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115 ~u'... STREET. SPRINGFIELD, OR 97477 . PH:(S41)716-37S3 . FAX: (541)716-~)~' ,0lEi~t" .,
ELECTRICAL PERMIT APPUCATION .' 1<><:;,'<'0." r;\,,""~". .
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r:!ti('::i!:~C~~':;o~ 0 2.200 ~~::~t:~: $106.00
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.f .::(\'. Permill arellon-tramferable and expire If..ork is Each MllIIIlfact'd Home or .It
,;:~:('.r' not slarttd wlthln 180 days of issuante or If work is Modlllar Dwellina Service or
:.t'~.'.J1:..~.i:, .... Susp.onded fo.r 180 d."yo. . Feedor .S50.oo
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,\; ;~I;I:i:.'. ., ~~\"'~~60~tractor :'~i;i;l LA 1,1 n H f(.T1LIC I' ~OAmpsor less s~;.~.
/;);?' i: .' " '.., 201 Amps to 4OOJ}iIj;rE:NTlON' $75.00
'." ).~, .~. .:. g?O-DW: it:! 41/l"fllbl€' 401 AmpslO 6<Je}ill1psv rUles . Urea"" ~W.OO .
":'!if . i ,..,!.,.,,' ,I:. 601 Amps ro lffii'J,tmPl'ion C aUOPted h}SI6f.'rfiUlres "^;.
:,i~[ Jr.' c,I)Y;k""r:::11AEIJ E:. :' Phone l.f~t;-'?>';""'<j Over JOOOAn/pW61fi 952'00~n,,;r. Th"iJ7~l!}'egor> II'c'::~ .
-'~';I)' "IH:i':, I. :,: "L' ,. ReconnectOnlSJ190. YOU m 'VU7n Ih..$ S6~OO3 arA ~..' .;"'y.
"1' ';. . , ,. : .' ,,:' . . Calli . ay Ootai" J~gh OA~ -"wen
. :,,<, .. 2 r= 0 r"l C ~'7';<:_"'FV.",<.m... ."m~WfJ;.,!I,.. ~i1ll~;_.R(l~~~:m.,Rf.'"'~r~'fi
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ti1;:~~_~,f : . Exp~1iOIlDam II) I , / tJA In.lDl!llllon, AU'rallon ~f!R~?,'b~~ Utility Notihc one
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,tM'j~~:.:"" q>ns;tr..~.~n~,~~ber 5K I., on 201 Ampo1r:J400AmpaS69.00
Hil:!~pr:' ::'lnBIIIII!.11 ~1l!!Il".!' ""I'!.\, :I',!, !D ',',I i' ". 401 Amps 10 600 Amps . SJ9Q~, ,
~~~:;ilf'~j'.~,',- :\~~II.l, _~ ~t *,'Da:te. ' .I! I' "1 .. 0 600Am 000 V ''B"ab .\ll~i' 'I'
t,. ,~fl' . .1 lil:I",l,,~' '1.'.1/' ., ,! '-"'."" .".. '. . vor ...... ., 1';'..0r.,1 oils '.eo .. ove. 'e". ._..
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:.'~:~jJr I ~'::i(\iW.J. .::ik,,:)l }~,i r'il::~. nY';t . _~. No""'c~te~t.tion or Extension Pe~ Panel I $4"3""0::"'0'"'-' l J -'7
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~:!(,~;! '." :,:,i,.'(}Lil";<:-:"< . '::2;.'~' ,! d. .._ . OlVice or Feeder Penn it 1 $~,.p'~":, '"'
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",.U',+\i;;: . :t.'~i .' . i\ S,-"",.t!ine Li.'"'.'& S 50.00
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~;'11~~1\, .:. : !h"hI:'fAI!8tlon l.s beln8 macl~ on property 1 own which Limited Energy/Commercial $ 45.00
~t'~-;1v.~t.' :.' ~L:!~~t~~~~~ ,~e; lease pr.teIn. ~infmunl Electric Permit IDspeetion Fee is $4S~OO +'t.:. S,'!1"."f.~llrges
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':.;' t.ti'I\.' OwnerS:Signature:' 4. 2S.&.Bt'O:tAi;"df;;'4H()~""'\';t,1!i'II~1t<~0!l~;;;l:'.f~ L{ Co
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::i:i~?i' ";11' ;'~11""!'I';J :i I' ~,;', '",n'" I .THIS PERMIT SHAll EX~ ~ Ivl;i~i~~~ . I{ ~o
:'\;i\)"'~I ;"".>'" d,:, " \ 1,1 d.,,>,. AUTHORIZED UNDER TH\ f/: 5 7 "iJ
;l,':%~jil.' ~~~~Ii: ~~~;~~i~j~,~t31\~~~'LCOMMENCEO OR \$ ABJliRWm.l~O FOR f[, '1.\; -
'~;~'l;i,;t . !11l\fl;l:~f :l'~ (:;:.III,J,\.... ANY 160 .OA't PEfUOO. Sh>mlDrivc(l":)<lluild....FOnn>;/EI~Perrn;tAppU~I.cJ.d'"
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HON 15:37 FAX 5417283889
CITY OF SPRINGFIELD
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
,,541-726-3676 Fax
541-726-3769 Inspection Line
. CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2005-00330
ISSUED: 03/24/2005
APPLIED: 03/24/2005
EXPIRES: 04/10/2006
VALUE: $ 6,200.00
SITE ADDRESS: 3018 GATEWAY ST
ASSESSOR'S PARCEL NO.: 1703220002200
Springfield TYPE OF WORK: Restanrant
TYPE OF USE: Alteration Commercial
PROJECT DESCRIPTION: Remove interior waD and door at merchandiselstorage for new refrigeration unit.
