HomeMy WebLinkAboutPermit Electrical 2008-8-12
r;.~; ~ "CITY Of SPRINGFIELD, OREGON
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225 FIFTH ,TREET . SPRINGFIELD OR 97477 . PII1541)726-17S1 . FA" (541)726-3689
ELECTRICAL PERMIT APPLICATION
CIty Job Number CO""" -z..OO K-~ 0 /I 8' "r
--, .A.!.
t_ ", .."
Date
I 11,0011'I(ft\f Ol,'nVSl'ALlAT(ON' " !
3000 ~\TE..uJAVf C:;,
LEGAL DESCRIPTION ( (,ATEltJA~ tJJ'U-
'5PRIIJ6F'l8-0 ,()K "5OCTlow B.)
JOB DESCRIPTION '1703 zzoo C> z:~o-o
~02t0 SIC-i-l- aI7Ti~c;" Q\eC'JtT
3 I' COMl'LEl'E FEE. SCHEDULE. ~BHOM-
A f;'1c,! Rc.'''l€ntJaI,- :'.i{.gIMI Multl;l'l1lmlv p~ld"clllllg I~rilt.,
ServIce Included
1000 sq ft or less
Each addlltonal 500 sq ft 01
portIOn thereof
$11700
$ 2100
Perm.ts are non-transferable and expire If work .s Each Manufact'd Home or
not started withIn 180 days ofIssuance or If work IS Modular Dwellmg ServIce or
Suspended for 180 days Feeder
i rCON1}0C1'Olu~!Sf~il~4TI~yl B 'r;~;~: F;~d~i..~~~~on:_AlterallOns 01 Relop'lton
Electncal Contractol (AiZ/4?A/ C:;/r.J..J 200 Amps or less $ 70 00
ATTEN 201 Amps to 400 Amps $ 83 00
Address "Il,()f) I JF cf..J~'E5 'P 7.2fullow r:'~O"4all~,"%9JlPEfcjIT\~s $13800
i Notification aff~R~;,sQli 1IfJ€!~a you to $180 00
Clly ~J C)i2. Phone 51 ( ;;j ~~~ 1li2-0C11~+S~A~~ ~eYi'I':rh $413 00
, . YOU mafOOluaeW<91iJifh OAR 95 0 $ 55 00
"T77c ( Calling the ce t "10 cOPies of th 2,001_
.-:zag c nUmber for llll; ~rdNofe"lW 1,,1 R rUle~ t "
SupervIsor LIcense Number J ( U ( /' C ~ KUlmtMlU3IlV/ Clt..ft'~1jRf'c1clS
- { ~ entef/S~i::::B!i!!r,Ull,1 'Notlf~'''' ' ,
-800-332'234 ICatlon
InstallatIOn, Alter~bn or RelocatIOn
$55 00
, -, - c I
~ ,~t,.'''~
/0/3/16X
L4~<{'1
Constr Contr Number q- z5&J cL"'S
ji'j61/1 ()
ExpIratIOn Date
200 Amps or less
201 Amps to 400 Amps
40 I Amps t9 600 Amps
Over 600 Amps or 1000 Volts see "B" above
D I~BrJ\mh'9tc.~lt' -~:-
$ 55 00
$ 7600
$110 00
ExpIralton Date
SIgnature of SupervIsmg ElectncIan
,,""'\ '
c::-7/1/J _ / /'}/i New AlteralIon or ExtenSIOn Per Panel
/f/<"u-.--k / / ~7- ~ ~ One CIrCUIt
, I // / . P 1'~. Each Add1ltonaI CIrCUIt or WIth
1...1. 77...--:./ A-v, _ ]JiJS R' ,ervlce 01 Feeder Pelll1lt $ 400
Owners Name UI't"tvv. / ,VV1~1J'HO _
Address' 110 .. Ai IJItcIl-8L COMMfJZfD UN~fk~{(Rlif~'YiJgerYlLC/fCedcr not mcludcd)-Each InstdlldtlOn I
. ,/. -.. filVY 1 (JfD OR I .. HIS"PfR'~ -WOff1(
