HomeMy WebLinkAboutPermit Electrical 2004-11-22
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ELECTRICAL:q;EJ!.MlT APPUCATlON, ,\"" I"" f , G-~ ~'o' ','
CityJobNumbtr ('it. l"\lfJ\ Date II vt.1V'-l o.,~ 0,% '~:"c>;o;I> .
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JOB DESCRIPTION
JIJl/IDIj) QmJ O)nf'Q( .
Permits are non-transferable and ~U-:if-WO--;;r.;-
Dot started lI'itbin 180 days ofissuanee or ifll'orkls '
Suspended for 180 days. "
If) _ ()'7. Insta1latlon, Alterlltion or Relocation
11 200 Amps orless $ 50.00
Conslr.Contr.Number '2!1- --tL-f-t.- ,201Ampsto400Amps $69.00
B ' 'D O"l ~ON: OregontaJ~8W~s I, $100.00
xpll'3lJon Ilte ~ " TOil rultr.llluu......Jby~'lffl~ ooovol~sce~"Ilbov~.. , _
S;cnature7!JSL' J,' ,~El . CatIon Center. Tho~ l!'i " "'~~
. r OAR 952.o01.()()10 thro~ ~-W . ension Per Panel
.......__L . ,_009.Q. You may obtain coRllm Q1i rules Ii, $ 43.00
.L .P', <:ailing tile cerner~ (Not~~tt::t;grplrcuit or with
~""'^" \ Oregon lS~tif~t $ 3.00
Name '\l " 1-80
Address \1:\. \. '^ Eo
, City ~c\. c:n R~hone
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MUN 15:U~ rAA 5417~~~~~Y
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2. ! '",:,
Electrical Contractor' ~~
P.D. rfI1/)(; l26"?3
Address
City 3:UPA1 ~ Ph~e~ --
.~ LW~
Supervisor License Number L.f~-S, '
Expiration Dille
OWNER INSTALLATION
The installation is being made on property I owo which
is not intended for sale. lease or rent.
~.Q.T~~im.: ' ' , , '
THIS PERMIT SHALL EXPIRE IF THE WORK
AIITHORlllilIINm:R TI-II<: P~~WIT I~ NOT
COMMENCED OR IS ABANDONED FOR ,-
In&~JliL,Q~P~69
l;lTY UF SP~lNGFIELV
1l!J00l
Service Included
1000 sq. It. or less
Each Ildditional 500 sq. It. or
portion thereof
Each Mmiufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
r
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
, S 63.00 CO?> .CD
I, $ 75.00
$125.00
$163.00
5375.00
S 50.00
J
~''''''!Il-'''_~f.t<;\l~';:~'I''>:OM__lOIl'lil
c. .' . . ~~~'~.~~~'"::'i~-..::m~~~
Pump or izrigation
Sign/Outline Lighting
Limited Energy~esidential
$ 50.00
S 50.00
S 25.00
7".4 Stale Surch3ii~
10% Administrative Fee
TOTAL
Q,W i;~~SViO;';;;.-'-'-^"'ri311
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CITY OF SPRIl'i~J!U.L1J
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-01461
ISSUED: 11130/2004
APPLIED: 11/29/2004
EXPIRES: 05/30/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541.726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3520 GATEWAY ST
ASSESSOR'S PARCEL NO.: 1703153301400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
PROJECT DESCRIPTION: 100 Amp Panel Change - Emergency Replacement
Repair
Commercial
Owner: CONOCOPHILLIPS CO INC.RETAIL
Address: PO BOX 1539 PASO ROBLES CA' 93447
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor
NORTHSIDE ELECTRIC
License
80593
Expiration Date
03/18/2005
Phone
503-585-4879
BUILDING INFORMATION I
# ofUnils:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
unTH'H"'.
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
THIS PERMIT SHALL EXPIR~l,IDEViEIIOP,MENT INFORMATION I
AUTHORIZED UNDER THIS PERMIT IS NOT .
Frontyard S~th:a'c!i~NCED OR IS ABANDONED F~verlay Dist:
Side 1 Setb~~!w 1 BO DAY PERIOD, # Street Trees Rqd:
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback: % of Lot Coverage:
Solar Setbacks:
REQUIRED PARKING
Total:
Handicapped:
Compact:
ATTENTION: Oregom~...fWlO~MENTS I
Street Improvements: fo"~w rules adopted by the Oregon Utility
, Notification Center. Those rules are set forth
Stor'." Sewer A~ailablln OAR 952-o01{1010 through OAR 952.001.
Spec18llnstrucllon: 0090 Viou may obtal'n ' f h
. copies 0 t e rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
:':'..1_. :v ;f;al~~~i~-n"\DescriDtion I
Sidewalk Type:
Downspoutsmralns:
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 on
.
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CITY OF SPRINuJ<l~LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-01461
ISSUED: 11/30/2004
APPLIED: 11129/2004
EXPIRES: 05/30/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F~~~ ~
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6.30
$4.41
$63.00
11130/04
11130/04
11130/04
1200400000000001666
1200400000000001666
1200400000000001666
Total Amount Paid
$73.71
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
~~ ' .
~uired In~'jl~r.tinn~ I
Electric Service: Approval required prior to utility company energizing service.
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 ohny 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
Paee 2 of2
J~5 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004.0 1461
COM2004.0 1461
COM2004.0146 1
Payments:
Type of Payment
CreditCard
11/30/2004
.
RECEIPT #:
-~
1Iit. ,
1200400000000001666
Description
Penn ServlFdr 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
NORTHSIDE ELECTRIC
Received By
llh
(,;heck Number
Batcb Number
PaRe 1 of 1
liii.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Date: 11/30/2004
Item Total:
Authorization
Number How Received
012283 By Mail
Payment Total:
8:10:15AM
Amount Due
63.00
4.41
6.30
$73.71
Amount Paid
$73.71
$73.71