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Home My WebLink AboutPermit Electrical 2008-7-8 SPRINGFIELD " }J j ^A_o"'--_../..~~t1 ~~~.I r~ ,,~"-J ZON MlLC/ INITIALS NlV'\ DATE 1~14--06' SOURCE(Y\.J/"5O'V -- ~ , 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAJ\. (541)726--3689 ELECTRICAL PERMIT APPLICATION City Job Number C0rv1zoo8 -0 {050 Date 7- 8 -08 I LOCA.TION OF INSTALLATION 3 COMPLETE FEE SCHEDULE BELOW 3333 (,/vc(LI$EIIIJ he.. ~ DEl:RIPTlON ~ 170~Zlf'o 00 9oz. A Nen Resldentlal..- Smgle or MultI-Fanul) per d"ellmg umt //G(b1/ /). 'U- ~ l\ SeTVlce Included I JOB DESCRIPTION ~ 4F ~6BiGd>>/, Stc;,1II 1000 sq ft or less Each addItIOnal 500 sq ft or portIOn tbereof $10600 $ 1900 PermIts are non-transferable and expire If work IS not started wlthm 180 days of ISsuance or If"ork IS Suspended for 180 days Each Manufact'd Home or Modular D"ellmg Service or Feeder $50 00 .. CONTRACTOR INSTALLATION ONLY B Services or Feeders - InstallatIOn, AltelJtlOns or RelocatIOn 2 Electncal Contractor E5f I1~J $ City G.t6G<JG 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Pbone tff1.5-S~t.{/p Over 100011RJilsWolts n ,~<Slll1M'.!~bflttl\\\lW '1 &.~~ON: ~~~~~d b'l \"~~~~e ~;l~ SupervIsor License Number 0<0 - ~@;&I tel, -n<cse ;dn'O'f.\ll\~ry:,'ij' or Feeders tlo\rt\ca\iOIl ~.OO~O \"tOU~s 0\ \\'\e~~ 7 - ( - 2.Q,,( cat-R9S~~"''1 ob\aln ~Jtalt\\lJd/i'~~~n or RelocatIOn , 9()9Q, -l"'"\ne cen\et. ~ 3WlJ\:ln~s W~ss / (p 3l.f 7~~~~ 'Of \"e O~~~i!JQI~Js'3to 100 Amps "..,. Get'\8t III 40 I Amps to 600 Amps 3-/t,-20fl Over 600 Amps or 1~00 Volts see "B" above D Br Jnch CirCUIts f9976 J}JilbE; & $ 63 00 $ 75 00 $12500 $163 00 $37500 $ 50 00 Address ExprratlOn Dale $ 50 00 $ 69 00 $100 00 Constr Contr Number ExpIratIon Date Signature ofSupervlSmg ElectncIan ~ Owners Name ?~ Ii&. (+ l -r~ j3u..c 1</7 i City Fu.....&-~ Pbone New AlteratIOn or ExtenSIOn Per Panel One CIfCllIt Each AdditIOnal CIrCUit or WIth ServIce or Feeder PermIt $ 43 00 $ 300 Owners Slgnature E Miscellaneous (Sel \1Ce/feede;'not'*~~) -Each Installahon - , . \~~~ ~O" Pump ~r Img~~I~~\ \. ~,~~ t.~'''''' 'CO ~ _ $ 50,00 ~O~~tl ~ ~~ ",,-'CO \l O~t5)Y'> $;m 00 ,,~~~~e~~'il $ 25 00 ~b~ Ri Jal . $4500 MlllUe; r~~~~ectJoD Fee 1S~ 00 + Surcharges 4 ~t:9TAL OF ABOVE j--U s:S"' ;t4p/o State Surcha;ge - b t (J 10% Admmlstrahve Fee 5 Si..j 5% Technology Fee Z 11 ss Address OWNER INST ALLA nON The IDstallatlOn IS bemg made on property lawn whIch IS not mtended for sale, lease or rent InspectIOn Reqnest 726-3769 TOTAL bit):.. Shared Dnve(T )/BUlldmg FOlmsfEfectncnl Penrut Applll..UhOn 8-06 dOl.. Status Issued 225 FIfth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO ISSUED, APPLIED' EXPIRES: VALUE COM2008-01050 07/1412008 07/14/2008 01/1412009 SITE ADDRESS 3333 RlverBend Dr ASSESSOR'S PARCEL NO 1703220000902 Spnngfield TYPE OF WORK Electncdl Work Only TYPE OF USE New CommercIal PROJECT DESCRIPTION SIgn hghtmg for Emergency entraDce I CONTRACTOR INFORMATION I "O~ .~"'1 Contractor ~~e'" ~'" ~Icense E S & A SIGN CORP ~~,~e~,e~~~~~~~70 I BLIcIIW~INGIl'ft1'.6RMAqllbN~ ,Ai 'I'" 1\\\ -1 ""1 #c~'~~o~j,~~9~~~"~~~~~ ~~ ~~:(j~~\'~\~~~nJ~!\~t>% ..O~~C~~~~~~~~~,~~~~ ~~ co/$' ~o ~0 ~~l\Y'?