CIty f.L'tt~, lPhone _ 80 DAY PfRIOSI4~NDUftit'j ZT; IS NOT $ 55 00
r:l ~gn/Outlll;e'r IJiGdg / $ 55 00
qWNER INST ALLA nON LImIted Energy/ResldenlIa] $ 28 00
r ~ 'l, - . \ ~
f ^ The mstallatlOnJs bemg made,on property'] own w1uch , '-~' LlmtledjEnergy/Commerclal.., \'-', ,"-. - ->1 1$ 50 00 "I-
I ~'j~ ,..,'~ "'d''X;. V"'l" ...1....~'t."-'.:lo...;'1,JI,,\,\ -'1\' 1'{1~", "'t!.J.i.'~,..,)/\,~1.'1J;l~~1'11""t'~~'/'!I<-.1(JA'(J,)'"'t'~Hi!i''' "r;l'!fl,(.i..:,~/,)
~.:;" .' IS\llot m!ende fo~s~le)eq.se or rent~/~~-.,t)- ~~,L, ~ I' 't;'1~ ~1\1IDm1Um~Elcctflc Permit Inspection' Eee1ls $50100 +:Surcharges
~rlu~-{)~d~"j "\:')'4,,-,!ff d~'~{i !..~~",.,J%.l~"\-II..'i,.J.\.,tl.J). f' "\f-:"-. ,'..~'..;~ -".. __,_,'.l-... . ~~.. ~~ ';!t"
~l'....,,;~ ~)..J,,# r,r:J-~}\J' '\ M~" 0"'.ft\.I"i.tf&~.t ,-,n "r'\." ).1 1i'~ , $,J "~':-4: S;.7'B10''";rAL7oF.....,'.~O. V'E-..,.......;l',.*'"'" -.., .}~,r..,/. t C:c tZs:)
'~n" i OwnerslSlgnarure '.......,. ~~.j'fJ", ~ ,~~H"'~A~ .;l~~ .: t___~... .. ,,~, ~0~ ~ ~~. ',r:.,ltt'Cf;.!!~ 1 ,j *~hJ!;..~ ...Ic-/J
$ 48 00
c; C; co
12% State Snrcharge
10% Adl1l1l1lslratlve Fee
5% Technology Fee
?,~
c:-~
::2 '7 '5
InspectIOn Request 726-3769
T01AL &9 'irS
Shared DlIVC( I )/I3Ulldmg rorms/Flectncal PermIt App\!catlon 1-08 doc
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CITY OJ:< M'ldNGFIELD
Building/Combination Permit
PERMIT NO' COM2008-01189
ISSUED: 08/11/2008
APPLIED: 08/09/2008
EXPIRES. 02/11/2009
VALUE'
Status
Issued
225 FIfth Street, Spllngfield, OR
541-726,3753 Phone
541-726,3676 Fax
541-726,3769InspecllOn Lme
SITE ADDRESS 3000 GA TEW A Y ST
ASSESSOR'S PARCEL NO 1703220002300
Spnngfield TYPE OF WORK Electncal Work Only
TYPE OF USE
PROJECT DESCRIPTION New sIgn, eXlStmg CIrcuIt
Owner GATEWAY MALL PARTNERS
Addless lION WACKER DR BSC3,04 ATTN PROP TAX ADMIN
CHICAGO IL 60606
I CONTRACTOR INFORMATION I
Contractor Type
Electncal
LIcense
64549
Contractor
CARLSON SIGN COMPANY
r. BUILDING INFORMATION I
# of Umts
Pnmary Occupancy Group
Secondary Occupancy Group
Pnmary ConstructIOn Type
Secondary Construction Type
# of Bedrooms
# of Stones
HeIght of Structure
Type of Heat
W dter Type
Range Type" r~qUlres you to
Energy'path'le Oregon Ulillty
" 'Spnnkl~d' IilildiQpre set forJl7a
IJ. J010 throuah U'AR 952-001-
00 '- I DEVELOPMEN'PINI'ORNrA,IQN;l
Cdlrl, ~ !'...
