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Home My WebLink AboutPermit Electrical 2008-1-7 \,--,' ZON l-\>Z.- lNJTlALS ~ T-A-. DATE \-K-CJ(, SOURCE~QS ("/./ / - 7 - at" 225 FTFIlI STREET . SPRINGFIELD, OR 97477 . PH (54t)726-3753 . FAX (54')726-3689 ELECTRICAL PERMIT APPliCATION CIty Job Number (0 vV\ LOO g- - bc OZ ( Date 1 I LOCAll0NOFINSTALLATION: 89D N~,urAI'" (,k1".r. D RIV~ LEGAL DESCRIPTION / ?OZD-SZZ og)OC JOB DESCRIPTION tveL.. ,1=RVII'A' 3 I COMPLETE FEE SCHEDULE BELOW A 1 New ReSldential- Smgle or Multi-Family per dw~ilmg ~~~t - ServIce Included 1000 sq It or Jess Each addltlOnat 500 sq It or portIOn thereof $11700 $ 2100 PermIts are non-transferable and expIre If work IS Each Manufact'd Home or oot started wlthm 180 days of Issuance or If work IS Modular Dwellmg ServIce or $55 00 Suspended for 180 days A'JTE......ON Feeder " .. II Orl!Clpn raw requrf.$S-VOU.!.. _ ~ _ _ 2 I CONTRACTORINST.AWiCJIH~Dted by tlTa O~lIIili}Feeders - InstallatIOn, AlteratIOns or RelocatIOn '~J&A.Genter;--Those ruI";....,,, aetfOtfI'r -- "-- -- - -- - .- Electncal Contractor N ~~ V:2.~2:~~:t~op~~:m~~~~s / $ 70 00 7 0 calling the center. (Note th~Vtelepl1bWe!f~O Amps $ 83 00 Address number for thA OrAgon Utllr!tlN_tYOAOO Amps $13800 Centef Is 1-80Q-332-~psto 1000 Amps $18000 CIty Phone Over 1000 AmpsIV olts $413 00 Reconnect Only $ 55 00 SupelVlsorLlcense Number 40'2.3 5 ExplfatlOnDate [6-DI-2.61 () Constr Cootr Number tv-A ExprratJoo Date - Signature of 3..~.. ".smg Electnclan J('~ T)--;?~iV Owners Name \vill "'MA.U..... ~"'Cl<. "f',~. Address 251') S. S7 u. Si-. CIty 'SA.'~CI~L.b Phone 1 ~-4 c;'4., OWNER INST ALLA nON The mstallatJon IS bemg made on property I own which IS not mteoded for sale, lease or rent Owners SIgnature InspectIOn Request 726-3769 C ! Te;'porary ServIces or Feeders Installahon, Alteration or RelocatIOn 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D. ijl1&gU~~i:0, New Alteration or ExtenSIOn Per Panel One Crrcwt Each AdditJona] Crrcwt or WIth ServIce or Feeder Pemut Z "" $ 55 00 $ 76 00 $110 00 ,~ $ 48 00 $ 400 <\? ENI4W~~~Jf;Y.~~t:Il!i;'I:~;~K-EaCb rnstallatlOn TiffS4l'E1'I~~ ' ~ - - --- AIdif4l\l~I.lNDER THIS PERMIT IS NPI500 ~I}j)l'MIiIllG!iDgQih!s ABANDONED reR $ 55 00 .JI~lltaci311~&fJi\l9Qa1 $ 28 00 Lllmted Ellergy/Commerclal $ 50 00 MlII,mum ElectrIC Perm.t Inspechon Fee IS $50 00 + Surcbarges 4 I SllI!Wf4'BifXBoVE : -It7 Y . CD 12% State Surcharge -----. -7' :J b - 10% Admllllstratlve Fee "7 B 0 - 5% Technology Fee "3 ~ 0 -II -'(9 Db TOTAL Shared Dnve(T )/Butldmg FormslElectnca1 Permit ApphcatlOn J -08 doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' COM2008-00021 ISSUED. 01/0712008 APPLIED: 01/07/2008 EXPIRES: 07/0712008 VALUE. 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541.726-3676 Fax 541-726-3769Inspecholl Lme SITE ADDRESS 890 MOUNTAINGATE DR ASSESSOR'S PARCEL NO 1802032208300 SPRINGFIETYPE OF WORK Electrical Work Only TYPE OF USE New Commercial PROJECT DESCRIPTION New servIce Owner WILLAMALANE PARK & RECREATION Address 250 SOUTH 32ND STREET SPRINGFIELD OR 97477 Phone Numbel 541-736-4044 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I # of U lilts # of Stories Primary Occu ~Poregon law requires yclJ<\I1lht of Structure Secondary 0 c~ rill \!l!IOpted by the Oregon ~of Heat Primary Co ,cb.Ylb l:Jlfuter. Those rules are seWtifllil Type Secondary ~ ~ I\GJ~-d<r.p..OO10through OAR 95:fk~Type # of Bedroo You may obtain copies of the rumre~ Path calilng the center. (~~t,~'}'~l~ :~~;,f.