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Home My WebLink AboutPermit Electrical 2003-12-10 ~c; It:: ~ ~ ,~l~?EIJVlr: I 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PII,(541)726-3753 · FAX, (541)726-,!68~ 1lP,I? 0 ? 2003 ,;;,~/ ELECTRICAL PERMIT APPLICATION _ /. /CHFRR Y/ CttyJobNumberCOU1200]'- 0/230 Date IZ/ro/ 03 ~ YC/TYE/EC ,~""" "," "''' "7f!"y!'n, ' ",h-'~ ",~','"'t/;''' '- ~,lR/r; ,-" 3. l :CO~MPLETE FEE SGflEJ)V~E BELQ,lJ\1 x , ./ , > _~"<- , ~ ~ f->/> ,,/.t.......:::..'" ".t'~l~'. '" -"..~j'<,,, ~ ) ~'"'"<<:~, vv~.;;.,..~.,,::' '" '"~~v~ ~v.;,,>:;.0'::;>,..,. ~,,~ ~t 1. :' LOCA1TON OF INSTALIA1TON ~, r-~i- 'c Z-} ~ e~( ~. 'l9~Z ;13 ~ ~r LEGAL DESCRIPTION 1000 &H-~~ A. ~'~'c<<sR~siJi~ti~1 ~- sj~gi'ci~~l):Nii1fti-F'Yiifiily;~~~:;'~\,~lIin:i~~if:.- . ~, ~v ^-ff...,i ...~,'~ , , "'" ()c)OOOOOO 00000 Service Included JOB DESCRIPTION Tt>"",,, UJ~\~"5 .$(:.<"l{.~ 1000sq ft or less T c:' c....L. J'Nlf"'followlng proJect as subrEat:h1(lllikhtlnm1a1l6~@l~q ft or - '-.) ~ C.l(', \ \" Z n.'B_ QlOrtlgJa~~ not requlIfuPfi€lHlftlieffil:9fuse approval I . --r--:i'7"lo \ Permits are non-transferable and expire if w02&~l\,g -+-""'1 V Each Manufact\d Home or ~::;:~::: ~~~~o:::~~y~~~::a~c~~~::~:::g'oat:: ,I t::~~j se~~e:'.~ _ _ _ $5~:O __ ~ ~ v '- 0 ""i' *'~~ w- t0GiW"'''hmUUlV v;>, ~ ~ 'ff-if"*fo(@.'''',' ....;o:~~.,*< t.. l....'\' 2 ~ CO!JlTR~CT9R INST..4LE4.TI.ON01~[LY , B. Sen:ices-cr- Feea~L:s - !nstallatio!l5~Alterationi;.or ReIQdiioh:' , . ~t@y~"k_v."':'- ,~~,v" '( ~% ~ ~...." l ~~v \;"Q" <<:, ..~ ,~_t,v~'~'" ~:. -.-~<:.. Electncal Contractor t'k Q. f r~C IT'\ t: \ (!j- r ~ <- 200 Amps or less '$ 63 00 (., 3 ~ \ Q I ? '\":.-\-. Ij -+ 201 Amps to 400 Amps $ 75 00 Address 6 L () '-< h d. .) \ (~~ \ S t. 401 Amps to 600 Amps $125 00 C" \ 601 Amps to 1000 Amps $163 00 CIty ()~ ~~ ~ "730Z Phont0(3)3<l 9-7bO~ Over 1000 AmpsNolts $37500 Reconnect Only $ 50 00 $106 00 $ 19 00 Installation, Alteration or Relocation 200 Amps or.-less rj -SI1011Ia\J\l r aChJ;(SS YO$j~6:00 M t t. ~ I ...../" I WI 1 . ~ '. 201;~ps ,\o.iOQ'A~ps;d Lry me Ur(J~n I "'$~69 00 j...",v',] ~ . _ I\~'C' H('.' .'-:". IOj 4.01,1 i~l1}.P~~ tp. qOQ Amps . N)!'~ :J n, ' : " _ ~ ,_';19..0 00 \J\..i IV <,;l. \ ''''1'- 1'.."...,11h;' "\rr~ I j...... ~ , Over\600'".:AmpS' or -j.OOO V olts'-see>'B:' .abo"Ve., .1., ') . i- ,,:v i"';.~~ :''''h-Y;..:''---..~...,.~~..f1fi..rl ~5. "','vcv:@;v'" v7--/ N~"'''''_ ~~A...-f i",,~V~ w-,_,,<= ~ V~~,"","","W""_~ D.)FBrancn ClrrUlts :('t 4.~:". '>'-, t :;;' r: .,'~~ .~~ "-:~7;/"t'<lr-;" tf",~gA,htp{"~C*r"";~'"\.,/'~'~~-' ~,~.. '" ~v ~-#$0-'"~~,,:!,,, .;::, val '"' I . """,. t\'~~l('~a~ 0, New Alteration.or..,Eitensiofi Per. Panel ,~ H' ,- nurn....:'" ~. - .' "".,-,r- "" !lJ' \ One CIrCUIt-' ...., ,< ~.... ,. .' ..:. -,'- ",. $ 4300 Each AddItIOnal CrrcUlt or WIth ~ (,-.-. (\c... P ) ServIce or Feeder Pemut Owners Name 0 t)O ,I -' I.l ~ d ~ ~-e.. Address b 4 ~ "A" S\t"'~ E. r~ii;li;~~S~~~(ser,~:r~IT;;~~~;i;~nIlCIUded)!E;~hI~s~;Il;tiOl;~ "'0*,{"0< '*'~^~ .", """'" ..,,~ <",%4~ y~ Aj\:<i<~... -.. ~~Y _ _""-"&<,.,,-,,,,,':;.-...-0 clty5f f~ "'~~;t'\ J crz4'l>hone(')C11)7'14-~~'aC) Pump oflrngatlOn $ 50 00 IJ NlOlTret: Slgn/Outlme Llghtmg $ 50 00 OWNER INSTALLATION THIS PERMIT SHALL EXPIRE ffmTl~ WQ~esldentIal $ 25 00 AUTHORI~D UND.~ THIS PkOl\/UTdlc NOT/C 1 $ The mstallatlOn IS bemg made <W,t:>J"\?