HomeMy WebLinkAboutPermit Electrical 2004-12-14Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 Inspection Line
PERMIT NO: COM2004-01532ISSUED: 1211412004APPLIED: 1211412004
EXPIRESz 0611412005
VALUE:
SITE ADDRESS: 1795 5TH ST
ASSESSOR'S PARCEL NO.: 1703264200603
PROJECT DESCRIPTION: Low voltage
Owner: pACIFIC pETROLEUM CORp
Address: 4780 VILLAGE PLAZA LOOP STE 21 EUGENE OR 97401
Contractor Tvpe
Electrical
Contractor il 9lR 952-001-0010 througfiftffig62-06pxpiration Date
ADr SECURTTSggQ,Iftffi 6q6btai n cop ies 59g{iB ru I es by 0st07 t20os
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New Commercial
lity
forth
Phone
54t-736-4973
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
vW'^'@'
9enlqr rp'1 -800-3i32-23"i.+).
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARJ(NG
Total:
Handicapped:
Compact:
pnone
fication
nla
LL EXPIRE IF THE WORK
Sidewalk Type:
Downspouts/Drains:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
DEVELOPMENT INFORMATION
Description Tvpe of Construction
I
Value Date Calculated
q
Valuation Description
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 I nspection Line
Building/Combination Permit
PERMIT NO: COM2004-01532ISSUED: 1211412004APPLIED: 1211412004
EXPIRESz 0611412005
VALUE:
'aid
Fee Description
+ l0oh Administrative Fee
+ 77o State Surcharge
Low Voltage - Commercial Indus
Total Amount Paid
Amount Paid
$4.50
$3.15
$4s.00
$s2.6s
Date Paid
12n4t04
t2n4t04
t2n4t04
Receipt Number
1200400000000001744
1200400000000001744
1200400000000001744
Plan Reviews
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.
Low Voltage: Prior to cover.
Reou
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 will be 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
Pase 2 of 2
\LL-i
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
velopment Services Department
Public Works Department
RECEIPT #: 1200400000000001744 Date: 1211412004 1:54:53PM
Job/Journal Number
coM2004-01532
coM2004-0 rs32
coM2004-01532
Description
+ 1Yo State Surcharge
+ l0o/o Administrative Fee
Low Voltage - Commercial Indus
Amount Due
3.15
4.50
45.00
Item Total $s2.6s
Payments:
Type of Payment Paid By
uneckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check TYCO djb 3lss4 In Person $52.65
Payment Total:
---Tffi
t2/14/2004 Page I of I
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225 FIFTII STREET ' SPRINGFIELD, OR97477 o PH;(541)726-3753 oF
ELECTRT CAL P ERM TT AP P LI CATT O N
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LEGALDESCRIPTION I
JOB DESCRTPTION
To3zbLtL
Oc>(* 3
and erpire if work ls
of issuance or if work is
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
uhiti t :+:
$
$ 19.00
$50.00
A.
Permits are
not started within 1t0 daYs
Suspended for 180 daYs.
,
Electrical Contractor
Address
dC'
,:j.t,r iL
B.it ri
city M Phone . 14t' 73 ( - dfi73
SupcwisorlicenscNumber <2-' ta C.
Expiration Date
Constr. Contr. Number
Expiration Date
Signanrre of Supervising Elecrician D.
Installation, Alteration or Relocation
rAm/sdP$nDllSB'.' tt I e r
: Q0loEtrd'ertotroorcr6e
la0t Q&ildled 0db,'eu*gsr
o5t?lAlh8&,i6' fb66 nd[*
qJ0&9Be,9A*$I&8id
entsaHaQmWl !i:1,
200 Amps or less
201 AmPs to 400 AmPs
401 Amps to 600 AmPs
$ 63.00
s 7s-00
s125.00
$l63.oo
-
$37s.00
s s0.00
$ s0.00
$ 69.00
$100.00
$ 43.00
$ 3.00
$ 50.00
$ s0.00
$ 25.00
Over 600 or 1000 Volts see "B" above.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Servicc or Feeder Permit
Owncrs Name C{-""1(_
Address 't7 t9 V;t b, *
6.ttl--
e* Le E.'ffi "iiiiH.i${$i# J:lt ,si rln J,a "ai
-i a' l" r" ii s rr a t io n :
'l'ri"*.i r' . , il.r:l .ii i'-:;:risli;:ii l
Ciry Phone Pump or irrigation
Sigr/Outline Lighting
Limited EnergYlResidential
'tYo State Surcharge
l0% Administrative Fee
TOTAL
ls?. a{.,
OWNERINSTALLATION
The installation is being made on property t own which
is uot intendcd for sale, leasc or rcnt'
Owners Signature:
Inspection Request: 726-3769
LimitedEnergyiCommercial X . $45'00
Minimum Electric Permit Inspection Fee is $45-00 * Surcharges
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