HomeMy WebLinkAboutPermit Electrical 2005-11-01Status: Issued
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-726-3676Fax
541:7 26-37 69 I nspe ction Line
Building/Co mbination Permit
PERMIT NO: COM2005-01545ISSUED: 1U01/2005APPLIED: 11/01/2005E)GIRES: 05/0112006
VALUE:
SITE ADDRESS: 200 S MILL ST Springfield TYPE OF Electrical Work Only
ASSESSORTS PARCEL NO.: 1703353207801
TYPE OF USE: New Commercial
PROJECT DESCRIPTION: 200amp service and circuit for sump pump adjacent to Willamalane building
Owner:
Address:
Contractor Type
Electrical
Contractor
OLSSON INDUSTRIAL
Expiration Date
0u26t2009
Phone
541-747-8460
WILLAMALANE PARK & RECREATION
200 s lurl,I, sT
SPRINGFIELD OR 97477
License
63473
Frontyrrd Setbrck
Side l Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
1r)
Overlay Dist:
# Street Trees
Paved Drive Rqd:
oh of Lot Coverage:
N
1
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
Sidewalk Type:
REQTIIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or muftiplier
Square Footage
or Bful Amount
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Descriptbn Tvpe of Construction
lof2
Value Date Calculated
\
(-rI\ r r(Ar- r (rK rNrgSl\iIA,!!!2I\_l
nol
# of Unib:
Primary Occupancy
Secondary Occupancy
Ptimary Construction
Secondary Construction
# of Bedrooms:
\s1
ICE:
PRIN
Status: Issued
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-7263676Fa;x
541:7 2647 69 I ns pe ction Line
Buildin g/Co mbination Permit
PERMIT NO: COM2005-01545ISSUED: 1110112005APPLIED: lll0ll2005E)PIRES: 05/0112006
VALUE:
Fee Description
+ l0o Administrative Fee
+ 77o State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Total Amount
Amount Paid
$6.60
$4.62
$3.00
$63.00
$77.22
Total Value of Project
Date Paid
tuy0s
tltLt05
tult05
11fit05
Receipt Number
r200500000000001647
1200500000000001647
1200500000000001647
1200500000000001647
Plan Reviews
To Request an inspection caII the24 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.
Electric Service: Approval required prior to utility company energizing service.
Rough Electric: Prior to Cover
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 SpringfieH and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCT PAI\CY will be made of any structure without permission of the Community Services Division,
- Building Safety. I further certiff that only contractors snfl smployees 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
2of2
Date
r ees raro I
_Keourreo tnsDecuons I
225 Fifth Street
Springfield, Ore gon 97 477
541-726-3759 Phone
,City of Springfield Official Receipt
:velopment Services Department
Public Works Department
RECEIPT#: 1200500000000001647 Date: lll0ll2005 11:41:56AM
Job/Jurnal Number
coM2005-01545
coM2005-01545
coM2005-01545
coM2005-01545
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ l0% Administrative Fee
Amount Due
63.00
3.00
4.62
6.60
Item Total:$77.22
Payments:
Tlpe of Payment Paid By Received By
uhecl( Number
Batch Nunber
Authorization
Number How Received Amount Paid
Check OLSSON INDUSTRIAL
ELECTRIC
djb 41175 In Person
Payment Total:
$77.22
$77.22
tr/U200s lofl
leuaf,3"e
I
225 FIFTI{ STREET . SPRINGFIELD, OR 91477 o PH:(541)726-J753 r FAX: (541)726-3689
r:L
City Date
I. I.OCATION OF INSTAI,IAT'ION 3.UL!1
T;:(:?'RI{:AI. I'ER[.|I'I' AT}T}IJ(.'A"I'IO,\' . . -robNumber Corn1oof - O/5YS
Zoo S nArl,(S{-
LECAL DESCRIPTION
t7o 3i sj z - o7 8c\ll
JOB DESCRIPTION
200A Serv'ice
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
Address l9l9 l,aura St
Constr. Contr. Number 634-13
Expiration Date 0U26109
Signature of ns Electrician
OrvnersName Springfield LJtility Board
Address 202 S I 8th St
City Springlield Phone 117-3751
OWNER INSTALLATION
l'he installation is being made on property I own lvhich
is not intended for sale. lease or rent.
Orvners Signature:
201 A+trsTEFODl ,\ mps s to
.10 I Amps to 600 Amps e
O!
zonrn9
A. New Rrsidential *
iervice Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
per dwelli*g uriit.
$ 106.00
$ re.00
$50.00
2. C{JNTIIAC'I]OR INS',{ALIATrON ONLY
L.lectricalContractor Olsson Industrial Electric 200 Amps or less I $ (13.00 6.1 .00
re
one -
6ot Nopi{iffitbo Ge$e
city Springfield hone 541-747 -846Q over ro00 64ft46ft$01-001C
Supervisor License Number #3334S C.
Fixpiration Date 10101101
r. Those ru
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or rvith
Service or Feeder Permit
catlon
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps S 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
$ 41.00
$ 3.00 3.00
E. Miscellaneous (Service/feoder notincluded)'"-liach Inslallatior;
Limited Energy/Commercial $,15.00
Minimum Electric Permit Inspection !-ee is $45.00 + Surchargrs
SUBTO:{AL 66.00
1.62
FOR 6.60
Pump or irrigation
Sign/Outline Lighting
Limited F.nergy /Residential
PEfrIS.
s 50.00
s 50.00
$ 25.00
7 t .22Inspection Request: 726-37 69
Shared Drive('l'.)il3uilding Forms,[]lectncal Pernrrl Applrcittion I ()3 dot
B, Seryices or F'eeders - lnstallation. ;\lterations or Itelocr{ion:
bf
ANY 180 oAY