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Home My WebLink AboutPermit Electrical 2005-1-27 225 FIFTH STREET. SPRINGFIE D, OR 97477 . PH:(541)726-3753 . FAX: (5 1)~~... ELECTRIC~'ERMlT APPliCATION () ~../ "?", '?9,o" ~1. . ~ 9:' City Job Numb r J f~,'f5 -~ate I - N) . 0 s:' of", <> ~ "<>", ..../ .. ~ - ... ~ ~....' "o~.r ~ 0", >:> /,;"" 1. ~'ti!!i_fjj'iil~~~', 3, ",..of,.' bio 0 rt'n, J ... ::::&-: ?../",~_ ~'~<m .... LEGAL DESCRIPTION A, 1Ilit,"Ih~~,~1l "0 \ '/ n 2J~~i,:::~~\~~r~i.~--'8>4'~,lF~i;'~~-;:\.;U;IK~I~d~;iP'f'~::~!'W'~'7:.'iF ~ ',i~, -. l' -).~. ~... tv. .":It", [.,.'.r11--...." j'~.. "'It . ,. . ~'1. 1 ..' .' '" t. - .., . ~ ,~ .1.1...'-.... ....-.. '\ ~,,-.l~. { .~ 08 DES'" I'T ON' ," ,* . ". " ' , . ,.... ,', ft"'''''", '",' _' / J \:IRI - I I ~......:..:......-:........ ...A--.:..~_. .~!l.._'-:......__ ...::o--!... .-~;;..lOOO sq. ,.or less:.~;:;.__ . .Ph'j,.".' ,'" n . Each additional 500 sq, ft, or $P.A"'YLr>cL, I ,,0 I P C'A "'-1 "A J portion thereof , I Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, 2, Electrical Contractor GR€G0N fl.: craw c: ~ RV.lCE.. P.O. BOX 2237 E~6EN[f SR 974~ Phono$l 'i.'.:{~-I ~);;l Addrcss City Supervisor License Number 'j ~"" q~--S - _.- .- ..-- - Expiration Date I n ~ 1 - OJ , ... Tf'" . . '. Constr, Contr, Number ~I u, I S' I c;? Expiration Date a - _'\ x- - 0 I, Signature of Supervising Electrician ' iLd(1/1)"./ ( - ~ o'::nersN~~~~~ f(f~ Address ~I ( S:i- , C~\;lo1k Phonel~Co -rAJ3 OWNER INSTALLATION Thc installation is being made on property I own which is not intended for sale, lease or rent. Owner; Signature: \ ...." ")';' .' , i" ',' Inspection Request: 726-3769 Each Manufact:.1J:1\lee or law requires you to MoATJiEJ'w1\\iH~:se~gp~r Util" FeellaHow rules adopted oy the Oreaon ..~,oo .., T", sa rules are set forth, :/ '~~~~l!W B. .', ' t.t'dfAR:eIO'~riJi[t;t~':?~~~~ 0090, You may 0 airl '(;u~ib 200 "\mH~~ l~ center. (Note: the teleph$l~gl,oo 20 I N.nP.tlBr4;'Ql) t\mpslregon Utility NOtltlC~lbo 401 Amps to(oQ@]l\mi!s1-800-33L-<!J44). $125,00 601 Amps to 1000 Amps $163,00 Over 1000 AmpsNohs $375,00 Reconnect Only $ 50,00 c.~~~~~~~::~ .. Installation, Alteration or Relocation ", ... . '200 Amps or less $ 50,00 201 Amps to 400 Amps' " $ 69,00' 4.ql,AmPs to 600 Amps DC IF 1\-\1' WOHVSIOO,OO .,\ \~~. ~u~\ \ F~P\"C. ,~ \(' NUl . 'Over.600li'1iripS'or-I,000, \! olts s€eWElI' aoo\1e, 1.., --. . ... - - . - .. .-- - D: J.\U. ,.......IJ'H \ un IV . ,- f"fNew,lA1terationl!lr,Extension Per Panel \,\0;, ~^V \,\."'v~' f\Qriecfr),uit', I s 43,OU Each Additional Circuit or with / II Service or Feeder Permit T S 3,00 4..3 dtV ~,dlo E. __111~~J..m;;~~~ Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50,00 $ 50,00 S 25,00 S 45,00 Minimum Electric Permit Inspection Fee is, $45,00 + Surcharges 4. 7% State Surcbarge . '10% Administrative Fee &5()<l) .:; q~ , , ','. 1(J"o qq ~.s- TOTAL Shared Drive(T:YBuilding Forms/Electrical Pennit Application 1-o3.doc ...".......,. .' . . CITY OF SPRINGFIELD Building/Combination. Permit PERMIT NO: cOM200S-00079 ISSUED: 02/01l200S APPLIED: 01l20/200S EXPIRES: 08/01l200S VALUE: $ 0.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 660 MAIN ST ASSESSOR'S PARCEL NO.: 1703353109000 Springfield TYPE OF WORK: Store TYPE OF USE: Alteration PROJECT DESCRIPTION: Demo non-structural walls. Electrieal remodel. Commercial Owner: Address: HARRIS AND BERKMAN 91167 MARCOLA ROAD SPRINGFIELD OR 97478 ATTENTION: Oregon law requtl'.l?