HomeMy WebLinkAboutPermit Electrical 2008-4-10
SPRINGFIELDiij ZON ~~
~ _ INITIALS
~ DATE . \~.OC"
225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH.(541)726-3753 . FAX (541)726-3689 ~ SOURCE LA ~
ELEt.;lKlCALPERMITAPPLICATION ,/ I ~c
CIty Job Number COV\A. 2. 0> 0 F - c:> 0 $""0 z... Date ~/II 08
1. I LOCATION OF INSTALLATION: 3. I COMPLETE FEE SCHEDULE BELOW
'2-c)1~ {l..-YMPIL ~
o CITY OF SPRINGFIELD, OREGON
LEGAL DESCRIPTION
/703 ZSLfZ
OllOO
A. I New Residential- Single or Multi-Family per dwelling unit.
Service Included
JOB DESCRIPTION lJPfI.-o 1000 sq ft or less
~~ Each addltlona1500 sq ft or
~ SlW ~M i"Ve:"t..L.e!, Tb~ 'portIOn thereof
$117 00
$ 21 00
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 Modulfe~U\T~,~e or $5500
Suspended for 180 days. :T\ON' oregOf\:~ Oregon Utlhty
1^\:T.:.T.EN .' dopteq-by.tbe - e'set-torth
2. I CONTRACTOR INSTALLATI~~~c~nte~.:Ti!'~Jg1r8"fIS2'-'OO1nstallatiOn, Alterations or Relocation:
NotiiICa: I 001-0010 throU, s' of the ru\es~'J
Electncal Contractor ESiJ Pr 6/ W ~~ ~~J}3~ay obta10(j;R~\~\Rel~phO~8 $ 70 00
0090\\. '~ the center2ott1R~\ftY<\Q~~~on $ 83 00
Address B1Q1S" 'P~~E: (2.P ,~~~~2dor the.Or~.s~tl2._~mps $13800
center \S ~o 1 Amps to 1000 Amps $180 00
CIty ~fS Ii)(\" Phone 4B5-'59t-(... Over 1000 AmpsNolts $413 00
Reconnect Only $ 55 00
SupervIsor Ltcense Number
~/t.f S I G-
ExpIratIOn Date
/o-/-eJR
Constr Contr Number l~~41D
3111o ('2-0L I
ExpIratIOn Date
SIgnature of Supervlsmg ElectncIan
~/(~ 4/~~-
(- .
Owners Name N,17?IM A1A?~
Address 2? M,;r. IV\. U (fL ~.
CIty ~ 12-A ( n a., {k Phone
Cl~()3
OWNER INSTALLATION
The InstallatIOn IS beIng made on property I own whIch
IS not Intended for sale, lease or rent
Owners Slgnatur~ ( A
Inspection Request: 726-3769
c. I Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less $ 55 00
201 Amps to 400 Amps ~ 'IJO~76 00
NOf\tl2'JPs to 600 At~'Rt'~ \ fl.: r N(1110 00
"Q\~1~~-'l!~\~
~l\':l~-,"- tp_~\\~\S_~Bt\Nt)
C~~~~\f~Sion Per Panel
t\W{e'tiQurt -, $ 48 00
Each AddItIonal CIrCUIt or WIth
ServIce or Feeder PermIt $ 4 00
E. I Miscellaneous (Service/feeder Dot included) -Each Installation I
Pump or lITIgatIOn $ 55 00
Stgn/OutlIne LIghtIng $ 55 00
LImIted Energy/ReSIdential $ 28 00
LImIted Energy/CommercIal $ 5000
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
4.1 SUBTOTAL OF ABOVE I Cc 0
7:),0
C,.&O
'7.r:;o
~,2,1~
69.K
65.~
12% State Surcharge
10% AdmInIstratIve Fee
5% Technology Fee
TOTAL
Shared Dnve(T )/BUlldmg Forms/Electncal PermIt Apphcal10n 1.08 doc
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: cOM2008-00502
ISSUED: 04/10/2008
APPLIED: 04/10/2008
EXPIRES: 10/1 0/2008
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2073 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703254201100
Springfield TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Sign lighting
TYPE OF USE: Alteration
Commercial
Sidewalk Type:
Nonct~ sM~t\.I')(P1f\!"1M!SnspoutS!Drains:
1''''\S PERM'" 'tt\\S PERM\'T tS
AU'THOR\IEO UNOE: ~ANOONEO fOR
~~tAi:~~ g~o.
Owner: NISSIM ALBERT
Address: PO BOX 1733
ROSS CA 94957
I CONTRACTOR INFORMATION'
Contractor Tvpe
Electrical
Contractor
E S & A SIGN CORP
License
163470
BUILDING INFORMATION I
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Constructio? TYP).,tTENTlON: Oregon ~~,..
Secondary ConstructIon TfJlr6w rules adopted bY1MIJ&~ Utilitf
# of Bedrooms: Notification Center. ThoiiMfa ~ll!ttfottlt
inOAR952-OO1..oo10~~ n/a
.. . I I - nu m;a ..... .
UU:itn';"U:~~~1wATION ,
IUnberforthe Ore~
CInler"1~t:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Pae:e 1 of 2
Expiration Date
03/1612009
Phone
541-485-5546
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2008-00502
ISSUED: 04/10/2008
APPLIED: 04/10/2008
EXPIRES: 10/10/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
L Fees Paid J
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Sign - Outline Lighting Each
Amount Paid Date Paid Receipt Number
$5,50 4/10/08 2200800000000000440
$6.60 4/10/08 2200800000000000440
$2,75 4/10/08 2200800000000000440
$55.00 4/10/08 2200800000000000440
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 aU 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 I'emain on the site at all
times during construction,
Owner or Contractors Signature
Date
Pae:e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-00502
COM2008-00502
COM2008-00502
COM2008-00502
Payments:
Type of Payment
CredltCard
cRecelOt 1
RECEIPT #:
DescriptIOn
SIgn - Outhne LIghtIng Each
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdmtnIstratlve Fee
Paid By
ES AND A SIGN
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000000440
Date: 04/10/2008
Item Total;
Check Number AuthorizatIOn
Received By Batch Number Number How Received
dJb 010456 In Person
Payment Total:
Page 1 of 1
1 :50:08PM
Amount Due
55.00
275
6.60
550
$69.85
Amount PaId
$69 85
$69.85
4/1 0/2008