HomeMy WebLinkAboutPermit Electrical 2008-10-9
SPRINGFIELD
225 FIFIlI STREET' SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 , ~ '.
ELECTRICAL PERMIT APPLICATION
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City Job ~umber
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LEGAL DESCRIPTION:
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JOB DESCRIPTION:
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days. .
New 001. (()
2.
Electrical Contraclor -->o..:.1P (AJ.. r I +'r i ~r
Address :l'X 54 .J~"\ili \ . el
. I' . .
. City ~A. Phone 729- /07{
t/70rD s
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Expiration Date G- 7- 'dOlO
Signat1lre orJuperv' ing Electrician
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City ,7J~- .~'C 'Ph~ne
Supervisor Licell5e Number
Expiration Date
COll5tr. Contr. Number
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OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signat1lre:
NOTICE:
THIS PERMIT SHALL EXPIRE I~ IHE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
I ti CROMMFt;NSZm3.QB,IS ABANDONED FOR
nspec onAN"JI~eJu OAf Pt~IOD. ,
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Service Included
1000 sq. ft. OT less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'dHome or
Modular Dwelling Service or
Feeder'
$121.00
$ 22.00
$57.00
B.
200 AmpSOT less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 Amps\\, olts
Reconnect Only
/
$ 73.00
$.86.00
$143.00
$186.00
$426.00 .
$ 57.00
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c.
Installation, Alteration 9r Relocation
200 Amps or leiATTENTION: Oreqon law rE$15lir.ee you to
201 Amps to 4dol~les adopted by the$Jr~.ijlln UI!IIlY
. 401 Amps to ~(j>Wifig;ion Center. I nose rU~lIr&s,,, IU' LI,
In OAff952-001,OOtC ;1"uu",li()'AFt\;l52-9B~'
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New Alteration tir Ext~im!lfl!rf_'332.2344).
One Circuit . $ 50.00
Eacb Additional Circuit or with
Service or Feeder,:Pennit
$ 5.00
E.
Pump or irrigation $ 57.00
,Sign/Outline Lighting $ 57,00
Limited EnergyIResidential $ 29.00
Limited Energy/Commercial $ 52.00
Minimum Electric Permit Inspection Fee is $52.00 + Surcharges
73 (:)~
(5,/(,
7,30
::J.,. (,,5
4.
12% State Surchai-ge
10% Administrative Fee
5% Technology Fee
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TOTAL
Shared Drive(T:)IBuilding F9nnsIElectrical Perruit Application 7-08.doc .
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Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01515
ISSUED: 10/08/2008
APPLIED:, 10/08/2008
EXPIRES: 04/08/2009
VALUE:
225 Fiflh Street, Springfield, 0 R
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line.
SITE ADDRESS: 1396 MAIN ST
ASSESSOR'S PARCEL NO.: 1703363203501
Springfield TYPE OF WORK: Retail
I
TYPE OF USE: Alteraiion
Commercial
PROJECT DESCRIPTION: INSTALL ELECTR[CAL SUB PANEL
Owner: SKILLERN JOHN
Address: PO BOX 711 ATTN AD VALOREM TAX DEPT
DALLAS TX 75221 .
Owner: SKlLLERN INV L TD PTRSHP
Address: PO BOX 711
DALLAS TX 75221
.1 CONTRACTOR ~NFORMA TION I
Contractor Type
Electrical
Contractor
JEM ELECTRICINC
License
[6[235
Expiration Date
09/07/20 [0
Phone
541-729-1074
BUILDING [NFORMA TION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type .
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Strnctnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding:
LotSize:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
SqFt Basement:
Sq Ft Garage/Carport
Sq, Ft Other:
O~cnpant Load:
nla
I DEVELOPMENT [NFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUlRED PARKING
. Total:
Handicapped:
Compact:
I PUBLlC [MPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Spec!al lnstrnction:
,Sidewalk Type:
DownspoutslDrains:
Notes:
'Page I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01515
IS,SUED: 10/08/2008
APPLIED: 10/08/2008
EXPIRES: 04/08/2009
VALUE:
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Fees Paid I
Fee Description
+ ]0% Administrative Fee
+ 12% State Surcharge
+ 5%. Techuology Fee
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
$7.30
$8.76
$3.65
$73.00
]0/8/08
]0/8/08
]0/8/08
]0/8/08
Receipt Number
]20080000000000]05]
1200800000000001051
120080000000000]05]
1200800000000001051
Total Amollnt.Paid
$92.7]
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
Re/luired Insnections I
,
Final Electric: When all electrical work is complete.
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 hereiu, and
that NO OCCUPANCY will be made of anistructure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors aud employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ens e that all required inspections are requested at the proper time, that each address is readable from the
street, that the perm' card is located at the frout of the property, and the approved set of plans will remain on the site at all
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Page 2 of2
225 Fifth .street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1200800000000001051'
Date: 10/08/2008
1l:20:45AM
Paid By
Item Total:
Check Number Authorization
Received By Batch Number . Number How Received
Amount Due
73.00
3.65
8.76
7,30
$92.71
Job/Journal Number
COM2008-0 1515
COM2008-0 1515
COM2008-01515 .
COM2008-0 ISIS
Description
Penn Serv/Fdr 200 amps or less
+5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment
CreditCard
Amount Paid
JEM ELECTRIC
DLM
233208 In Person
Payment Total:,
$92.71
$92.71
cReceintl
Page I of I
10/8/2008