HomeMy WebLinkAboutPermit Electrical 2004-1-16
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Status:
Issued
. CITY OF SPRINGFIELD'
Building/Combination Permit
iP-ERMI:r_N O:_COM2004:00058.::J
ISSUED: 01116/2004
APPLIED: 01116/2004
EXPIRES: 07/16/2004
VALUE:
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 414 MAIN ST
ASSESSOR'S PARCEL NO.: 1703353107400
Springfield TYPE OF
Electrical Work Only
TYPEOF USE:
PROJECT DESCRIPTION: Two Branch Circuits
'Owner: NESSCO I NVESTM ENT CO
Address: 37309 AGATE DR LEBANON OR 97355
I CONTRACTOR INFORMATION I
Contractor License Expiration Date Phonc
BUILDERS ELECTRIC INC .ATTij~9610N:Oregol11iuIOA2ll1li711res ylStlIMS5-0922
BUILDING INFORMil:IOir"" "UU~ltlU oy me uregon Utility
m " Center. Those rules are set fort
# of Units: # of Stories: "OAR 952:001 -001 OI!/;'{gltl1,h OAR 952-00
Primary Occupancy Group: Height of J090. ,You may obtairsfFPi~f>iIt&dp.e rules I
Secondary Occupancy , Type of Heat: callmg the center. ~ctlf.lldblFt6llaphone
Primary Construction Type Water T)'pe: number for the Oreg;q'"RJtijji\f~eotification
Secondary Construction Range Type: "--"N;"" 1-RSlj1'fY.c;,;€lllltll'~rport
..nT'CE' '"1
# of Bedrooms: . Energy Path: Sq Ft Other:
TH~S ~~H~IT SHALL EXPIRE IF THE WORK Impervious Surface Area:
nu. IIVflILt:.U UI'4Ucn I nli) len'''''' ..... .."..
cnM~1J:NrI'D OR IS ABANDON{DEVEWPMENT INFORMATION'
A~fll~tY~AY PERIOD, - , -" '
Front yard Setback: Overlay Dist:
Side 1 Setback: # Street Trees
Side 2 Setback: Paved Drive Rqd:
Contractor Type
Electrical
REQUIRED PARKING
Total:
Handicapped:
Compact:
Rearyard Setback:
Solar Setbacks:
% of Lot Coverage:
IpUBLlC IMPROVEMENTSI
Street
Sidewalk Type:
Storm Sewer Available:
Special Instruction:
Downspouts/Drains
Notes:
I Valuation Descrintion ,
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
I of 2
.
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: cOM2004-0005S
ISSUED: 01116/2004
APPLIED: 0111,6/2004
EXPIRES: 07/16/2004
VALUE:
Status:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
II III
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend' Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
Receipt Number
$4.60
$3.22
$43.00
$3.00
1/16/04
1/16104
1/16/04
1/16104
2200400000000000036
2200400000000000036
2200400000000000036
2200400000000000036
Total Amount
$53.82
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection requestcd before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made thc following work
day.
I Reouired InsDectioDs ,
I Rough Electric: Prior to Cover
2 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 JlCrformed shall be done in accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon JlCrtaining to the work described
herein, and that NO OCCUPANCY will be made of any structure without JlCrmission 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 insJlCctions are requested at the proJlCr time, that each add ress is readable from
~~~et, that the permit card is located at the front of the property, and the approved set of plans will remain on the site
a;;5Y!t;;;jUct/hq,U}f/'(/60Ivj) /-/0 -Oc)/
Owner or Contractors Siglla;~' U Date
2 of 2
,
" . €ITY OF ~_.MNGFtELD; OREGON,' : CJ ", :,
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project as submitted has the following
">f,' If! M,ctdoes not require specific land use
225 FIFTII STREET. SI'RINGFIELD, OR 97477 . PII:(541)726-3753 . FAX: (54!~t?t~Jl'd9 r'(l
ELEcTRICAL}?lJ!&l1'APPLICAlI95f! Zoning "- L
City .lob Number U J;YJdtYJ7f -ax:IJate 1- I (p - dr5'b <(. f'ote. \ -.10 ;1)
I. t! Hjjp;it!,cliji.6J~J!JsfAt.LA1'tpN:' ,~,T'l ), [co~ljEEfE-i;iIfs7!H!fiJUEtlJj'Pr:.lJl;;:; ,~::.; .J~v::'(;;' ~.:'
qlL( m2lIJn'OJ==H'--"'~ . .-.. ...--,.-- ---"-" _~'''''_d,L-_"" . ~.Lj
LEGAL DESCRIPTION A. 1,'NC\~;li~~id;nli~"-::::iii,;gIC_?; ^,ul!i~!'!!.i1iil)' pc;.;d.'\:~nli'~\~~i!:{.J
1-, 0 3> :5 5 3 I <974 Ob sUerv:e ;';'c1ndcd' , ~,,' -^.~ "'~' ,", ,.J'.L_~u~\J:>,_~jf
JOB DESCRIPTION 1000 sq, fj, or less $106,00
n- (Q,..., _ -r L t1 ~ If'{j' ~ h Each additional 500 sq, ft, 01'
~ r, '-^ I' A..L-- P p011ion thereof $ 19,00
. rJ'!:~i'~r:':.'_~I~.,-j'.-:"";:;'""'l'~', """\_'~ ':~!:;,"'r.~{.~~l. l1~"";"'I:""~~1. d - l'
C. fltlelUpornry Ser"lces/or,I'J'eeder,s~' ,:'~ i ,:r, ...", tJ;\\~\i {J ",,"./ ":::':"t:\1:i~t:~1~{..
,... P. . '.: . ." h<....I.."'."l}l'~"''.:' ""'...0\1'0 l._\I~,t!I.....'.:.::>';,I_,Jo..~.'.'f:J~
, _ . i=r \TION:Oregon la~ requires you, I',
Expiration Date 10 I 'L\ II Instnlla'?llJ. "}\~ ~rah0l1u!:..fiRpW\qll3 Oregon U\lhly
tolloy.{.rUles aoul' "" to.
