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Home My WebLink AboutPermit Electrical 2008-1-3 / ' ZON ~ri IV INITIALS ~\I\ A DATE\ ~{,..,... , SOURCn,",",\ ~ SPRINGFIELD 225 FIF I H ~TREET . SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (';4])726-3689 ELECTRICAL PERMIT APPLICATION ~ City Job Number COWl 2:00'7- Of s. oS .ay; Date 01/03/2008 1 'tcLOCA nON OF~~rAL!:~1 !ON-~:_~ _:' 780 Harlow Road LEGAL DESCRIPTION /70~ Z2.3L{ -.--,---........--- - _.------- .. - -....--~ . 3 COMPLETE FEE SCHEDULE BELOW -' .. ----~ o zgoo 1-- - --....-.....~ - --- - -- ------- ---,-- --- - A Nev.' RC\ldcntJ<II- Smgle 01 J\luJtJ-F anllJv per dwrlhng UllIt - ~~ - ~ . ---~ ~- - - - - - - - - .. Harlow Road Pump Statlon Service Included 1000 sq ft or less Each addItIOnal 500 sq ft or portIOn thereof Each Manufact'd Home 01 Modular Dwe!hng Service or Feeder $11700 JOB DESCRIPTION $ 21 00 Permits are non-transferable and expIre If work IS not started wlthm 180 days of Issuance or If work IS Suspended for 180 days $55 00 ~ -.- - -- -~ ...--..... ~ J 2 r CONTRACTOR I~S!ALLill'ION ONLY B ~Cl' I<:CI\ or Fcedel' - In\t.1IIottlOn, i\ltCl atlom 01 R( IOldtlO1l Electncal Contractor Olsson Industrlal Electrlc 200 Amps or less 201 Amps to 400 Amps Address 1919 Laura Street 401 Amps to 600 Amps 60' Amps to ] 000 Amps City SDrlnqf,~lr1 Phone 541-747-8460 Over 1000 AmpsNolts Reconnect Only 1 $ 70 00 70 00 $ 83 00 $13800 138 00 $18000 $41300 $ 55 00 1 Supervisor License Number 3334S ATTENTION: .oreg,on law regulrl!s you.lo .-. -, !':'l\ow..wles alfoptll'il~\1'{8 Oie'98i'1 tltMyctc' s NotIfication Center. Those rules are set forth l" nAR Q62-OO1_dfW"'III~llgfiIOmlf!152[d&'fucatlOn 0090. You may ~l/'Ir\nIllplelloof the rules by $ 55 00 calling the cen\liln !(hlf)lel ~ tekWhone $ 76 00 number for the Q/lea~"tMi~\}() I!l.llI/JJcallon $110 00 Center itJ~p~Allo Volts scc "8" above ~- - -.. ..---- - ..... -...- '"' - -'-- - ,--- D L~r.m~h ClrclI~ts _ -'--_~ _ ~ / , , Expiration Date 10/01/09 Constr Contr Number 63473 ExpIration Date 01/26/09 Slznature of S ervlsmg ElectncIan .V , 7;L A -7~ Owners Name .5<<N Address 7 J .::- <kLL.:u1 &-rlfLt:~&o(( COtL-f ('",A/t'""'-&.'Lc..A- ( <;.rS.~E New AlteratIOn or ExtenSIOn Per Panel One ClrcUlt Each AdditIOnal Circuit or with Service or Feeder Pemut 33 $ 48 00 $ 400 132 00 MI\lell.lI1coIIS (Scrvlcc/ftcdCI not IIlcludcd) -Lllh Imt.lIldtlOlI .... ~ ~ '- - . City Phone Pump 01 tmgatlOn $ 55 00 Slgn/Outlme Lighting $ 55 00 Limited Energy/ReSidentIal $ 28 00 L,mIted Energy/Commercial $ 50 00 MIfllmum ElectriC Permit InspectIOn Fee IS $50 00 + Surcharge!) - - OWNER INSTALLATION The installatIon IS being made on property I own which IS not Intended for sale, lease or rent Owners SIgnature 4 I SUBTOTAL OF 1).BOYl; .' I 340 00 40 80 34 00 17 00 Inspechon Request 726.3769 12% State Surcharge NOTICE- 10% AdmmlStratlve Fee THIS PERMIT sWAllrm~{lF THE WORK AUTHORIZED ~ THIS PERMIT IS NOT 431 80 COMMENCED OR IS Al!l:A'NOONED''F€lR Fonn,/EI"I""t P"m" Appt"'Mn 1 08 doc ANY 180 DAY PERIOD. Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO' COM2007-0I30S ISSUED. 08/30/2007 APPLIED 08/3012007 EXPIRES: 07/03/2008 VALUE: 225 FIfth Street, Sprmgfield, OR 541.726.3753 Phone 541.726.3676 Fax 541.726.3769 InspectIOn LlDe SITE ADDRESS 780 HARLOW RD LIft StatIOn ASSESSOR'S PARCEL NO 1703223402800 SPRINGFIETYPE OF WORK Electncal Work Only TYPE OF USE New Commel claJ PROJECT DESCRIPTION Temporary service and 2 CIrcmts Owner SUN RETIREMENT CORPORATION Address 735 COMMERCIAL ST SE SALEM OR 97301 I. CONTRACTOR INFORMATION I Contractor Type Electncal Contractor OLSSON INDUSTRIAL ELECTRIC License 63473 ExpiratIOn Date 01126/2009 Phone 541.747.8460 , BUILDING INFORMATION I # of Umts Pnmary Occupancy Group Secondary Occupancy Group Pnmary ConstructIon Type Secondary ConstI uctlOn Type # of Bedrooms # of Stones He.ght of StI ucture Type of Heat Water Type Range Type Energy Path requlr~'QJ BUlldmg ;letk O...gnl',laW . - -- · l'I'1tt tlll~'~les adoptetd"bYs '1 \'I",~: . ',- INFORMATION' ,u vn Center, 0 I ~W ~".!'! l ' Notification .