HomeMy WebLinkAboutPermit Electrical 2005-2-22
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)7~6(l%;,;
ELECTRICAL PERMIT APPLICATION " ",,/. ' ,~,,/ "";1>.o~ .
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City Job Number CoWl'Z.Oor-O 03 Date "0 ,~ "","'''"
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LEGAL DESCRIPTION' . . A.,~~~1~f~~';Wit{~!f~'!~'l*~"ii~, ;:"~{~!~~~iY~~~
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17D3.2200 .07-(07 Service Included ' <>,-",olt,,;
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JOB DESCRIPTION ' 1000 sq, ft, or less ,10 00
..,.- "Ti-1I1! }..':'Il r/1I1.77'::"I\ f)/lJIJ/JV" l\Jl/..-tl Eachadditional500sq.ft,or ~
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Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or $50,60
Suspended for 180 days. Feeder
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:tr Electrical Contractor L. R. Brabham,
6~1
Address 68 West "Q" Street
Inc.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 60~ ~u\res you to
ATiENbtij~~Etg~qgQ ftiePElregon UtilItY til
\0110'11 r(jjv&tt~61P~~e~\es are set ~\'
NotilicatiR&~'<1t~~WthrOugh OAR 952 "'i
inOA~~2~:\~~~~' a~!;ef\Jletl
0090, dJim~JeT\te'1.ta.f!m . .-. ,
callingme 0; gon Utility 0 I
nurntlDSlanAng!l~ rA~~~...~~l>cation
(', nter ,,, ).t)(l~ ". '
20lYJ\illps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps'
,City Sprinqfield Phone 747-6638
$ 63,00
$ 75,00
$125,00
$163,00
$375.00
$ 50.00
Supervisor License Number 4944 S
Expiration Date 10/01/07
Constr, Contr, Number 8699
Expiration Date 12/18/06
Over 600 Amps or 1000 Volts see "B" above,
w~!t113:;f1:ll:s...- ,,. .~.."" '
D. ~Bi:anc!i'E:i~cuits
Signature of Supervising Electrician
$ 50,00
$ 69,00
$100,00
./ ' /J New Alteration or Extension Per Panel ,;.
...if~ ~L ~ One Circuit ,/ $43,00 13.
,'; /' c:Y Ea:h..Ad1!tl~nal Circuit or with /. - 3 , -
r /' ,A- n />... }';114(.n I" _ I j _.......s~ebbEeeder Pe111llt EXPIRr If TU~ \~~,OO
, Owners Name--l.T.r:"RS; 11.. " (,.. " - ,. 1"t1.IV~S_ _ ,/fTt;- LC..R~B~\~SHI\LL ~' ]T 1e:!)lOT ,,__
LID N 1'/,4.'" ^ miM~",~,", !!l""~"'l1l:'!I$:l~~'~"[,,""~~~
Address, _ "" ..-"Y.. ~ ",-/L E. ~~~,f,t!~!1~t\l.e1'ii\!iJIAi~~<'!<:~;!~~t3'!!.=~
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Ity_L-rT\L~\"-'-"'~' 700e' _ ..'_' Ud1A?i'l'f,l~,aWNPtt'lIUU.
, 'bOb06 I Signitlutllne Lighting
OWNER INST ALLA nON Limited Energy/Residential .
The installation is being made on p"p-..j I own which Limited Energy/Commercial
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges.
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4.' tSUBTOTAL;OEtABOVE,~'" ~",.p;,Iii~~~'., Jt@~
W!i-'irjtS"",~v",--',,,,"~j~~; .i;~'!,~~ ~ . ,
3,~~
4- 6D
53, I;).
Owners Signature:
7% State Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)IBuilding Fonns/Electrical Permit Application 1-03.doc
$ 50,00
$ 50,00
$ 25,00
$ ~5,OO
~
.
. CITY OF Srtur~\JFIELD '
Building/Combination Permit
PERMIT NO: COM2005-00I88
ISSUED: 02/16/2005
APPLIED: 02/16/2005
EXPIRES: 08/16/2005
VALUE:
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 3030 GATEWAY ST
ASSESSOR'S PARCEL NO.: 1703220002109
Springfield TYPE OF WORK: Eiectrical Work Only
TYPE OF USE: Addition
PROJECT DESCRIPTION: Add 2 circuits for Sears Portrait Studio / dedicated power and data cabling
Commercial
Owner: GATEWAY MALL PARTNERS
Address: 110 N WACKER DR BSC 3-04 A TTN PROP TAX ADMIN
CHICAGO IL 60606
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
LR BRABHAM
License
8699
Expiration Date
12/18/2006
Phone
541-747-6638
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I BUILDING INFORMATION I
r,~TF"TlaN: Oregon law requires you to .
frl~~er ~WJ~e~:dopted by the Oregon Uti~ SIZe:
, . .Ile.ght or.$tructur~1 ose rules are set fultfit 1st Floor:
Not"~~"(l~ l' .fl1'ller. n
Type of 8eat:001 0 th gh OAR 952-~9fJ 2nd Floor:
in C'" as" .001- rou
Water Type. , 'es of the rule~'hllt Basement:
OOSitait, geltYiJe':ObtaJn(NcoPI. th te,ePhofn-fit Garage/Carport
CE\\'€rgylw,llf:nter. ote... e tif t lhFt Other:
ntSp.hikfelrtiUlIlilmgon Utlhlynl)lo lea ccupant Load:
, roM'O' ;" .j-jlnn-~'l2-2344\.
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I
"OTICE' Sidewalk Type:
\,. EXP'a~ InHE WORK
THIS PERMIT SHAll DownspoutslDrains:
AUTHORIZED UNDER THIS PERIv111 I:;' I~U]
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERiOD,
Notes:
I Valuation Descriotion ,
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e I of2
.
. CITY Ul' ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00188
ISSUED: 02/16/2005
APPLIED: 02/16/2005
EXPIRES: 08/16/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
L.Ff'f'~ Pai'LJ
Fee Description,
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$4.60
$3.22
$43.00
$3.00
2/16/05
2/16/05
2/16/05
2/16/05
Receipt Numher
1200500000000000211
1200500000000000211
1200500000000000211
1200500000000000211
Total Amount Paid
$53.82
Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
~f'~tinn~1
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
By signature, I state and agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is true and correct, and I 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.
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 ofthe property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Paee 2 of2
225 Fifth Street
Springfi.eld, Oregon 97477
541-726-3759 Phone
.'
Job/Journal Number
COM2005-00 188
COM2005-00 188
COM2005-00 188
COM2005-00 188
Payments:
Type or Payment
C.heek
'I
2/1612005
.
RECEIPT #:
-~._""""'.
Wi! ._~ .'-'..",-_...'.'"
_ ~'W,> . ::!
, '> 1
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-, ~ . " " . .
Jli..ty of Springfield Official Receipt
"elopment Services Department
Public Works Department
1200500000000000211
Date: 02116/2005
Description
+ 7% State Surcharge
+ 1 0% Administrative Fee
Add, Alter, Extend Cire
Add, Alter, Extend Cire Ea Add
Paid By
LR BRABHAM INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 31719 In Person
Payment Total:
Page 1 of1
1:39:35PM
Amount Due
3,22
4,60
43,00
3,00
$53.82
Amount Paid
$53.82
$53.82