-g~ti~8'ber: follow rules adopted by the Oregon Utility ~I~t;t;,,~t;~n r.pntpr Thosp. rules are set forth ,- "^D 0"''-001_OC'.10 thrn1lgh OAR 952-001- I CONTMC'[ORJNEORMATIOIS_~ies of the rules by calling the cervfl~ (Note: the tel,ephpne conlractor number for the-'eff",~ Utilitfl'.RMlI\!!y,urPate OWNER Center is 1-800-332-2344\. OREGON ELECTRIC SERVICE 161518 69/04/2005, 541-726-0327 Contractor Type General Electrical Phone 541-343-168 I BUILDING INFORMATION I # of Units: Primary Oeeupaney Group: Secondary Oceupaney Group: Primary Construction Type Secondary Construetion Type: # of Bedrooms: B # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VB nla Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setbaek: Solar Setbacks: I DEVELOPMENT INFORMATION 11<r'It1E IF THE V\lnuv , . ,U I. 'v.lILcU UI~lJtH THIS PERI\11 T ISREQllIRED PARKING f'l '^"f "EN' {'ED OR I NU I Overlay"Dist: \J S ABANDONED Fo,Total: /l/>1\'1unn~y rr # Street 'FreesIRqil: PERIOD, Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: I PUBLIC IMPROVEMENTS i Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Paee 1 of3 -'ar~~, ! ~.,: ~,.,,~ . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line I Valuation Descriotion I Description Estimate Tvpe of Construetion $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 500.00 Estimate Total Value of Project )?pp<. P..itl I Fee Description + 10% Administrative Fee + 7% State Surcharge Demolition Plan Review CommlIndlPublie + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add Amount Paid Date Paid $4.50 $3.15 $45.00 $29.25 $8.50 $5.95 $43.00 $42.00 1/20/05 1/20/05 1/20/05 1120/05 2/1/05 2/1/05 2/1/05 2/1/05 Total Amount Paid $181.35 I Plan Reviews I . LU i' U.l' ~1"tOl'\jlJ...~LD Building/Combination Permit PERMIT NO: cOM200S-00079 ISSUED: 02/01l200S APPLIED: 01/201200S EXPIRES: 08/01/200S VALUE: $ 0.00 Value' Date Calculated $500.00 $500.00 01/20/2005 Reeeipt Number 2200500000000000075 2200500000000000075 2200500000000000075 , 2200500000000000075 3200500000000000039 3200500000000000039 3200500000000000039 3200500000000000039 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, inspeclions requested after 7:00 a.m. will be made the following work day. I R'pnnirp:,t 'n~n~ Demolition: After demolition is complete, sewer is eapped or septie is pumped and filled and inspection Is requested and approved, and all debris is removed from the site. Rough Electrie: Prior to Cover Final Eleetr1e: When all eleetrieal work Is complete. Pa2e 2 of3 . . CITY OF ~rKJr\iu.l'I~LD Building/Combination Permit PERMIT NO: cOM200S-00079 ISSUED: 02/01/200S APPLIED: 01l20/200S EXPIRES: 08/01l200S VALUE: $ 0.00 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 completed applieation 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 Ordinanees of the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and that NO OCCUPANCY will be made of any strueture without permission of the Community Serviees Division, Building Safety. I further eertify that only eontractors and employees who are in compliance with ORS 701.005 will be used on this projeet. 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 eonstruetion. ~()d:bL"~(l<L ~ Owner or Contraetors Signature ~Io;)./ CQ/ollos Date Paee 3 00 225.Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . .:~INa.~~ ___ :, WiL,,~, i ~. I - --"_.~., . IiiM.Y of Springfield Official Receipt .elopment Services Department Public Works Department RECEIPT #: 3200500000000000039 'Date: 0210112005 8:38:47AM Job/Journal Number COM2005-00079 COM2005-00079 COM2005-00079 COM2005-00079 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 43,00 42,00 5,95 8,50 $99.45 Amount Paid Check OREGON ELECTRIC SERVICE njm 18342 By Mail Payment Total: $99.45 $99.45 2/112005 Page 1 of 1