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Home My WebLink AboutPermit Electrical 2003-11-18 ~ , , ..,,, ..,' .., 1 ' :::-:;:' .'.. ,..,.-:,; ~_.. ",.;~,-,-';,~G:P~D,0RJ.J':iQl't.":'-,....~,;(;~-"j";! .~.I_"l.. ..., ,,' I ~..~.~ ;,_,~~4'''', \.' ::"t'_~1,.,.., . ~'~#'. .'.....~ . .l'>",''l~'"",<:''' .~ eel as sua.d3Jt~o%'wlng , nol fequire specific land use 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:'([;ij'f)1i6-3689 (l c:.. - N.3< "t I ELECl'RlCAL PERMIT APPLICATION / ' Zoning City Job Number CC#fZ,OO] :.. 0 I / 5'7 Date II/I a/oj Date j 1- \Cj - 0 J 1. iEdcATidNioft..ii.NSTAn!41j;oNli!r~~, 3. ~'C{wpffETEPEE~~hEE~~~~tow;~~";~P~;M:w.r.P L~~"\<\Id~41;ii;.~~~"-_' .......M~:L.....'t~~~>~~'?~~ ~~.~~~~~~w:.....-........,.' -'WI1IW...:"....~5:l"-~ ~~:t!' ';:1<;<:) t?1 ~ '::lJ"'-UA LEGAL DESCRIPTION /703 -s. 531 ~:'~.L;-~'" :.,'l.';;' _,..~~...".P""Q~"..._.,,;-~T...I1'"........_ '4~.". ,.;;:-,~..' '-.~-.;:~-f~':r9 E. ~s~I,I.!W:e9.!,!5,'(~~rticet,fe!!i~r :!I,!!' !ncl.!1~e(\,~&~~ctl )ns.t~!l.a~il!J\"1 TI("'""._'"r,.... hw requires you to $ 50,00 "TTEN rump or rrngatlOn 0 egon Utilih, -& ,,+-rl ~"tnB r . ..., follow rule:Sigii/0utline Liglitinges are set Inr $ 50,00 --- ,,......r.te:f Those rUI OWNER INSTALLATION, lo\ificatlon Limitea EnerllY.lResidential~ 952-00 $ 25,00 , OAR 952.I)M,.Q.(iE' U ,,,rjucu\'!" ~: ::1 rules I $ 4500 The installation is being made on property I own which', YoU ~~mlt6DunHgJvtj~!!l9'~rcla e , is not intended for sale, lease or rent. 0090, MinimU~,EIe<:tric,pei-iriitlIi;s'p<;Afti6~('F1~ is $45,00 + Surcharnes calling 11'~~::':~:,:[~~~v,,,\JI.\ij\W:"!9:titi?:'l"i~%\ ~"~~ b Owners Si~oeturee. ' , numbljf ,}SUBrO,TAIJ,rOF-'AEq.,'ltFj.. '-.r, :~, . ,/{"-,,, :;r>," J Z ') rt"U I '''I;. (}"".....~~.t;:,.'l'i~~.IJA~~l..r:<-.\~. !~7=..."'''' '\i~~~1t: THIS PERMIT SHALL EXPIRE IF THE WORK 0' '66/ AU I nUr\lLtiJ UI4U{F; -:-1110 rffiMH IS NOT 7 Y: State Surcharge COMMENCED OR IS ABANDO~ED R ~o Admmlstratlve Fee ' /2- TO Inspecti~4.ootOPJ'6ffi&90D. ~~tlfO~AL $ N.3 !!- ,^,~,J Shared Drive(T;)lBuilding FonnsJElcctricat Penni' Application t.()3.doc //000 JOB DESCRIPTION /'Y1u~ P I(Jv 'l.. C. - ~ \o<-*\~ C:t: ~ ' Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, 2 ~'C01VTit4.crOR~iNST; r'Ji-;f,tiO'Ni(jNI:Yj . U~l:~,1~~li...;';'~'''''' ;r r~..~:'"'Z".;.t.:::""....&.;'-,';,-~" Electrical Contractor C~WR<\.c.--n...f2/ Address JJ1J. ~o'1-. 2 (p <( City CN4 \ ~lVv~ (~ Phone 7 t.{lf--07 o~ Supervisor License Number 3r;;~~- S Expiration Date /0 ( L t.{ 10 \' 'I Constr, Contr, Number 20-'2.. '1 q c.. Expiration Date lO / 2... <{ / n '\ I Signature of Supervising Electrician A(J. ~IJ.U( Ii Owners Name .sic.~ I~ l/trd.....&< -f- b'3 '7 l3.' ST - City S? (~ Address Phone Service Included . ~F:R~~~~if:$~~~\fii!t:[~~:i.~~~1t\\:J:i~i:rl" _. A. ,~t".:;!!.tSi~"~,,t,~;,i ~iitgleO!,M!,1\i~.f!!!!jI5:;pfr' d~~IIl~_.i<..~ 1000 sq, ft, or less Each additional 500 sq, ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19,00 $50,00 f'-'" 'I;- :~,~.,.:;:,~" "}~.... ~\\'. '~t.(Ji'- \;p'~ ~',(.(:>. '_ li'l:-.l.h" 'i'\' ~. J .",".,,~ ". n. /.. " .'],~..'.. . ..' 'j B.lf~g~~Si~.h~!b~~~~~!;S~!~~!tII,~!,~~~r;.1JJ~~~H?pjg~!O~~t~~P':l , 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only / 63 $ 63,00 $ 75.00 $125,00 $163,00 $375,00 $ 50,00 c. [~OJ~t,~~iBj.c~:'o'r~f:!