HomeMy WebLinkAboutPermit Electrical 2008-12-3
',': CITY OF SPRINGFIELD, OREGON
Q.,U
.~ ~~~At~_~~!
~ SOURCE\Y\.D-:5pl?}
. ~
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FAX, (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number (ClVV\ <....OC)?'- (") j 77(
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
, 60 I Amps 10 1000 Amps
Phone4? OtrZ 797 Over 1000 AmpsNolts
'~ f 1~1::\'T'nl Reconnect Only
fO:/O\l' .' ~ v: Ore ,
1 I Q tPir!t:CfU/c;s ad 9.QlJ..lal>;
''-1, U ~0;'!?>t'on Ce' tC?ts, If<im!l.Ja'lt;\t8l\PsiCCSuor Feeders
, n er r-"'Y- ne:Gr=Y,UI -
099..Q'" tlb2-00t_00' hOSe rUle e90n Utilit
Expiration Date l () - 0 l - 2..0 K.J:r. YOu_may Obt;fnSil.\Il!.tt,91'~fle:r~'l'ld}fnRelocation
\, I q q 7numbe~ ;~e center'I~.'niPs'(j"~l 952-001_' $ 57.00
Con sir, Contr. Number """\ 3 f't; r,the Ore OJ..ffurih8>tWl!l~~ by $ 79.00
- ...ens t-8d~ I f.JiJEi,~~'ff/i itly~ $114.00
E . . D 1'2 -7..- 0 - -z.. 0\0 -~2!234dl I at/on
xplratIon ate , Over 60'0 Atrtp'! or WOO-Volts see "8" above.
D. I Branch Circuits
,Sig~atur ...-wzvz.f supervisi1ng El-leljJctrician /1
' New Alteration or Exte":sion Per~Panel I
" One Circuit $ 50.00
I ~ '1 Each Additional Circuit or with
:) ( I' Service or Feeder Permit
Owners Name (;"M "^ ~ H- I: n:>1t?V-'rie-s LLC ,
Address I) 5"" '7..5 . 'S"f:-- t O>'"\.--NortCt:'- s.v, ~.I Miscella~eous (S~rvicelreeder not incl~ded) -Each Installation I
City f/t1 f;?y V-.A.-!lt:r Phone THi,c; ~/T S Pump or irrigation $ 57.00
AUTHORIZE HA/j;~f\iI:'''1pim~1.v $ 5700
OWNER INSTALLATION COMMENCEg UNDEBiJiItH~FJnffl/iJtffsi~epl1K $ 29.00
The installation is being made on prope~lIJllwP8t'J1B~Y pOR ISuYliftN/J&rm!fflWl'ftrQ-tIl $ 52.00
IS not mtended for sale, lease or rent. WJOiLm Electric Perm'i{1nspection Fee is $52.00 + Surcharges
Owners Signature:' 4, I SUBTOTAL OF ABOVE I b;-
12% State Surcharge 780
10% Administralive Fee 1,,0
5% Technology Fee ,~. yzr
gz..iE-.
1. I LOCATION OF INSTALLATION:
_l'-t I Lf M 4 n,) ST
LEGAL DESCRIPTION: /7033b3Z
T-t'flJ4T T;J,Ltl
JOB DESCRIPTION:
0::>400
AD\> t{ LW.flll.lb CI'gCULTs.
Permits are non-transferable and expire'ifwork is
not started'within 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTORINSTALLATIONONLY I
PI -~ bLccTlLtC-
Address '? 0,'6'0)( L{BBcr.
Electrical Contractor
City
c: u...c '-'t-c.J '<---
/
Supervisor License Number
Inspection Request: 726-3769
/2 -J -02
Date
3. I COMPLETE FEE SCHEDULE BELOW
A. I New Residential,- Single or Multi-Family per dwelling unit.
Service lncluded
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
, Modular Dwelling Service or
Feeder
$121.00
$ 22.00
$57.00
Bo I Services or _Feeders-Installation, Alterations or Relocation:
$ 73.00
$ 86.00
$143,00
$186.00
$426.00
$ 57,00
<::;0
:?:
/')
$ 5.00
TOTAL
S.haied Drive(T:)/Building Forms/Electrical Permit Application 7-08.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01727
ISSUED: 12/03/2008
APPLIED: 12/03/2008
EXPIRES: 06/0312009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1414 MAIN ST
ASSESSOR'S PARCEL NO,: 1.703363203400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: 'Add 4 circuits
Owner:
Address:
EMMITT PROPERTIES LLC
13593 SE PORTLAND VIEW.PL
HAPPY VALLEY OR 97086
'1 CONTRACTORINFOR~ATION I
Contractor Type
Electrical
Contractor
A-I ELECTRIC
License
149937
BUILDIN? INFORMATION'
Expiration Date
12/31/2009
Phone
541-606"2797
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type WateLType:
Secondary Construction Type: I~effl~:t~ .
# of Bedrooms: ""'TION'. oregon \a~h~l!ll"ll)OP,,'t!ll~~ 'I
f>JT c." dopted bY S rYtkJe&lJid 1 n . n/a
ldlo\N rll\eS~~_.~, Those I~R:.- 'p Q,,2- , .g.
\~o\i t~~19'52._00 j -001' 1iEyji't~:fMBN'l"iffll8RMA TION .
'nO,.,,. b' , ". . , I
\.. may 0 ,- t . In" lo'~"
. 0090,' . 'IO~\18 centel. (No ~Ji.i\'it'i N, otilicatiOn ,
calling jar t\18 Olegon .:Y.~~r~*ist:
nUllioelc nter is j-800-irStreet Trees Rqd:
e Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
REQUIRED PARKING
Total:
Handicapped:
'Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Notes:
D~outs/Drains, :
. HEwun..
fu~:~~i~ t~~: :~;~~~ci'f~:Ol .
., ~~~~~~;~I~r~~tio~ ,
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
,Pa!!e 1 of 2
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2008-01727
ISSUED: 12/03/2008
APPLIED: 12i0312008
, EXPIRES: 06/03/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'Total Value of Project
'F~e~ Paid I
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid Date Paid ' Receipt Number
$6,50 12/3/08 3200800000000000773
$7,80 12/3/08 3200800000000000773
$3,25 12/3/08 3200800000000000773
$50,00 12/3108 3200800000000000773
$15,00 ' 12/3108 3200800000000000773
Total Amount Paid
$82,55
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.
I ~~9~iredTn~\1ectio!,s I
Rough Electric: Prior to Cover
Final Electric: When all elect:ical 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 ofthe City of Springfield and the Laws oftheState 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 certify 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 the front ofthe property, and the approved set of plans will reinain on the site at all
times during construction. .
J
9wner or Contractors.Signature
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541'-726-3759 Phone
Job/Journal Number
COM2008-0 1727
COM2008-0 1727
COM2008-0 1727
COM2008-0 1727
COM2008-0 1727
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
BRYAN HURLEY
. .
City of Springfield Official Receipt
Development Services Department
Publ~c Works Department
3200800000000000773 ,
Date: '12/03/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 083771 In Person
Payment Total:
,
Page 1 of 1
IO:27:15AM'
Amount Due
50.00
15.00
3.25
7.80
6.50
$82.55
Amount Paid
$82.55
$82.55
12/3/2008