NOTICE: II ' 200 AI'mSt~a'i~on Cemer. Those rules FSf5tl'uu
Conslr, Contr.-NW!Jh,ef:prifi'{)Sll.,p, FXPIRE _IF THE WOHK 201 ^,1;lciA~g'$~!1~l'.~-0010 thrO~gh uAf\;~~6~~'
" AUTH,QHIZEQ UN_D>;R',~IS PtRMIT IS NOT 401 A51m6~ ~lM~iQ.y'obtain COPI~S OT t$1t06h~no
ExpiratIon f)nle."..L1,.;J 'l'r/.l;") nR f;) JU::.~ MnnNm ~OR 0' ,cIIO.....II' Iln"""nn'l"r, 11I.1n!f.l'lnI11ele.p" '
l"v""..,I Jet:. _ ,\-:: ' ... \C'_"., <;"_IT1l\S'.'. ~_<vo IS SC~'~UlIi~~lfjCa,!iPl'
Signatl' ofS 'dX'i~;\\g iil~dtril:\J,\IOD, D. miiFn,~.~ll.1uIi~~{f.\J},~~~~~n~~e2'.!2~44)'~A~t~;~!\i;I!n~~i1t,'I~
New Alteratiun or Exteusiou .I('r panel;
~ ~ne Circuit $ 43,00 .~. au
Each Additional Circuit or with / (Jl)
Service or Fceder Pelmit $ ),00 ::;> ,
Permits arc non~transferahlc and expire if work is
not started within 180 dn)'s of issunncc or if work is
Snspendcd for ISO days.
2 P::coNfi:RA6TOinNsi:UiJA'T10N:ONLY\,
. li _'i~"tt!t!~:'!l.t:~. _/.:~/IlQ:;'Jl:i.!LiS..':"'J~t"i.r:.-~y_::_;:; t
Electrical Contractor Hl' i I efT S C Itt '\I If /r'(;
Address lQC) /v\clci i ~:)C(I
City E'l j<jl.:.;'flt'
Phone Lr;;,c:-, en::r)
SupClvisor License Number
~1(IO - s
Owners Name ~ 5f
Address
(o~
0/
Cit.;$pr ; n
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OWNEI~ INST ,LATION
The installation is being made on propcl1y I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection He1lucst: 726-3769
Each Manufact'd l'lomc or
Modular Dwelling Service Of
Feeder
$50,00
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II. ':,Se;'\'ices 0';" J1eede,'s'''- lustnllntin;l, Allcrnii01I' 'oi:iRcloenjlori:~";,:l
t;,';".:,"J.!.~t~ ~"::. . l.'":lrt:::.f'.:l.:!1.\.~!'~.!,'~', :',;lP,;".,. ,';; '.'.!,;"........~...d'~;',L:t~:Pl.':l~,~~~I40,'~
200 Amps 01' Icss
20 I Amps to 400 Amps
40 I Amps to 600 Amps
(,0 I Amps (0 1000 Amps
Over 1000 AmpslV olts
Reconnect Only
$ 63,00
$ 75,00
$125,00
$163,00
$375,00
$ 50,00
E, n~irscenJ,i~~,iHs~r'~J~;ii~:;d-;.7n'i;f ii;~ii,a~d)~2.E;r~ki ~I;ti~ili. ii~i~:tl
t.'.f/;lt-r;;- _ J.;,.,l'fl: :_ "~1< : . ~ \::' ~.T,~'.'1' '~..t;.~~~....;;t;..,..~'\;\'"";.:..'(.', '':'';. "'''~. ~"",,\....>.t:: . ., ~P~."".
Pump Of in'igation
Sign/Outline Lighting
Limited Encrgy/Re:-;idcntial
Limited Energy/Colllmercial
$ 50,00
$ 50,00
$ 25,00
$ 45,00
'I\'1inimum Electric Permit Inspection Fee is $45.00 + Surcharges
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7% State Surcharge .,3 , ;) ;;l...,
10% Administrative Fee Aj, (00
,63.gL.
TOTAL
Shared Drivc{T:)fBuilding Fonm;/Elcclrical Pcnnit Application I.OJ.doc
225 Fifth~Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00058
COM2004-00058
COM2004-00058
COM2004-00058
Payments:
Type of Payment
CreditCard
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Receipt #: 2200400000000000036
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
njm
Check Number
Batch Number Authorization Number
Paid By
BUILDERS ELECTRIC
000278 091033
City of SpriDgfield Official'Receipt.
Development Services Department',
Public Works Department
Date: 01/16/2004 9:32:58AM
Amount Paid
Item Total:
43.00
3.00
3.22
, 4,60
$53.82
How Received
In Person
Payment Total:
Amount Paid
$53.82
$53.82
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