number for the Oregon Utility NotifIcation
Cent6t)I&It~Iil32-2344),
# Street Trees Rqd
Paved Dnve Rqd
% of Lot Coverage
Front yard Setback
SIde I Setback
SIde 2 Selback
Rearyard Setback
Solar Setbdcks
I PUBLIC IMPROVEMENTS I
StJ eet Improvements
Storm Sewer AvaIlable
Specldl Instruction
New
CommercIal
ExpIratIon Date
03/04/2010
Phone
541-382,2182
Lot SILe
Sq Ft Isl Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Garage/Carport
Sq Ft Other
Occupant Load
REQUIRED PARKING
Total
HandIcapped
Compact
SIdewalk Type
DownspoutslDr dms
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
":X.1f.l:.:ri3ffj-(;F; 13 ~ONED FOR
.l\i&.~lllD\lli5llrprtlOn I
Notes
DeSCrIptIOn
$ Pel Sq Ft
or mulltpher
Squdre Footage
or BId Amount
Tvpe ot ConstructIOn
Page I of2
Value
Date Calculated
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01189
ISSUED. 08/11/2008
APPLIED: 08/0912008
EXPIRES 02/1112009
VALUE'
.
225 FIfth Street, Spnngfield, OR
541,726,3753 Phone
541,726,3676 Fax
541-726,3769 InspectIOn Lme
Total Value of Project
fees PaId I
Fee DescnptlOn
+ 10% AdmmlstratIve Fee
+ 12% State Surcharge
+ 5% Technology Fee
SIgn, OutlIne Llghtmg Each
Amount PaId
Date PaId
$550
$660
$275
$55 00
8/11/08
8/11/08
8/11108
8/11/08
ReceIpt N umher
2200800000000001227
2200800000000001227
2200800000000001227
2200800000000001227
Total Amount PaId
$69 85
I Plan ReViews ,
To Request an inspectIOn call the 24 hour recordmg at 726-3769 All mspectlOns requested before 7.00
a m wIll be made the same workmg day, inspectIOns requested after 7:00 a,m wIll be made the following
work day,
I Reouired TnsnectlOns I
SIgn Electncal After connectIOn IS made but pnor to energIZIng
By SIgnature, I state and agree, that I have carefully exammed the completed applIcatIOn and do hereby cerllfy that all
mformatlOn hereon IS trne and correct, and I further certIfy that any and all work performed shall be done m accordance WIth
the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the "01 k descnbed herem, and
that NO OCCUPANCY WIll be made of any structure WIthout permISSIOn of the Commumty ServIces DIVISIOn, BUlldmg Safety
I further eel tIty that only contractors and employees who are m complIance WIth ORS 701 005 WIll be used on th.. ploJect
I further agree to ensure that all reqUIred mspectlOns are requested at the proper tIme, that each address IS I eadable fI om the
slreet, that the permIt card IS located at the front of the pI opel ty, and the approved set ot plans wIll remam on the SIte at all
times dunng construction
Owner or Contractors SIgnature
Date
Paee 2 ot 2
225 FIfth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0] ]89
COM2008,O] ] 89
COM2008,O \\89
COM2008,O 1189
Payments
Type of Payment
Check
cRecemtl
RECEIPT #.
DescriptIon
Sign - Oullme Llghtmg Each
+ 5% Technology Fee
+ \2% Slate Surcharge
+ 10% Admmlstratlve Fee
PaId By
CARLSON SIGN
=~::~
:IIi: .
CIty of SprIngfield OfficIal ReceIpt
Development Services Department
Pubhc Works Department
2200800000000001227
Date' 08/11/2008
Item Total
<":heck Number AuthorizatIOn
Recened By Batch Number Number How Recclved
dJb
In Person
Payment Total
4767
Page 1 of 1
2 52 02PM
Amount Due
5500
275
660
550
$69 85
Amount Paid
$69 85
$69 85
811 112008