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HomeMy WebLinkAboutPermit Electrical 2008-11-6 ~WN tv j . INITIALS ~ ~ _.~. DATE, \\.l.l>.O~ -.,. ">illl'l SOURCE ~ 1//>/oS . 225 FIFI'H STREET. SPRINGFIELD, OR 97477 . PH:(S4t)726-37S3 . FAX: (S4t)726-3689 ELECTRICAL PERMIT APPLICATION/ City Job Number COWl L-.CO 0 -0 ( 6z..o 200 Amps or less $ 70,00 201 Amps to 400 "Amps $ 83.00 401 Amps to 600 Amps $138,00 601 Amps to 1000 Amps $180.00 Over 1000 AmpsNolts $413,00 Reconnect Only $ 55.00 uires yOU .to '19 tV S / 6- '''' O'f"~."<'iffi.\a'ticJe@."":';;;;n';!'\t\\ltd\(~_~~~'~"?'~&""'~'lI~' v TrNT\O d.. empOl:3f"\1:.lO::eJi\'lCesnr::-Fee e.rs - ""~"?\ .'"~-m;~ "'""'" If,~.ji,f',,,,,,,,"_-r~rJ.o.~<"~_ ,^ T r, 'c\opteo uy"',,,<:e,, ,,-, , e' setlOI 'i1~,,,~_..,,\,.,,)i~"..;tr.;..,,,",,,,,! ,"',,"'~"" 10\\OW rules a \ r ThOse rules ~l 95~Op1' 10 -(- 20 I / "',,Iilication CfI'il~m~,tW!!~~~ifn oru~qsytion in OAR 95Z~~Q,~'0Il~ ~ ~:\~phone. $ 55,00 0090,. '10Utne e\!h~p!Jt\9~~~DmS'ti\iCation $ 76,00 calling A\m!il'?A" \l~ T<v) number iO~~\S 1~BO\)-' $110,00 Ce'l:JVer 600 Amps or 1000 Volts see "B" above, D i'B~i~ci'-'~~1jitfi~~~~kW~i~~~~~~~~?~~~l~~!i~~';: Signature of Supervising Electrician . t'~l,4;l'r!i'<~'''''~'?-*"'r;-'~.'\'''''.'''''Y,,,.%~-S:f6~!~F'''''<,,~~''';'"#*;1%1<i~'Th:;;~\;;;t~~t4';t':..;~:*:,:;a:.*;:-;,;:;~::.::.....?;,,;....,:;::l .4 / I New Alteration or Extension Per Panel /4/L. .A One Circuit $ 48.00 : \ Each Additional Circuit or with ::~~sN",:; D~~~)' _.~R-( (~~E' S;~~;;;~;~'fJ~r~~*~W~;[~f~~1fi~ffim~, _f II "::!.'L.J!.-O'f '- "'<".<~."""""'-"'<."""""''''''''''.'''~''''~.'''''=-'''''''''H'''''''''''''''''''''~~'.....""" Citf--J'\ 'c.,). c.. 0. -/--( Phone Pump or irrigation 100 Sign/Outline Lighting :t i~ 'N ,00 57 OWNER INSTALLATION "I~i~ '~nergy/Rest'e~?\?t \M'1' \S t! ,00 The installation is being made on property I own which Wihli ~~~~\~.~~n r()~ 50,00 is not intended for sale, lease or rent ~n~:~ tm!1i!e~~~,~:~~~:~~~urChargeS Owners Signature: ' 1i>.~~25~~~~w.~~.,j!f~ l J'-f I~Administrative Fee 570 5% Technology Fee 'W, 7Z~ r~~'W'-~'9-r~!!;;~.r,!"''ia'ol~~~;~~~uo;$(J:"~~~~;r\'~:;;:;~'tP"''.\}~1; 1. :rJ/LOeATIONOEINSTALIfATIONi~~..,* _"";".~,,41,_-;',*-~~~t-.~~~,,,,~~.-,r_'''-=-'''''''''''~'t;'::';<J~''''-'2:>;;''''~'~:~ S.O~ G-~lf'&; 'S. T . LEGAL DESCRIPTION: t /70:3 '2z0-0 a Z:3"O(:) JOB DESCRlPTION: IN f\::,'I'10v'- r-v 1M. . s? 91l:,; 5i~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. l~~1i~!!~m:mr~~&{f) Electrical Contractor IfVlVl4{ JU,J(. \.Iu-l~ City Uo t:V~~ b,V\,iM3 )\, Address Phone Lf &Lf /I,{9> v Supervisor License Number Expiration Date Constr. Contr. Number IIAI.3JJ 9/Dd/b Expiration Date Inspection Request: 726-3769 Date :!iW,~~""~o:;<~,,,'~"':n>,,~~,if;,.'tJ.t'~~"~~""1It'.~/~.f:~~j.'Y?!!iffl!~'i'Z;iIJ;,f/{;;:p..~!$J:}J:1lll . 3. !]eOMPLETRFEESeHEDUEE'BELOW:<'''''''';~'\lA~;c'iii\'~?!!>'' ,;....-.....!">""""-"'"".;.u....~~'..,f'"<"";.;:'i'_,~~~~;;';"'T,'~,""'_'~;..,...,.+,,~,~..,.,,_~~~-.....~~~~:.i;t~.ii.::;~;,<;~~<i'~~ ' r'6~i;J~e}.f-d;f:~~'\t~~~_;~~..g...,."""_~....,~;..~-.m:~~;~1;;.T..wf",~fl.."'""'~~Jt.S~ A, ~]'\/e"','Residential"",Siirale'orcMiilti;FamiIYme~:dwelliiJg,unit~~ ~,~~1',$t,~.,::-.."''''"W;..''''4'''!W~_~'-,:"..,>,,.',',..l:o..-;l,Jl4,<(;O'~.i-''-'"'':.''.'::;>.:""'~-:;;..w..\'"~;.;':;"'""_.;;,;,.._ '''''''V''"l'U'~;:<;-~'I' ;..,~";:;,,,,~.;;;l,~ Service Inclnded 1000 sq, it, or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117,00 $21.00 $55.00 . . ~~'1?;"'$'#~{:'I~~~A,:~~;;C;;1',"~1'Ji"W-frW~~tj?