/Commercial / $ 50 00 stJ 00
IS not mt.nded for sale, lease or rent TH UIi&:um Electnc Pernut InspectIon Fee IS $50 00 + Sorcbarges
I PERMfB.QJ,u,H b
Owners SIgnature AUTHdR/~~ ,s;;:~ ~ff!'rHE WO 5lJ, 0
COMME Stflt~rg/ilQhiillltS PER RK -f ~o
. ANY 1 N 1'H1RnI@'A!lfKI~ MIT IS NOT .5 00
80 DAY~ ~lMuuNED FOR .t SO _
. 6/~
TOTAL
Shared Dme(T )!Buddmg FormslElectncaJ Penmt Apphcatlon 7-07 doc
InspechoD Request. 726-3769
-Wi:~
CITY OF SPRINGFIELD
Building/Combination Permit
Status
225 FIfth Street, Spnngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lllle
PERMIT NO. COM2007-01925
ISSUED. 12/26/2007
APPLIED. 12/26/2007
EXPIRES: 06/26/2008
VALUE:
Issued
SITE ADDRESS 1720 S A ST
ASSESSOR'S PARCEL NO 1703363106200
Spnngfield TYPE OF WORK Electneal Work Only
PROJECT DESCRIPTION low voltage bnrglar aldrm
TYPE OF USE New
Commercial
Owner HARDY RICHARD JAMES & KATHIE K
Address PO BOX 931
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
Low Voltage Electncal
Contractor
ADT SECURITY SERVICES INC
License
59944
I BUILDING INFORMATION I
# ofUOIts ATTENTION Oregl1ilOlffi'tiftiOllilres you to
Pnmary Occupancy Group follow rules adopteR~~Ilf1ijf-cglilii\ftlhlJtllity
Secondary Occupancy Group Notification Center ~4Ifi!j,flre set forth
Pllmary ConstructIOn Type In OAR 952-001-001 CW;\WlJ(jIy~J\H 952-001.
Secondary ConstructIOn Type0090 You may obta'ltli~! the rules by
# of Bedl ooms calling the center B ~lePhone
number for the OregflA Yfllll'tlon nfa
Center IS 1-8'60: - .
I DEVELOPMENT INFORMATION I
Frontyal d Setback
SIde I Setback
SIde 2 Setback
Rearyal d Setback
Soldr Setbacks
Overlay Dlst
# Street Trees Rqd
P dved Dllve Rqd
% of Lot Coverage
I PUBLIC IMPROVEMENTS I
Street Improvements
Storm Sewer AVdllable
Specml InstructIOn
ExpiratIOn Date
05/07/2009
Phone
541-736-4973
Lot SIZe
Sq Ft 1st FloO!
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Gdrage/Carport
Sq Ft Other
Occupant Load
REQUIRED PARKING
Total
HandIcapped
Compact
SIdewalk Type
NOTICE: Rownspouts/Drams
THIS PERMIT SHAll EXPIRE If THE WOR
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
I\I~ I I oUru,;u~LE:-:i&:>'
I ValuatIon DescrmtlOn I
Notes
DeSCriptIOn
$ Per Sq Ft
or multIplier
Squdre Footage
or BId Amounf
Type 01 ConstructIOn
Page lof2
Value
Dafe Calculated
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO. COM2007-0]925
ISSUED 12/26/2007
APPLIED ]2/2612007
EXPIRES 06/26/2008
VALUE:
225 FIfth Street, Spnnglield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspecllon Lme
Total Value of p, oJect
Fees Palll I
Fee DescnutlOn
+ 10% Admmlstrdllve Fee
+ 5% Technology Fee
+ 8% State Su, charge
Low Voltage - Commeludllndus
Amount Paid
Date Paid
Receipt Numher
$500
$250
$400
$50 00
12/26/07
12/26/07
12/26/07
12/26/07
2200700000000001907
2200700000000001907
2200700000000001907
2200700000000001907
Totdl Amount PaId
$61 50
I Plan ReViews I
To Request an mspectlOn call the 24 hour recording at 726-3769 AllmspectlOns requested before 7 00
a.m, will be made the same workmg day, inspectIOns requested after 7'00 a.m, will be made the followmg
WOl k day.
I Re'llllred Tnsnection~ I
Low Voltage Pnor to cover
By signature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certlly that all
mformatlon hereon IS true and correct, and I further certify that any dnd all work performed shall be done m accordance with
the Ordmances of the City of Spnnglield and the LdWS of the State of Oregon pertaHHng to the work descnbed hel em, and
that NO OCCUPANCY Will be made of dny structure without permiSSion of the CommuDlty Serv,ces D,vlslOn, Bu.ldmg Safety
I fu.ther cerlIfy that only contrdctors and employees who are m comphance with ORS 701005 Will be used onth,s project
I further dgree to ensure that all reqUIred mspectlOns .Ire requested at the proper lime, that each dddress IS readdble from the
street, that the permit card IS located at the front of the property, and the approved set of plans Will remam on the site at all
times dunng construction
Owner or Contractors Signature
Date
Pa2e 2 of2
225 Fifth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
8~AINQFJBLD JlJiU' ,1I~U;j ,
ii(""
City of Springfield Official Receipt
Development Services Department
Pubhc Works Department
Job/Journal Number
COM2007-0 1925
COM2007-01925
COM2007-01925
COM2007-0 1925
Payments
Type of Payment
Check
cRecemll
RECEIPT #.
2200700000000001907
Date' 12/26/2007
DescriptIOn
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Pa,d By
ADT
Item Tot.1
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
dJb
2611496
In Person
Payment Total
Page 1 of 1
2 00 OIPM
Amount Due
5000
250
400
500
$6150
Amount Paid
$61 50
$6150
12/26/2007