HomeMy WebLinkAboutPermit Electrical 2008-3-12
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FA~: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number Ce ""'" l.,oCS ~ - cro L{ 1 L{
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1. I LOCATION OF INSTALLATION:
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LEGAL DESCRIPTION: 17'0 J > b<.t z.
~'-' ~{><_ __e~\n_~n\\ e> e>fe>D
JOB DESCRIPTION:
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Permits are nbn-tninsferabre'anll expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. : CO~?!~C'!f!!!_!}vS!~~!.~~~ ~NL! _:
Electrical Contractor '~I\~ ~ ~ CS\~~~
....,) -
Address
OJ lot:> 6(" \"",pS
"6\ ·
City &C'f-'<U).. I 0'(, Phone
Q,..40.7
t.[8 ~. Jj~J
Supervisor License Number t( q t-( ::; / f.:r
ICJ - (- 0<;(
Expiration Date
Constr. Contr Number
I b\ 'A\3
~ \ Ib~
...
Expiration Date
s,gna2Z1Eloctridan
Date :~ I \ ';;J O~
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3. , COMPLETE FEE SCHEDULE BEWW
r -.- - - -. - - - --- ,-.- - .- - - . . .. - . - -,
A. l_~~w Residential- ~iI~_~le~~: l\1~lti~.lFamily per dwelling unit.
Senice Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$ 21.00
$55.00
B. : Services or Feeders - Installation, Alterations or Relocation:
-------~ - ~ -~- - * -- - --~
200 Amps or less $ 70.00
201 Amps to 400 Amps $ 83 00
401 Amps to 600 Amps $138.00
601~A1rlP~fid~c)w~sm IElw requires YOt.$t60.00
q{,~II%1>~"y{m'\~R1ed by the Oregon UtgijIW.oo
R~glmfk% IMI (enter, Those rules are set ~tfuo
In W\M 5'2:U01-0010 through VAM l:Ib:o::-Oli}1l.
POgO: You m~y_o.btai.':'..G9.Rms' of tlie rules by-
e, l_wn~~fi.e~~l&~ 1i'J'0l~,.~m:~ telephone
numlJer fer tHe Oregon Utility. Notification
Installati~€i\I~MifJ~Jl!!~).
200 Amps or less $ 55.00
201 Amps to 400 Amps $ 76.00
401 Amps to 600 Amps $110.00
9'y-er. 6~0 Amps or 1000y .<>.lts s~ ~'B" ab?ve.
D, : Branch Circuits
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Se~or Feeder Permit $ 4.00
ownersName~'p(l_r (''l)\\C ~r\\\ ~("oPe1\-n6)LLC 'll~aCE:--- _. _ ____ _________ . _ . _.
Address \ ~::rD Yna ~ ~---:-Y-ee., Eo ' TrHt&fjDfJ1!MU~(Service/feeder not included) -Each Installation :
. ' AUTrr o,./IIVI/-f .SHAr - .-- -- -.. -- - -- - - - . I
City 6pf,~-G\e,Ld) ~~on 3A:'0)~lct ().2to(P tJ.i9wJJlfl6t!JNDE~ ;~PIRE /F 'T-!=If 1~,~5.00
Cn.4li 'l{I)=1-slo.qqt:t1 J$Np19>> fQt(f)~/SA ISPERn4.1:r'SfY~lfo .55. CO
OWNER INSTALLATION K\c:.o..~J.O "5<::ll\€xo Limited JJ~;R&#fYtja?ANDONFD Co ~Aio
The installation is being made on property I own which Limited Energy/Commercial . R$ 50.00
is not Intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $50,00 + Surcharges
- - - . - - -
Owners Signature
Inspection Request: 726-3769
$ 48 00
4. I SUBTOTAL OF ABOVE
Sb~,oC
G?foO
5.?O
~ ~~;~
12% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Dnve(T )/Buddmg FormslElectncal Permit ApplicatIon 1-08 doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00474
ISSUED: 04/07/2008
APPLIED: 04/04/2008
EXPIRES: 10/0712008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1870 MAIN ST
ASSESSOR'S PARCEL NO.: 1703364200800
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Sign lighting
Owner: SCHUCK CRAIG
Address: 1748 RIVER POINTE LOOP
EUGENE OR 97408
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
IMAGE KING INC
License
161313
BUILDING INFORMATION I
Expiration Date
09/01/2008
Phone
541-484-1482
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
!
# of Stories: I ;. I [}\Ij' '0 Lot Size:
Height of StructUI12tdOVV i""le" tv. Oreg Sq Ft 1st Floor:
"v In '-I 80~
Type of Heat: In Oi{EttlOn C actoPtecJj.q/(Flt.r~gd ~loor:
Water Type: 0090 A 95<-00 enter. 'hSitRt}!3~~fnentyOl.t
Range Type: Oalli YOll tna 1-0010 th~qtFkifit!lfgetfiU';&rt
Energy Path: nlltnb ng the 0: Obtain ~sijL~gf') Set fo ty
Sprinkled Building' er for thJ''7!J:r. {No 'M-I€UR9m'i~..oo'th
C""~. Or~... Ire':' fl-. ' me ,.,,, 1.
I DEVELOPMENT INFORMATI~~"11-800~~~ti";;'-N;~~h~~~ Oy
<-<J44~~~t1~ED PARKING
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC Jku~fEMENTS I
A' fi/s PE,R';n Sidewalk Type:
"1Ur/i IVllr S
COIVI OR/ZED 'HALL ~ Downspouts/Drains:
ANy 1~~~~p~i!{~L:;)t:M~;l~OhK
,OD. ONfD f:nr.. NOr
- \~
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page 1 of2
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2008-00474
ISSUED: 04/07/2008
APPLIED: 04/04/2008
EXPIRES: 10/0712008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Admimstrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Sign - Outline Lighting Each
Amount Paid
Date Paid
$5.50
$6.60
$2.75
$55,00
4/7/08
4/7/08
4/7/08
4/7/08
Receipt Number
1200800000000000314
1200800000000000314
]2008000000000003]4
]2008000000000003]4
Total Amount Paid
$69.85
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
l Reouired Insoections I
Sign Electrical: After connection is made but prior to energizing
By signature, I state and agree, that I have carefully examined the completed application and do hereby 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 of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa2e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541,~ 726-3759 Phone
Job/Journal Number
COM2008-00474
COM2008-00474
COM2008-00474
COM2008-00474
Payments:
Type of Payment
Check
cRecemtl
RECEIPT #:
DescrIptIOn
Sign - Outlme Llghtmg Each
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstratlve Fee
Paid By
IMAGE KING
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000000314
Date: 04/07/2008
Item Total:
Check Number AuthorIzatIOn
Received By Batch Number Number How Received
dJb
10768
In Person
Payment Total:
Page I of 1
9:44:40AM
Amount Due
5500
275
660
550
$69.85
Amount Paid
$69 85
$69.85
4/7 /2008