~~~i?Jhf:)'~f:~'ff;~~-di~~~~~1;f1l B. ~~~$~~~e~~~;1{..~t~~U.:~~-~gt~~~~~~~J:.~ TOTAL Shared Dri~e(T;)lBuilding ForrnslElectrical Permit Application I-08.doc , " CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-01626 ISSUED: 11/05/2008 APPLIED: .11/05/2008 EXPIRES: 05/05/2009 VALUE: 225 Fifth Street, Springfield; OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3000 GATEWAY ST SPACE 916 ASSESSOR'S PARCEL NO,: 1703220002300 Springfield TYPE: OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Sign lighting - Burrito Amigos Owner: Address: GA TEW A Y MALL PARTNERS 110 N WACKER DR BSC 3-04 ATTN PROP TAX ADMIN CHICAGO IL 60606 Contractor. Type Electrical I CONTRACTOR INFORMATION I . o.u\leS ~U~U'\i\\''1 ' .. Contractor oli \a'i'J Ie Qle4nIC ,,~\n ExpIratIOn Date IMAGE KING IN~".,.\ott Q1e.?oo \)~ \"e.,\oS ~6~.:l.J\0\' . 09/01/2010 /'.\ ,,,. . - ....-, _~~_u ~"\n~'.. sp~ \ 'lo~II8UlLDIN6-INEORM\\.TIONl\lle 0\ , . '3.\.\""" _vv' - ' ~~.;> - l~ona l-\o\\\\C 957.,00\ ",aili co? , \"e \ele?, a,\iol\ \Ii Oi'-I' ~N12.~tO~~s: \I-\o\e;, .\~ ~o\\\\C 0090, .'<0\ItRigj1tfOf'~~r~~\I\_2'344). . call\li9fWl<\'iltl Rc~!~oo''3'32. \1u(\\'oe\6\!,\lltllfyPe: ,; Range Type: Energy Path: Sprinkled Building: Phone 541-484-1482 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: !I , n/a II Lol Size: Sq Ft 1st Floor: S9 Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I. DEVELOPMENT INFORMATION I Front yard Setback: Side I Sethack: Side 2 Setback: Rearyard Setback: Solar Sethacks: " " Overlay Dist: ,''tJQ?~ # Stretl,Trees Rqd: \,\~f. \f i\-lf. ~Q" "~1ri,-iv~~\.\. fY:. 't.~\'J\11 \S "~~~~nern~'t.? "\-I\S.? Q~E\) fO? I:>.\\I\-IO?IIE\)r\ ()~ IS r-.~r-.~\) . I PUBLWIMjl~~;.'sf ~\..., REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Availahle: Special Instruction: , Sidewalk Type: :: Downspouts/Drains: il . ': Notes: I ,valuation Descrip,tion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footag~ or Bid Amount Value Date Calculated Paee I of 2 Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Sign - Outline Lighting Each Total Amount Paid Amount Paid $5.70 $6.84 $2.85 $57.00 $72.39 Total Value of Project Fees Paid I Date Paid, I Plan Reviews I 11/5/08 11 /5/08 11/5/08 11/5/08 CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2008-01626 ISSUED: 11/05/2008 APPLIED: 11/05/2008 EXPIRES: 05/05/2009 VALUE: Receipt Numher 1200800000000001110 1200800000000001110 1200800000000001110 1200800000000001110 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. I Reouired Insuections I Sign Electrical: After connection is made hut prior to energizing 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 he 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 he 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 he used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readahle 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 , , Page 2 01'2 Date 22~ Fifth Street Springfj.eld, Oregon 97 477 541-726-3759 Phone Job/Journal Number COM2008-0 1626 COM2008-0 1626 COM2008-0 1626 COM2008-0 1626 ' Payments: Type of Payment Check cReceiotl " City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 120080000000000 III 0 Date: 11105/2008 Description Sign - Outline Lighting Each + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By IMAGE KING INC Received By djb Page I of I I: Item Total: Check Number Authorization Batch Number I Number How Received 11909 ! In Person Payment Total: 10:42:IOAM Amount Due 57.00 2.85 6.84 5.70 $72.39 Amount Paid $72.39 $72,39 11/512008