~tl~,~~-;'!)~"" ~~;~~~,~~'~C'~.iJ Installation, Alteration or Relocation 200 Amps or less 20l Amps to 400 Amps 401 Amps to 600 Amps' Over 600 Amps or 1000 Volts see "B" above, D ~B"~;'J.,,\{,"," '1i',~'C"':','.';,'- <v:;;:tiftJ, '-~~<<,>;,;'.g,- :'Jf*r~,",'~~~ ~',\\;&i?~,':~i't:~.'.)~<'4l;j"t . i: '~?j~?:.;-;S~(1 . fio)I.anc.. ',.tt:~!1.~I..~j.J;:,._ ,'Jr..,'., \,'." '" ,':.~~'''' ;1:.J.""I:,~~,' ~'.w'4k' "! ~'''':(>' :-"'_~ $ 50,00 $ 69,00 $100,00 New Alteration or Extension Per Paop' One Circuit " Each Additional Circuit or with ,2.0 Service or Feeder Permit $ 43,00 $ 3,00 bO . . CITY OF I)rKll'llJJ1u,LIJ . Building/Combination Permit PERMIT NO: COM2003-01157 ISSUED: 11/18/2003 ' APPLIED: 11/18/2003 EXPIRES: 05/18/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 555 MAIN ST ASSESSOR'S PARCEL NO.: 1703353111000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Electrical only - NO OTHER WORK TO BE PERFORMED UNTIL REQUIRED PERMITS ARE OBTAINED Owner: STELLAR INVESTMENTS LLC Address: 637 B ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor GLEN A CAMPBELL License 73995 Expiration Date 0512412004 Phone 541-744-0705 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft 0ther: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING Total: Handicapped: Compact: Rearyard Setback: % of Lot Coverage: Solar Setbacks: U to ,_, _. .,,,.~~nn IRW requires yo , , f~I~~;'r~'I~~ '~dopted by t; '''I p'UiiLI~jM'pioVEMENTS I , Center Those I l, , Street Imprl\'CeJijentS:On '10 through OAR 952-00 NOTIC(.S.idewalk Type: r)t'R P52-001-OO 'f the rules \ -. UT t:bJ" J... CI'DIDE IF THE WORK Storm Sewer'Avallalile: ' a' obtain copies 0 THIS PEDownsl' ,utslUra!ns=' SpeciallnstR.~flb'n:~ou ~ Yenter, (Note: the tele,~ho~e AUTHORIZED UNDER THIS PERMIT IS NOT calling t o~ ~e Oregon Utility NotificatIOn COMMENCED OR IS ABANDONED FOR Notes: number~"ntP' i~ 1_800-332-2344). ANY 180 DAY PERIOD. I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 . . CITY OF ~nuNGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2003-01l57 ISSUED: 11/18/2003 APPLIED: 11/18/2003 EXPIRES: 05/1812004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee~ Pail! I Fee Description + 100/0 Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid $12.30 $8,61 $60.00 $63.00 ,Date Paid 11/18/03 11/18/03 11/18103 11/18/03 Receipt Number 2200200000000001777 2200200000000001777 2200200000000001777 2200200000000001777 Total Amount Paid $143.91 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 Renuirel! Tn~neetion~ I 1 Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service, 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 oil times during construction. Owner or Contractors Signature Date Pal1e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01157 COM2003.01157 COM2003-01157 COM2003-01157 Payments: Type of Payment Check .. ~-,~"..",..,~"H!" ',"'",". r " i .."". ; .' -, . ,# , ': ' j ........-..---...' '---, Receipt #: 2200200000000001777 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By GLEN CAMPBELL Received By DJB Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department, Date: 11/18/2003 2:53:46PM Amount Paid Item Total: 63,00 60,00 8,61 12.30 $143.91 How Received In Person Payment Total: Amount Paid $143,91 $143.91 . .