~kled BUlldmg numu~1 IVI 'II~ ~_... . Center IS 1-800-332-~~l'ELOPMENT INFORMATION I Lot SIze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft GaragelCarpol t Sq Ft Othel Occupant Load nla REQUIRED PARKING Front yard Setback SIde 1 Setback S,de 2 Setback Rearyal d Setback Solar Setbacks Overlay DlSt # Street TI ees Rqd Paved Dllve Rqd % of Lot Coverage Total HandIcapped Compact I PUBLIC IMPROVEMENTS' Stl eet Improvements Storm Sewer AvaIlable Speclallnsh uctlOn Sidewalk Type NOTICi~wnsl!outSj(lrlll.W\lRE IF THE WORK THIS PERMIT SHALL tll.!" T AUTHORIZED UNDER THIS PERMIT IS NO COMMENCED OR IS ABANDONED FOR : i ~'I 1?n n iN PI=RIOD. I V aluation Descri~tJo~ I Notes DeSCription Type of ConstructlOlI $ Per Sq Ft or mulhpher Squal e Footage or BId Amount Value Date Calculated Page 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' cOM2008-00021 ISSUED 01/07/2008 APPLIED 01/0712008 EXPIRES: 07/07/2008 VALUE' 225 FIlth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Total Value ot ProJect Fees PaldJ Fee DeSCr1Pt101I + 10% AdmmlStratlve Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend ClfC Ea Add Perm ServlFdr 200 amps or less Amount Paid Date PaId ReceIpt Number $780 $936 $390 $800 $70 00 1/7108 117/08 1/7/08 1/7/08 117108 1200800000000000011 1200800000000000011 1200800000000000011 1200800000000000011 1200800000000000011 Total Amount PaId $99 06 I Plan Reviews I To Request an mspectJOn call the 24 hour recordmg at 726-3769 All mspectTons requested before 7.00 a m will be made the same workmg day, mspections requested after 7:00 a m w,lI be made the followmg work day. I Reolllred Insoec~i,~,ns I Rough ElectriC Prior to Cover ElectriC ServIce Approval reqUIred prior to utJhty company enel glZlng servIce Fmal ElectriC When all electrical work IS complete By SIgnature, I state and agree, tbat I bave carefully exammed the completed apphcatlOn and do hereby certIfy that all mformatlOn bereon IS true and COrl ect, and Ilurther certJfy that any and all work performed shall be done m accordance wltb the Ordmances of the CIty 01 Springfield and the Laws of the State of Oregon pertammg to the WOI k deSCribed berem, and that NO occur ANCY WIll be made of any structure wltbout permISsIOn 01 the Commumty ServIces DIVISIOn, BUlldmg Safety I turtber certJfy that only contJ actOl s and employees who are m comphallce WIth ORS 701 005 WIll be used on thIS proJect I further agree to ellsure that all reqUIred mspectlOns al e I equested at tbe proper tIme, that each address IS readable flom tbe street, that the pel mlt card IS located at tbe front of the property, and the approved set of plans WIllI emam on the sIte at all times durmg constructIOn Owner or Contractors SIgnature Date Paee 2 of 2 225 F,fth Street . Sprmgfield, Oregon 97477 541-726-3759 Phone C'ty of SprIngfield OfficIal Rece'pt Development Services Department Pubhe Works Department Job/Journal Number COM2008-00021 COM2008-00021 COM2008-0002l COM2008-0002l COM2008-00021 Payments Type of Payment Check Cash Change Job/Journal Number COM2008-0002l COM2008-00021 COM2008-00021 COM2008-00021 COM2008-00021 Payments Type of Payment Check Cash Change Job/Journal Number COM2008-00021 COM2008-00021 COM2008-00021 COM2008-00021 COM2008-0002/ Payments Type of Payment Check Cash Change cRecelOt I RECEIPT #. 1200800000000000011 Date: 01107/2008 DescriptIOn Perm ServlFdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee PaId By WILLAMALANE WILLAMALANE WlLLAMALANE Item Total Check Number AuthOrizatIOn Received By Batch Number Number How ReceIVed dJb 70746 In Person dJb III Person dJb In Person Payment Total DeSCriptIOn Perm ServlFdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By WILLAMALANE WILLAMALANE WlLLAMALANE Item Total Check Number AuthoflLatlOn Received By Batch Number Number How Received dJb 70746 In Person dJb In Person dJ b In Person Payment Total DescnptlOn Perm ServlFdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + ] D% Admmlstratlve Fee PaId By WILLAMALANE WlLLAMALANE WILLAMALANE Item Total t:'heck Number AuthOrization ReceIVed By Batch Number Number How Received 70746 dJb dJb dJb In Person In Person In Person Payment Total Page I of I 1 43 34PM Amount Due 7000 800 390 936 780 $99 06 Amount Paid $9017 $20 00 ($11 II) $99 06 Amount Due 7000 800 3 90 936 780 $99 06 Amount Paid $90 17 $20 00 ($11 II) $99 06 Amount Due 7000 800 3 90 936 780 $99 06 Amount Paid $9017 $20 00 ($11 II) $99 06 11712008