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Home My WebLink AboutPermit Electrical 2004-12-1 .. I .. . SPRINGFIELD .or.n^~1 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX9~41)726.3689"'o.. 0/..;:---,-, ~.' '1 .. ~ "''; '.. '- " "-.... ELECTRICAL PERMIT APPLICATION ,,~ "'- O"/~ Ot;;"''''';'-~ CityJobNumberCOIWZ004-0ILfh8' Date IZ 01 oq O",;,..O'oS<".~""- "9"/~;:~,,?_, .) Service Included II .. Each additional 500 sq. ft. or ...... i ~4l\. k5Gt0 ;<,'(" IlfJ{"fl.. ClILJ e;iI~f~ I-hv,~ortion thereof $ 19.00 Permits are lion-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder c. I Temporaryservices or Feeders ATTENTION: Oregon law re~Uires. vou to follow rules'ostallalioo, Alteraf 0 or Rl!liic~ 100 . " auuf.I,tlU oy IlIe regon Utility Notification ~Q!ht-.J1!PSI%~'S'e rules are set fo,~t, $ 50.00 In OAR 952.@9\k.1DP,V?IiWll..-t]I1I\':)AR 952-C"./.- $ 69.00 0090.You rrr1JV &mPiiI\o(,(j9Si~!l'ffi the rule" Ly $100.00 r-~I"ng thWverl600 A'Trim;:!)r l.QQ01;Y:Q!1~lsJ"h'<Jl" above. number for fOO.GIOhLlCilIcuitiiity Notification Ce"~(,!~~te~~t?o~~?~~~oo Per Paoel/ One Circuit v../ $ 43.00 . Each.Add.itional Circuit or with Service or Feeder Pennit S~: r;I,smg Elec :~~ Owners Name ~co [)I-.:d(,/l~' Address V 0 2" ~ / :5 '3 '7 E.I Miseellaneous (Service/feeder notincluded)__Each 10sta.lI~tioo I City ~s: D ~~J8 Phone Pump or irrigation $ 50.00 cA Sign/Outline Lighting $ 50.00 OWNER INSTALLATION 011"E" Limited Energy/Residential $ 25.00 N \;. . .'''d'E'~r IC/:rl-l~ \^,081 K I u'" ~, The installation is being made on property I own which'v\IT SHAk\!l1!Je nergy UommHCla T $ 45.00 I~ LL.) , , I nl" I ~''',rn ~''1e [l~RM\T IS NO IS not mtended for sale, lease or rent. TUORIZEDJ\jhiimum 'Eleetrie'Permlt.1nspeetioo Fee is $45.00 + Sureharges , AU " - . ~ ""1"""<;:" ~"" ENCED Ot~.f' "u"".:n;J1"<~>; , - I Owners Signature ~~~~ 80 DAY ~f1tf~TOTALOF ABOVE ; AA.c:r'\ 7% State Surcharge I, II U.(? 10% Administrative Fee Ii ~ .~ (9 TOTAL l~ ~ C> N ~ 2. l CONTRACI'()RlNSTAT.T..".TIONONLY I Electrical Contractor n I WI VlA.v1A..L? Address :4 ~ DO Vl ~ ~ 1 11 Ctl~ City PbYZ.fknolPhone ~M 5/'1 b()5b Supervisor License Number Y~4~ Expirution Date Ie, -I - .')6C!l'/ Constr. ContI'. Number /)/o-8~d(' Expiration Date 1(') - 1- JC':JC')l InSI>ection Request: 726.3769 ~ ~f\ ~~\$ $50.00 B. I Services or Feeders -lnstallatioD,:Alteratiol1'sor;Reloca'tioo: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpslV olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ~.Dc) $ 3.00 Shared Orive(T:)lBuilding Forms/Electrical Permit Application 1-03.doc . CITY OF SPRII"lul'lELJJ Building/Combination Permit PERMIT NO: COM2004-01468 ISSUED: 12/0112004 APPLIED: 12/0112004 EXPIRES: 06/0112005 ' VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3520GATEWAYST ASSESSOR'S PARCEL NO.: 1703153301400 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: PROJECT DESCRIPTION: Low voltage and I circuit Owner: CONOCOPHILLIPS CO lNC-RETAIL Address: PO BOX 1539 PASO ROBLES CA 93447 , CONTRACTOR INFORMATION I Contractor Type Electrical Contractor NORTHWEST PUMP & EQUIPMENT CO License 64567 1 BUILDING INFORMATION. ATTENTION: Oregon law reqUires you 10 # of Units: follow rules adoptedl:9YStO.ries:3gon Utility Primary Occupancy Group: Notification Center. l~tig!!trl!fl~r:.I!CJI!.I'!\ forth Secondary Occupancy Groullh OAR 952.001.001 dliYPM~ff~~;R 952.001- Primary Constructio? Type 0090. You may obtai~~\1Ii!ye~::he rules by Secondary Co~structlOn Type: calling the center. ~~e~~:1tr:l1e1~lephone # of Bedrooms. ber for the Ore,l}.nergyiliat~'otification num SUI\ 'kj"dYB 'Ud' nla Center is 1'8J1J!~Jl'2J~"I.mg: ,DEV"'LvrlVu;,l''U ll,,~vRMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: . # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Addition Commercial Expiration Date 03/12/2008 Phone 503-205-2158 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPRO~~~~,!:~S I THIS PERMIT SH~i~~'t'l!~ff'X.Pff THE WORK AUTHORIZED UNDiiwn~p'Q!lt$IP;;;~iif: IS NOT COMMENCED OR IS ABANDONED FOR , ANY 180 DAY PERIOD. Notes: I Valuation Descriotion , Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Paee I of2 Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description +,10% Administrative Fee + 7% State Surcharge . Add, Alter, Extend Circ Low Voltage - Commercial Indus Total Amount Paid . I Ff'f'~ PlIidJ Amount Paid Date Paid . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01468 ISSUED: 12/01/2004 APPLIED: 12/01/2004 EXPIRES: 06/01/2005 VALUE: Receipt Number 2200400000000001463 2200400000000001463 2200400000000001463 2200400000000001463 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. $8.80 $6.16 $43.00 $45.00 1211104 12/1104 1211104 1211104 $102.96 I Plan Reviews I I Ren\lirpd Inonpptlnno . II.lr1fl~ Rough Electric: Prior to Cover Final Electric: When aU electrical work is complete. Low Voltage: Prior to cover. 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 Pal!e 2 of2 Date 225 Fifth Street Springfield, Oregon 97477 54..t-n6~3759 Phone Job/Journal Number COM2004.0 1468 COM2004.0 1468 COM2004.0 1468 COM2004.0 1468 Payments: Type of Payment Check 12/1/2004 . RECEIPT #: ii:~ JiijJy of Springfield Official Receipt .velopment Services Department Public Works Department 2200400000000001463 Date: 12/0112004 Description Add, Alter. Extend Circ Low Voltage. Commercial Indus + 7% State Surcharge + 10% Administrative Fee Paid By NW PUMP Item Total: Check Number Authorization Received By Batcb Number Number How Received djb 171567 In Person Payment Total: Page 1 of I 8:54:04AM Amount Due 43.00 45.00 6.16 8.80 $102.96 Amount Paid $102.96 $102.96