Owner:
,: Address:
GATEWAY MALL PARTNERS
110 N WACKER DR BSC 3-04 ATTN PROPERTY TAX ADMIN
CHICAGO IL 60606
I CONTRACTOR INFORMATION I
. Contractor Type
General
" Electrical
Contractor
ORDELL CONSTRUCTION COMPANY
WEILAND ELECTRIC INC
I DUILUU-'U 1l"ll~v.n.MATION I
# ofVnlts:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
A2
VN
License
63030
58600
Expiration Date
01/02/2006
01/23/2007
Phone
541-747-8734
541-485-3639
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
: Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements: ATTENTION: Oregon law requires you to
Storm Sewer Available: f 1\ w rules adopted by the Oregon Utility
Special Instruction: o.fo t Center Those rules are set forth
Notllca Ion . hOAR 952-001-
. OAR 952-001-0010 throug
1~090 You may obtain copies of the rules by
. ter (Note' the telephone
~~~~~r'~o~ ~:; Or~gon Utility Notification.
. Center is 1_800.332-2344).
Notes:
Paeelof3
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
" w,t ~Op.~
"01\t~~ t;\\i Srlt>.\.l tJ.?~~~p.t;\\1 \~ NOi
irl\S !O~~l~O IlNO~P. :~~~OOtiEt) fOP.
"Ili n D Op. \S "v
COt-^t;\~NCOt:,,'{ p~\l.\Ot).
P.N'i 'SO
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.
. CITY OF ~r.K11'1GFIELD
Building/Combination Permit
PERMIT NO: COM2005-00330
ISSUED: 03/24/2005
APPLIED: 03/24/2005
EXPIRES: 04/10/2006
VALUE: $ 6,200.00
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Val\lation Descriotion I
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
6,200.00
Value
Date Calculated
Description Tvpe of Construction
=-
Total Value of Project
$6,200.00
$6,200.00
03/24/2005
Fpp<. p"it! I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
+ 10% Administrative Fee
+ '0/0 State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt Number
$.8.40
$5.88
$84.00
$4.90
53.43
$43.00
$6.00
3/24/05
3/24/05
3/24/05
10/10/05
10/1 0/05
10/1 0/05
10/1 0/05
2200500000000000334
2200500000000000334
2200500000000000334
2200500000000001403
2200500000000001403
2200500000000001403
2200500000000001403
Total Amount Paid
$155.61
I 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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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Pae:e 2 of3
.
. CITY OF SPRINGFIELD
Building/Combination Permit.
PERMIT NO: COM2005-00330
ISSUED: 03/24/2005
APPLIED: 03/24/2005
EXPIRES: 04/10/2006
VALUE: $ 6,200.00
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 compfeted appfication 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 witb
the Ordinances of the City of Springfield and the Laws of tbe 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.
f further agree to ensure that all required inspections are requested at the proper time, that each address is readable from tbe
street, that the permit card is located at the front of the property, and tbe approved set of plans will remain on tbe site at aU
times during construction.
Owner or Contractors Signature
Date
Palle 3 013
225 Fifth Street
Springfield, Oregon 97477
,
541-726-3759 Phone
.
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City of Springfield Official Receipt
.elopment Services Department
Public Works Department
RECEIPT #:
2200500000000001403
Date: 10/10/2005
lO:52:54AM
Payments:
Type of Payment Paid By
CreditCard WEILAND ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 010966 In Person
Payment Total:
Amount Due
43.00
6.00
3.43
4.90
$57.33
Job/Journal Number
COM2005-00330
COM2005-00330
COM2005-00330
COM2005-00330
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Amount Paid
$57.33
$57.33
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10/10/2005
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