HomeMy WebLinkAboutPermit Electrical 2004-6-23
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54tl>7t~6- ~s not require s ep~chlel's the tallo""
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ELECTRICALrf~!l!1/lSPl:!S,1l12N ". ZOning-':'U!..-.. "..'
City Job Number ~..\1.U.f;..\I_)t.XPate .ere_ 1.~d.3_0 -,_
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LEGAL DESC}W)'{ON ~ ~ 1"'-/,
l1 (j?,'J-l...~ \ {f--.J (L{ )
A. ~~~!~~~~~C
Service Included
IS
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
JOB DESCRIPTION
.
$ 19,00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
$50,00
2,
egNfii1iti&t@RVNSf~~T)Tl~4:#@N1e1W}~
B. s~.!i,ices 'or.:~ede~s I~st~ii~1r::t;JA:Ite.ration's or.'~i~~
Electrical Contractor''!1e L 1 III h? ;:- (;J f' Z"7 [6 200 Amps or less
_ /J 201 Amps to 400 Amps .
Address y/{) 0I.:2y/;-,/ ,..:J / 5 t:) _-3 ATTENTI(ONAQfJil!I&lldo.~ulres you to
. " I. followru~~?/II~O~~egOnUti!lty.
C'ty fIr /]/J ,M /} Ph c:/ II J O~ ~l::pi08~_ ho~e..ru(es are set '''...''''
1 ~i//ruc./ one ""'+, 7(/<l r" 'fil~9sRt!!g!n~!:\ bl;~h OAR 952.C:J-;
. 0090. You may obtain copies of the full., ;"y
:2 10 5 callin"'- =;''''1> "'-',\"""'" ..."..., -.....,.'""" '
Supervisor License Number ..: ),;; rr~ b<!..'f H'ell!l!. ,~aNIl.;:s:er.vi e~1 . . ',e,eoers
- num ar ..' ,
C'-"'nlp.!: i...1-8no-~~2-2344\ .
"'Irt'Stmlandn, )\lt~!ltion or RelocatIOn
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
$ 63,00
$ 75,00
$125,00
$163.00
$375.00
$ 50.00
Expiration Date '/ () -I) 1-() d
,
Conslf. Conlf, Number .... c; / 0 cP c?
Expiration Date h -;;; 7 -/) 5
u1~
'/
$ 50,00
$ 69,00
$100,00
.. :t<-" ~.'..... '~ . : .- ~'-
:-;".;io.,l'>,,;-t,h_...,!T"'~i.~<l'>":- -"'<>:':'~~.'. :.~
Owners Name
OWNER INSTALLATION AUTHORI 'fe4Eneruv;R..m:n,/VOOl FOR $ 25.00
COMMEN, . Urt I" RW'''.UV .
The in.stallation is being made on property I own whic~NY 180 }\'f~Rjl3ID'/CommefClal $ 45,00
IS not mtended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
New Alteration or Extension Per Panel
One Circuit \
Each Additional Circuit or with n
Service or Feeder Permit /.--'
$ 43.00
$ 3,00
4~p2
to .CO
Owners Signature:
4.
7% State Surcharge
10% Administrative Fee
4Cl.OO
3A~
"'\.0\0
S75..)
Inspection Request: 726-3769
~ \j)<6l9 ,2.1 \ 5
TOTAL
Shared Drive(T:)IBuilding FormslElectrical Permit Application \-llJ.doc
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1001 MAIN ST
ASSESSOR'S PARCEL NO.: 1703354105300
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00736
ISSUED: 06/22/2004
APPLIED: 06/22/2004
EXPIRES: 12/22/2004
VALUE:
Springfield TYPE OF WORK: Electrical Work Only
PROJECT DESCRIPTION: Add three new circuits
Owner: SPRINGFIELD UTILITY BOARD
Address: 223 A ST SPRINGFIELD OR 97477
TYPE OF USE:
Addition
Commercial
Phone Numher: 541-746-8451
, CONTRACTOR INFORMATION I
Contractor License
NEW WAY ELECTRIC INC_., tn 51088
Ofegonle:14 ,<]~iit~~.fflNG'INFORMATIONI
~oN: d bV\M e s~Uu. ,,,
# of Uuits: fl; tuI9& adopte 1\'IOse tU1e5 ~~~!!Jnlt~:
Primary occupai!~<P.':':: ~'O \fIfOUg\'1 0 Dg~!!~r'St'ructure
Secondary OccJ\l ~1~' \)\a\TI COpieS 0\ )'81i\'1~lHeat:
Primary Constrll (fIltI 0 lNo\e: \~e ~:\'lf.f;i!'ype:
Secondary Const WID cef\\6l'. On Util\~ R~nge Type:
# of Bedrooms: . __kAt 1Qf \he Ofe~0-332-2:Eb~gy Path:
ClI>>''''-'(ien\Bf IS ,. Sprinkled Building:
Contractor Type
Electrical
I DEVELOPM",,, 1 mruI<J>'IATION ,
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
. I PUBLIC IMPR.Q"JilMJN'I'8~'"
~~~~~~~t~6 ~:;i\\~;~~t~~~~ ;~~.w1
\li\\Q\\1 Q\\ IS to;g
~Q\'.fI\'.fI~~~~ ~~\\IQ\).
r-.W-{ ,~\)
Notes:
I Valuation Descriotion I
Description
$ PerSqFt .
or multiplier
Square Footage
or Bid Amount
Type of Construction
Total Value of Project
Paeelof2
Expiration Date
06/27/2005
Phone
541-686-2365
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Value
Date Calculated
-~
~
Status
Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 10% Administrative Fee
+ 7% State Surcbarge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
.
I Fee~ p,,w
Amount Paid
Date Paid
. CITY OF ~rK11'l'-'t<u'LD
Building/Combination Permit
PERMIT NO: COM2004-00736
ISSUED: 06/22/2004
APPLIED: 06/22/2004
EXPIRES: 12/22/2004
VALUE:
Receipt Number
2200400000000000823
2200400000000000823
2200400000000000823
2200400000000000823
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~
$4.90
$3.43
$43.00
$6.00
6/22/04
6/22/04
6/22/04
6/22/04
$57,33
I Plan Reviews I
~ Refluired In~~
Rougb Electric: Prior to Cover
Final Electric: Wben all electrical work is complete.
By signature, 1 state and agree, tbat I bave carefully examined tbe completed application and do bereby certify tbat all
information bereon is true and correct, and 1 furtber certify tbat any and all work performed sball be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 further agree to ensure tbat all required inspections are requested at the proper time, tbat each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Paee 2 of2
Date
22$ Fifth Street
, Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00736
COM2004-00736
COM2004-00736
COM2004-00736
Payments:
Type of Payment
CreditCard
6/22/2004
.
RECEIPT #:
~
lfiiitj,ty' of Springfield Official Receipt
.velopment Services Department
Public Works Department
2200400000000000823
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
NEW WAY ELECTRIC
Received By
djb
Page I of 1
Date: 06/22/2004
Item Total:
Check Number AuthOrization
Batch Number Number How Received
000417
025257 In Person
Payment Total:
9:36:08AM
Amount Due.
43.00
6.00
3.43
4.90
$57.33
Amount Paid
$57.33
$57.33