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Home My WebLink AboutPermit Electrical 2001-1-25 '.~ . . . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54 ELECTRICAL PERMIT APPLICATION City Job Numbe~ _ Q")() ~ I Date I. ~'fi!bQ;jft;b'<;;ift,ii7j'ri\i;\;1fMIi1~.'l<irrj;jiIJWIM:..."VJJ'lI :..1"'''''W"'oH.L'Ii.~~a':J;~~",!!!~~..~ -~ I rY'\CL..-..:.) s:1 LEGAL DESCRIPTION iJ 03 s~l..liL~.~ JOB DESCRJPTION iA ') '^-'>- t:oy::f;-{} / ^ ,~ tJ - fy~ Permits are non-trnnsferable and expire if work is no! starred within 180 days of issuance or if work is Suspended for 180 days. '~~':'~.~''-'_~':':'.~'..a;. . "',"" , ., ", ~. ," ',,' _",' 'I'"QMll~~ii' . ., : ~ '.' ';-.~ ..... I , '. . . -. !.i<ti~ Electrical Contractor O.REGnN FI Fr;TPi(; ,r;F~VICE- P.O: BOX 2237 . WGENE, OR 97402 Address City Phone ~'-/.3 - ( /OS?, Supervisor License Number . { ~'" Cj ~ S Expiration Date In-I-oJ Constr. Contr. Number II()f~/'f( Expiration Date Q -~X- - oC; Signature of Supervising Electrician K 7~(QJJ2~ , " Owners Name \bJt1V).J/ a 13/LrY ~ A ddress 32 \ 1Y'Ift( fY'\ <::>.,- Ci,y~l 0 rL Phon!1Cf${ -OLfJl OWNER IN~ALLATION The instillla,ion is being made on property I own which is not intended for sale, lease or rent. Owners Signarure: Inspection Request: 726-3769 ~~89 " '- ~~.;. o~ ~...o ~ o~. "", "'" 19 ~ O"o.:..o~ o 9--A .J { - &s -0.,,- 3. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof c. ~~~~l{4~li,llt~1#~~ Installation, Alteration or Relocation 200 A"mpsTqri!~? $ 50.00 201 Amii1;to1tOO,FRS . $ 69.00 401 A,.'rhP.S.t~1600t,t!.~f,'/;DAELL EXPIKI: IF THc$ JI,oO:OOK '-",''',"< UUlv RTHI' 'v" ('n.~. .~. I" lJl'RMIT IS NOT Over-6aa i:l.mpi@f,l.oOQ~V.o,lts,~,e :.B::.:a.bove, f ~,". ,'1-'"'' \~I ..>~ D... \i\,;,c.J.:'~ New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit I $ 43.0u 'ts.'J.. ~ $ 3..00 .8 6-0 E. ~s'BB_~~El1j Pump or inigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 S 50..0.0 S 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. Lf~~ .s.~ l..J ~'O ~~~ 8'6\ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application I-03.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00081 ISSUED: 01/27/2005 APPLIED: 01/2012005 EXPIRES: 07/27f2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 321 MAIN ST ASSESSOR'S PARCEL NO.: 1703353112600 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Gas piping. Type 2 hood fee covered by mechanical fee adjustment DB. Wire Tortilla Machine and meter. Contractor Type Electrical Mechanical Contractor OREGON ELECTRIC SERVICE AMBASSADOR PIPING INC 1'\1 1C.1"'jL'I'~' ;. t- ~,~.. . ~,,'. follow I" .:' Phonel'i.umber:'541-998-0471 ru [ - ....') .'''on II ~otification C;e-"..:r. 1, .cse rules :re s;t f~;th In OAR Q'\?_nn-:JV"\1() fh~......._l-. r..,.,.... .....~'"' _... nn -..J _... --- OJv j I CONTRACTOR INFO~;i6N~lay oblain copies of the rules by _ center. (Note: the telephone n~g~r lJ~tthe.~rftf'atW~itM~ifiCPme 1615~ er IS f WI~~44). 541-343-1681 121469 03/27/2005 541-726-5723 Owner: Address: BARRERA VERONICA 220 22ND ST SPRINGFIELD OR 97477 BUILDING INFORMATION I # 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 ofHeat:rlCE Sq Ft 2nd Floor: I\JU . Water Type:' Sq Ft Basement: Range TY'~~!TS PERMIT SHALL EXPIFSqIF(GifrageL9,rport Energy P~th: HORIZED UNDER THIS ~(OlMi'f~~:NOT Sprinkled,B\iililing:CEO OR 1!!"'~BAN19J,~'1.IBIJI.'uLoad: ""'II........... ~... ___ n ..... ..... ....... .. .,"'u I DEVELOPMENT INFORMATION' . 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: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Paee 1 of 3 Status Issued '225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Gas Outiets 1-4 Minimum/Adjustment Mechonlcol + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Clrc Ea Add Total Amount Paid . . CITY OF ~rKll'Oj\.J1<mLD Building/Combination Permit PERMIT NO: COM2005-00081 ISSUED: 01/27/2005 APPLIED: 01/20/2005 EXPIRES: 07/27/2005 VALUE: I Valuation Descrintion I S Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fpp<. PlIilLI Amount Paid Date Paid Receipt Number 1200500000000000085 1200500000000000085 1200500000000000085 1200500000000000085 1200500000000000085 3200500000000000034 3200500000000000034 3200500000000000034 3200500000000000034 S10.00 $4.50 S3.15 S4.00 $41.00 $4.60 S3.22 $43.00 S3.00 1/20/05 1/20/05 1/20/05 1/20/05 1/20/05 1/27/05 1/27/05 1/27/05 1/27/05 S116.47 I Plan Reviews I To Request an inspection caIl the 24 hour recording at 726-3769. AIl inspection requested befo're 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. Rough Gas: After line Is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee 2 00 . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2005-00081 ISSUED: 01127/2005 APPLIED: 01120/2005 EXPIRES: 07/27/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 correet, 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 ofany 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. . ~ OJ:tLL~GG.-- ~ Owner or Contractors Signature , Date l);:;'ilm , . n rv----... Pal1e30f3 225 Fift.h Street . Springfield, Oregon 97477 541-726-3759 Phone . .j:~;~ Ilk ~ of Springfield Official Receipt .elopment Services Department Public Works Department Job/Journal Number COM2005-00081 COM2005-00081 COM2005-00081 COM2005-00081 Payments: Type of Payment Check 1/27/2005 RECEIPT #: 3200500000000000034 Date: Olf27f2005 Descrlpllon Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By Received By OREGON ELECTRJC SERVICE njm Item Total: Check Number Authorization Batcb Number Number How Received 18339 In Person Payment Total: . Page 1 of I 1:54:56PM Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82