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Home My WebLink AboutPermit Electrical 2005-08-12Status: Issued 225 Ftfth Street, Springfield, OR 541:7264753 Phone 541-726-3676Fax 541:1 26-37 69 I ns pe ction Lin e F GFIELD Buildin g/Co mbination Permit PERMIT NO: COM2005-01091ISSUED: 0811212005APPLED: 08/11/2005E)(PIRES: 0211212006 VALUE: SITE ADDRESS: 160 S 14TH ST ASSESSOR'S PARCEL NO.: 1703363204201 PROJECT DESCRIPTION: Add 2 circuits Springfield TYPE OF TYPE OF USE: Electrical Work Only Addition Commercial Owner: Address: CANNED FOODS WAREHOUSf, 160 S 14TH ST SPRINGFIELD OR 97477 Contractor TVpe Electrical Contractor eS # of Unib: Primary Secondary Primary Secondary # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Sheet Storm SewerAvailable: Special Insfruction: Notes: G License 8714s nla Expiration Date tut0t2006 Phone 541-741-2596 the of Heat: Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Sidewalk Type: Downspouts/Drains REQUIRED PARJ<ING Total: Handicapped: Compact: \ \L N0 $ Per Sq Ft or muhiplier Square Footage or BkI Amount DEVELOPMENT INFORMATION Description Type of Construction lof2 Value Date Calculated ol \S Valuation Description I q$hL n\Y\) .\\00N r VL\ 0u Status: Issued 225 Fifth Street, Springfield, OR 541:72G3753 Phone 541-726-3676Fax 541:7 26-37 69 I nspe ction Line FS Buildin g/Co mbination Permit PERMIT NO: COM2005-01091ISSUED: 0811212005APPLIED: 08lllt}001E)?IRES: 0211212006 VALUE: Fee Description + l0%o Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Amount Paid $4.60 $3.22 $43.00 $3.00 $53.82 Total Value of Project Date Paid 8n2t05 8n2t05 8llzt05 8n2t0s Receipt Number 1200500000000001188 1200s00000000001 188 1200s00000000001188 1200500000000001188 Fees Pa Plan Reviews To Request an inspection call the24 hour recording at 726-3769. AII inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired I By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ 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 t}re front of the property, and flre approved set of plans will remain on the site at all times during construction" Owner or Contractors Signature 2of2 Date *5 225 FIFTH STREET . SPRINGFIELD, OR 97477 o PH:(541)726-3753 r FAX: City job Number (OaUZSoS - Ol O? / our" E LE CTRI CAL P E KMIT AP P LI CATI ON 3 A.LEGAL DESCRIPTION t?D3 363 L C>t{ ?-cl JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Elec.trical Contractor Address Service Included One Circuit Each Additional Circuit or with Service or Feeder Permit Pump or irrigation Si grr/Outline Li ghting Limited Energy/Residential Limited Energy/Commercial 7%o State Surcharge 10% Administrative Fee TOTAL AJA Z c-ttc,n( Q, B. Ge -a,.- d { /acf 2oo Amps o.$6gter is t-gOO-gez-2344i 37Sy flayd+" B. Rd 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only ,.^a $ 63.00 $ 7s.00 $lafr.q0 '$'iPn'oo $375.00 $ s0.00 City Supervisor License Number &s{r Expiration Date /o -l-a-7 Constr. Confr. Number g7 t <ls Expiration Date // - to "-b6 Sigaature of Supervising Electrician \ AP^"a'='^14C(,*^^sAG"Js tnl&siL*rtOwners Name Address tbc> s !!!^ sl E. City sPfo Phone OWNER INSTALLATION The installation is being made on properfy I own which is not intended for sale, lease or rent. Owners Signature Installation, Alteration or Relocation 200 Amps or less S 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "8" above. New Alteration or Extension Per Panel C. D. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges $ 43.00 $ 3.00 L(3 3 $ s0.00 $ s0.00 $ 25.00 $ 45.00 Llb 3z6o s3.az 4. Inspection Request: 726-37 69 Shared Drive(T:)/Building Forms/Electrical Permit Application 1-03.doc 1. So J o€t d pnone-l<'ll -2s?< You maY obtain RK ]T CI ANY tuu un 225 Fifth Street Springfield, Oregon 97 47 7 541.-726-3759 Phone 4ity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT#: 1200s00000000001188 Date: 0911212005 1:3e:0ePM Job/Jrurnal Number coM200s-0109r coM2005-01091 coM2005-01091 coM200s-01091 Description * 7o/o State Surcharge + l0o/o Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Due 3.22 4.60 43.00 3.00 Item Total:$53.82 Payments: Type of Payment Paid By Received By ChectrNumEi Batch Number ffi Number How Received Amount Paid CreditCard GARY MILLER djb 282247 In Person Payment Total: $s3.82 -$ffi {} t{ (. il 81t212005 1of1 ryt