()01-0010t"rOUg" \I e rules by FI ontyard Setha<\R OAR 952 may obtain copies 0 t ~~W\!lYlihst Side 1 Setback 0090. '(OUthe center. {Note: ~~ ~J~~ll.tl~es Rqd SIde 2 Setback calling 10r the Oregon Ut~ 2a4'4')ved Dnve Rqd Rearyard Setback num'oereenler 18 1-800-33 - % ~f Lot Coverage SOldl Setbacks Lot SIZe Sq Ft 1st Floo. Sq Ft 2nd Floor Sq Ft Basement Sq Ft Gal agelCarport Sq Ft Other Occupdnt Load nla REQUIRED PARKING Total Hand,cdpped Compdct I PUBLIC IMPROVEMENTS' Street Improvements Storm Sewer Avadable SpeCial InstructIOn Sidewalk Type Notes DownspoutsfDrams NOTICE: E IF THE WORK ~~~H~~~ri ~~~~~ ~~R PERMIT IS NOT f.:-:!.~~.,~"':'I:n nR 16~BANDONED FOR I ValuatIOn DesCrIDAW ISO DAY PERI . DeSCrIptIOn Type of ConstructIOn $ Per Sq Ft or multIplIer Square Footage or Bid Amount Value Date Calculdted Paee I of 3 CITY OF SPRINGFIELD - Building/Combination Permit Status Issued PERMIT NO ISSUED' APPLIED. EXPIRES: VALUE: COM2007-0130S 08/30/2007 08/30/2007 07/03/2008 225 FIfth Street, Spnngfield, OR 541.726.3753 Phone 541.726.3676 Fax 541.726.3769 InspectIOn LlDe Total Value of Project l1pp~. P'nti I Fee DescnptlOn + 10% AdmlDlstratlve Fee + 5% Technology Fee + 8% State SUI charge Add, Alter, Extend Ore Ea Add Temp Power 200 amps or less + 10% AdmlDlstratlve Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Ore Ea Add Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 401 to 600 amps Amount PaId Date PaId ReceIpt Numbel $11 80 $590 $944 $800 $110 00 $34 00 $40 80 $17 00 $132 00 $70 00 $13800 8/30/07 8/30/07 8/30/07 8/30/07 8/30/07 1/3/08 1/3/08 1/3/08 1/3/08 1/3/08 1/3/08 1200700000000001121 1200700000000001121 1200700000000001121 1200700000000001121 1200700000000001121 1200800000000000008 1200800000000000008 1200800000000000008 1200800000000000008 1200800000000000008 1200800000000000008 Total Amount PaId $576 94 I Plan ReViews I To Request an mspectlOn call the 24 hour recordmg at 726-3769. Allmspections requested before 7:00 a.m wIll be made the same workmg day, mspectlOns requested after 7.00 a.m wIll be made the followmg work day. LJeolliredJnsnections I Temporary Electnc Approval reqUIred pnor to UtilIty Company energIZIng pole Rough Electnc Pnor to Cover FlDa! Electnc When all electncal work IS complete Electnc ServIce Approval reqUIred pnor to utilIty company energlZlDg servIce Pa2e 2 of3 _QpN"~ u....' ~. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' COM2007-0130S ISSUED 08/30/2007 APPLIED, 08/30/2007 EXPIRES' 07/03/2008 VALUE: 225 FIfth Street, Springfield, OR 541.726.3753 Phone 541.726.3676 Fax 541.726.3769 InspectIOn Lme By slgnatnre, I state and agree, that I have carefully exammed the completed apphcatIon and do hereby certIfy that all mformatlOn hereon IS true and correct, and I further certIfy that any and all work performed shall be done 10 JccordJnce WIth the Ordmances of the City of Sprmgfield and the Laws of the State 01 Oregon pertammg 10 the work desCribed herem, and that NO OCCUPANCY will be made of any structure Wlthont permIssIOn of the CommuDlty ServIces DIVIsIOn, BUlldmg Salety I further certIfy that only contractors and employees who are 10 comphance With ORS 701 005 WIll be used on thiS p' oJect I further agree to ensUle that all reqUIred mspectlOns are requested Jt the proper tIme, that each address IS readable Irom the slreet, that the permIt card IS localed at the front of the property, and the approved set of plans Will remJm on the site at all times dUflOg constl llctlOn Owner or Contractm S S'gnJture Date Paee 3 of 3 r City of Sprmgfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Sprmgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007.01305 COM2007-0 1305 COM2007.01J05 COM2007.01305 COM2007.0 1305 COM2007-01305 Payments Type of Payment Check cRecemtl RECEIPT #: 1200800000000000008 Date' 01/03/2008 Description Perm ServlFdr 200 amps or less Perm Serv/Fdr 40 I to 600 amps Add, Alter, Extend Clrc Ea Add + 12% State Surcharge + 5% Technology Fee + 10% AdmInIStrative Fee PaId By OLSSON INDUSTRIAL ELECTRIC Item Total Check Number AuthOfILatlOn Received By Batch Number Number How Received dJb 48172 In Person Payment Total Page I of I I 43 55PM Amount Due 7000 13800 13200 4080 1700 3400 $431 80 Amount Paid $431 80 $431 80 , 1/3/2008