>e ~~~\~Q,e\ '~~.u.gy Path ~~~'9 cBPnnkled BUlldmg , DEVELOPMENT INFORMATION I Owner Address PEACE HEALTH PO BOX 1479 EUGENE OR 97440 Contractor Type Electncal #ofUmts Pnmary Occnpancy Group Secondary Occupancy Group Pnmary ConstructIOn Type Secondary ConstructIOn Type # 01 Bedrooms Frontyard Setback Side 1 Setback SIde 2 Setbdck Rearyard Setback Solar Setbacks Street Improvements Storm Sewer Available Special InstructIOn Notes DescnptIon ExpiratIOn Date 03/16/2009 Phone 541-485-5546 nla Lot SIze Sq Ft 1st Floor Sq Ft 2Dd Floor Sq Ft Basement Sq Ft GaragelCarport Sq Ft Other Occupant Load REQUIRED PARKING To~tal ~~'\ Hand ~ C t\~ ~~ ~~ ~t;;:)~ -#:~ ~~ ~t;;:) ., ,,~c;,t:'f;\~ I PUBLIC IMPROVEMENTS I ~, ~ c;,~;~<v~ ~~~....v ~\~~ ~c;,~ ~~ \.c;, 'V. &~.....<-~\S . '\'(\\. :\~~<.;..~{:.,~7Ofams ~<:)~\\'O~ ~ ~~ Overlay Dlst # Street Trees Rqd P dved Dnve Rqd % of Lot Coverage I V aluatIon DescnptlO~ I $ Per Sq Ft or mulllphel Square Footage 01 BId Amount Type 01 ConstructIOn Value Date Calculated Pa2e I of 2 -ijF ii1 . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01050 ISSUED: 07/14/2008 APPLIED, 07/14/2008 EXPIRES: 01114/2009 VALUE: 225 Fifth Street, SpTlngfieJd, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Total Value of ProJcct Fees PaId I Fee DescTlptlOn + 10% AdmmlstratIve Fee + 12% State Surchdrge + 5% Technology Fee Slgu - Outhne LIghtmg Each Amount Pdld Date PaId ReceIpt Number $550 $660 $275 $55 00 7/14/08 7/14/08 7114/08 7/14/08 1200800000000000774 1200800000000000774 1200800000000000774 1200800000000000774 Total Amount PaId $69 85 I Plan RevIews I To Request an mspectlOn call the 24 hour recording at 726-3769 All inspections requested before 7.00 a,m, wIll be made the same workmg day, mspectlOns requested after 7:00 a,m, will be made the following work day, I Reouired,~ n,~n~ctJons I SIgn ElectTlcal After connectlOu IS made but pTlor to eDerglZlng By sIgnature, I state and agree, that I hdve carefully exammed the completed apphcatlOn and do hereby certify that dll mtormdtIon hereon IS trne and corrett, and I further certify that any and all work performed shdll be done m accordance wltb the Ordmances ofthe CIty of SpTlngfield and the Laws of tbe State of Oregon pertammg to the work descTlbed herem, and thdt NO OCCUPANCY WIll be mdde of any Stl ucture WIthout permIssIOn of the Commumty ServIces DIVIsIOn, Bmldmg Safety I further certIfy that only contractors and employees who are m comphance WIth ORS 701 005 Will be used on thIS project I further agree to ensure that all required mspectIons are requested at the proper tIme, that each address IS readable from the street, that the pel mlt card ocated at the front of the property, and the approved set of plans wIll remam on the site at all times d mg constructIOn l /;t 1-/?8 w9' .~r~ Con;ractors Signature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-'726-3759 Phone Job/Journal Number COM2008-0 I 050 COM2008-0 1050 COM2008-0 I 050 COM2008-0 I 050 Payments Type of Payment CredltCard cRecelOtl RECEIPT #: DescriptIOn Sign - OutlIne Llghtmg Each + 5% Technology Fee + 12% State Surcbarge + 10% Administrative Fee PaId By ES AND A SIGNS *tij City of Sprmgfield OffiCial Receipt Development Services Department Public Works Department 1200800000000000774 Date: 07/14/2008 Item Total Chetk Number AuthOrizatIOn Received By Batl..h Number Number How Received dJb 014804 In Person Payment Total Page I of 1 1 38 OOPM Amount Due 5500 275 660 550 $69 85 Amount Paid $69 85 $69 85 71 I 4/2008