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Home My WebLink AboutPermit Electrical 2004-7-19 . _" CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00868 ISSUED: 07/19/2004 APPLIED: 07/13/2004 EXPIRES: 01/19/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 2510 Game Farm Rd ASSESSOR'S PARCEL NO.: 1703220002702 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Alarm System Contractor Type Electrical WILLAMETIE DENTAL GROUP PC o\TTc:~mnN' Oregon law requires you to % CONTROLLER-TAX D1V 14025 SW FARMINGTON'RD~BEA-yl:RTOted by the Oregon Ut,hty 97005 10\\01'1 rll!e:..d~~.:. Thnco" ,I"" are set forth "Ull"'''~''V'::;: -0010 through OAR 952.001- I CONTRACTOR INF(j)RMApeN'iJ in copies of the rules by UV:lU ,Uu' -J obta h Contractor ~a~cent!ff.x"hlparrJ~)j=JlbllneS03~-~ '6 - HONEYWELL INTERNATIONAL INC :>fi'llrsvl\tIWhe,~e~~\. 612 951 3974 ,..,..,.......-. . BUILDING INFORMATION I Owner: Address: # of Units: Primary Occupancy Group: 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: I~ 0 Tl C E: Sq Ft 2nd Floor: Water Type: THIS PERMIT SHA~l! f~lJfMtnwnt:HE WORK Range Type: AUTHORIZED UND~~~Ft Gar~geJCa[Poft Energy Path: .:m ~~er:HIVlI J I~ NOT Sprinkled BUilding~NOyMM1REONCJiD OR 'it, tJiJ~lW FOR " nAY PFRlon I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00868 ISSUED: 07/19/2004 APPLIED: 07/13/2004 EXPIRES: 01/19/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line U'ees Pai.d-J Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid Receipt Number $4,50 $3.15 $45.00 7/19/04 7/19/04 7/19/04 3200400000000000174 3200400000000000174 3200400000000000174 Total Amount Paid $52.65 I Plan Reviews , 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. I Rf'Oug;mJlwu,rfionsJ Low Voltage: Prior to cover. 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. 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 of the property, and the approved set of plans will remain on the site at all times during construction. 0: IJ 0 ~\ i('^-~aJ.- ~p Owner or Contractors Signature / -lq - LaoCf 0,~ Date Paee 2 of2 v 225 Fifth Street s'pringt'ield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2004.00868 COM2004-00868 COM2004-00868 Payments: Type of Payment Check 7/19/2004 RECEIPT #: ~ .IiiilY of Springfield Official Receipt Wvelopment Services Department Public Works Department 3200400000000000174 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage. Commercial Indus Paid By STEVE MOREHOUSE Received By njm Page 1 of 1 Date: 07/19/2004 Item Total: Check Number Authorization Batch Number Number How Received 4494 In Person Payment Total: 1:39:41PM Amount Due 3,15 4.50 45.00 $52.65 Amount Paid $52.65 $52.65 , o 0 CITY OF ~llNGFIELD, OREGON .:~1;)~,,, j, . . ' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541'>726-~3811~',~SSlJ~ ' D ~ . ~' ELECTRIC~ PERMIT APPLICAT~N ~/& O~i~ll 69lJi./I1&(jl) City Job Numb"U.b"LODY- --ml/J, ate '1'.n I d..c1e~6 7.'::) /2- ~6Ci"~~~/OIIO", DlR ----4.L:1., ' (j &' ~-C! (j lJ 'IJ{J , 'Oil se I. LOCATION OF INSTALLA'lTON 3, COMPLETE FEE SCHJ!!1'roLE OM '2-<610 b2me.mVTYl ~ LEGAL DESCRIPTION 1\'\,fulb-n1iY1 n-\- ~11I'l ~8W1 JOB DESCRIPTION ~M~1;rN1bO Permits are non-transferable and expire if work is not started within 180 days of issuance or if "'ork is Suspended for 180 days, CONTRACTOR INSTALLATION ONLY 2, Electrical Contractor t\rlV\1~/.AA Address \1:(;t..\-QC; flY\! ~et:I,IAOi;;\ Mt-W~1t\CO City Thl4\2tvd Phone BB-Q(JR--:33VO I Supervisor License Number qt.f.j 1,l'1} Expiration Date ,-old oC:; Constr, Contr, Number \ t;t) l to) I Expiration Date II7:lll'D 10 J=-pgElectrician €feN~ ' H.d'<tvLtMSL 1\ OwnersNamJJ~ttL ~~ Addres&2610 ('"Cl'rYl'?; 'F\...VYV) f2d..- Ci~q hd<PLone OWNE: INSTAdATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726.3769 A, New Residential - Single or Multi-Famil)' p Service Included 1000 sq, ft or I.NDTlCE: $106,00 Each additionalllfl~<p[tR<MIT SHALL EXPIRE IF THE WUKK portion thereof AUTHORIZED ur.mFR THIS FH~,o.(f IS NOT Each ManufacdlWtMfihlCED OR IS ABANDONED FOR Modular DwelliJl8~~ WAY PERIOD. Feeder $50,00 B, Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNollS Reconnect Only $ 63.00 $ 75.00 $125,00 $163,00 $375,00 $ 50,00 c. : Temporary Servi~~s or Feeders In'i\ll'\1l!WI'l0'~I@~G1l M.~I'''4''-''es you to 2ofDJ\.~rolt1s~dopted by the Oregon Utjji5jl,OO :J'llq>titil1p~iQf'4~I\\llps Those rules are set $~ruo 40IC/&\'l,~li?6eGk~10 through UAR 952-mlr.00 cPv~~Q()d~ummsad'r ~11<i~i~,~9'pi~s.qp~ r~les by ccllflng ~1fe qenYer, 11'f0'\~; lhe te'~'P'j!jbne D'BCiHlt%R6f~if~ Oregon Utility Notification New A1terMRrn1ilr iExiel\'Sanll>>eraFa'n"r). One Circuit Each Additional Circuit or with Service or Feeder Pemlit $ 43.00 $ 3,00 E, Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50,00 $ 50,00 $ 25,00 $ 45.00 4C) \ Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4, SUBTOTAL OF ABOVE 4f;; , 3.\5 4.sn 57.1~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T;)fBuilding Forms/Electrical Pennit Application )-03.doc