~C~fi"o1:tl''Sl. Lf!.tffiite, ~l1erg:1. ommerCIa 45 00 IS not mtended for sale, lease 0I4ldW1 AB~Ri'llt~I5PC~'ic Permit Inspection Fee is $45.00 + Surcharges ANY 180 DAY PERIOD. ,,- .-.'~-~,,'-;~-~~ A"'; '~f::-::"7" .--:----.-.~~T- 0" Owners SIgnature 4. f.B~~g'{~::~!:~OVE . .~' " 61- ~ ~- -~.... ~"",-,-~.-...~-~ ~~ ~!., &\>>>'> "y _ 4~ ~_~ ~ ~ -r L\ "'"$ ,9-- \ d ~ ~-S EXpIratIOn Date 1 0 -l .- c q Constr Contr Number ~ 1 ~6 <8 ExprratlOn Date 7 - <- Q-O-S 31-{?S) C SupervIsor LIcense Number ?'~~ ....~~ "'''>~S\ -~~" """}"%<.-<(..,}N,"" ~ -'-::'~:90Z' C. ;- Temp,orarj' ~erYiC~s or'Feeders ~A:<:M~" ..... ~;:,:s" " _~ ..3:L ,)..,t:;<.-.~ _ ~ -. \ tl- ,~ 04 Signature of Supervlsmg Electnclan ~~~~~ ~ $ 300 I 0" ~- 7% State Surcharge 10% AdmInIstratIve Fee $ 80 73 ry , .;" "- - (; yO ?<'~.j _J L- Inspection Request: 726-3769 TOTAL Lf b4 , Shm ed Dllve(T )fBUlldmg FonnsfElectncaJ Penl11t ApplIcatIOn] .03 doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01230 ISSUED: 12110/2003 APPLIED: 12110/2003 EXPIRES: 06/10/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1-5 at exit 192 NB off ramp ASSESSOR'S PARCEL NO.: 0000000000000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: PROJECT DESCRIPTION: Temp lighting service for roadwork Owner: ODOT Address: 355 CAPITOL ST NE SALEM OR 97301 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor MORROW MEADOWS CORP License 91668 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: {eS 'loU \0 Range\;r~pe';}C\U\ On U\.\\\\'l ~\\ON'.O{'E~PtgJ~P1lth:o{eg fe set ,or' p..'"'(\E.N adO?teo se fU\e5 a 0 952.-00 ....\\\e5 _~ \"\,\0- ",np.;" . ~_ \ 10\\V". "-0""- .\_""'f"I\..~P .._",,""'- ~ot\,\cat\q \ DEXE.t0RMENJ'"INEORMi\.J;IONa I Op..? 95... - 0'0\1::,-\1' - . t'(\e ~~.-.. . :\.\On , ,<ou ffla'l "pt' ~NO\9.. Not\\\ca 0090. t~\e C(O~~}~om~t:\t\~t~"'AA). ca\\\ng W#..:Street'Trees:Rqd:- ~e{'O{ ~ Q\Q' - nl..l'({\I-' r ~..J Paved Drive Rqd: % of Lot Coverage: SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: New Commercial Phone Number: 503-726-2552 Expiration Date 07/20/2005 Phone 503-399-7609 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I NOTlCE: HAll ~~pi~~\lYME WORK 1HIS PERMI1 S oElfmrglp~~I~\~l"{a'bsNOT AU1HORIZEOOUONo \S ABANOONEO FOR COMMENCE n ANY 180 OAY PERIOD. Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Pal!:e 1 of2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01230 ISSUED: 12/10/2003 APPLIED: 12/10/2003 EXPIRES: 06/10/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $7.38 $4.83 $6.00 $63.00 12/10/03 12/10/03 12/10/03 12/1 0/03 1200200000000002576 1200200000000002576 1200200000000002576 1200200000000002576 Total Amount Paid $81.21 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. I Reouired InsDections I 1 Electric Service: Approval required prior to utility company energizing service. 2 Rough Electric: Prior to Cover 3 Final Electric: When all electrical work is complete. 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 Date Pal.!:e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1230 COM2003-01230 COM2003-01230 COM2003-01230 Payments: Type of Payment Check Receipt #: 12002000000000'02576 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 7% State Surcharge + 10% Adnumstratlve Fee Paid By MORROW MEADOWS CORP Received By dJb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Departmen! Date: 12/10/2003 7:53:50AM Amount Paid Item Total: 6300 600 483 738 $81.21 How Received In Person Payment Total: Amount Paid $81 21 $81.21