HomeMy WebLinkAboutPermit Electrical 2003-09-17OF SP GFIELD
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-00911ISSUED: 0911712003APPLIED: 0911712003
EXPIRESz 0311712004
VALUE:
SITE ADDRESS: 470 S 2ND ST
ASSESSOR'SPARCELNO.: 1703353301000
PROJECT DESCRIPTION:
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New Commercial
NOTE: go to office for directions to job site. Site indicated is 310 B St>> Add 100amp
service in methanol containment area
Owner:
Address:
BORDEN CHEMICAL CO
180 EAST BROAD ST COLUMBUS OH 43215
Contractor Type
Electrical
Contractor
CHRISTENSON ELECTRJC INC
License Expiration Date
05t0u2007
Phone
541-688-61214s8
CONTRACTOR INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh ofLot Coverage:
K
1
Square Footage
or Bid Amount
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
OTICE:
1H IS PER MIl SH
c OMME
SETBACKS ANY 180
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
ZED UN
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplierDescription Tvpe of Construction
Page I of2
VaIue Date Calculated
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Valuation Description I
OF
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-00911ISSUED: 0911712003
APPLIEDz 0911712003
EXPIRESz 0311712004
VALUE:
Fee Description
+ l0Yo Administrative Fee
+ 7oh State Surcharge
Perm Serv/Fdr 200 amps or less
Total Amount Paid
Amount Paid
$6.30
$4.41
$63.00
$73.71
Total Value of Project
Date Paid
9tr7t03
9tr7t03
9tr7t03
Receipt Number
1200200000000002149
1200200000000002149
1200200000000002149
Fees Paid
Plan Reviews
To Request an inspection call 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.
I Electric Service: Approval required prior to utility company energizing service.
Renrr
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 wilt tre 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 all
times during construction.
Owner or Contractors Signature Date
Paee 2 ol 2
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
.{City of Springfield Official Receipt
Development Services Department
Public Works Department
Date:7 10:08:52AM
coM2003-00911
coM2003-00911
coM2003-0091I
Perm ServlFdr 200 amps or less
+ 7%o State Surcharge
+ ljYo Administrative Fee
63.00
4.41
6.30
Item Total:$73.71
Payments:
Type ofPayment Paid By Received By
Check Number
Batch Number Authorization Number How Received Amount Paid
CreditCard LARRY CHAPMAN djb 000171 087028 In Person
Payment Total:
$73.11
$73.7r
JTFBTIISFIIL*
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)
225 FIFTH STREDT . SPRINGFIELD, OR97477 . PH:(541)726-3753 o FAX:
E LE CTRI CAL PERM TT AP P LI CATI O N
City Job Number Cl'*r?frOS - AC rl I I Date 7-!f -9)- ...t,n ,,*o Sipnatur€
3.
{70 a Z*L :iJ-
LEGAL DESCRIPTION A.
tao3f 533 O/ocfr
689
ubmitted has the lo,lowingire specific lan d use
-/-oDale
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JOB DESCRIPTION
*u*: trcA{.uv*{
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
Service Included
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
to 1000 Amps
$ 63.00
$ 7s.00
$ 12s.00
$163.00
$375.00
$ s0.00
Amps/Volts
Only
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Over 600 or Voits see "B" above.
Address
City F,,*"ne Phone
Supervisor License Number 3759S
Expiration Date l0/0L/0/+
Constr. Contr. Number ?6-34C
Expiration Date to/0r/03
Signature of Supervising
Owners Name 'E,O rtsvv cFftw . (*L
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Permit S 3'00
B.
C.
D.
E.
6)
q-7a s ?* tAddress
City Phone 7L/6 YL/-61 Pump or irrigation
Sign/Outline Lighting
Limited EnergyiResidential
Limited Energyi Commercial
_$
_$
_$
_$
s0.00
50.00
25.00
45.00
OWNER INSTALLATION
The installation is being made on properfy I own which
is not intended for sale, lease or rent.
Owners Signature:
Minimum Electric Permit Inspection Fee is $45.00 * Surcharges
,>b>
Lll
7Yo State Surcharge
10% Administrative Fee
TOTAL
b5a'3/Inspection Request: 726-3769
4.
Shared Driv(T:)/Buiiding Forms/Electrical Permit Application 1-03.doc
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Eiectrical Contractor Clhri s lenson El ee f ri c
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