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Home My WebLink AboutPermit Electrical 2008-12-19 .f , ZON -V\O lNlTIALS \--Jp(\. , DATE \ 'I _ \<4 -0 (:, SOURCE 'CD-~-7./ 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)7~6-3689 ELECTRICAL PERMIT APPLICATION City Job Number ,l"n.v1 'LOO ~ -0 I bIg Date. , 12-/'-0% I. ffiti:JCA:1J.fijNYi!JBmSi~(iTiiXTifjNr~'r;~'WJtI! !4fu,;;t;;;T"h^."",**~~,.,,,,.,,,i*,,..,,,i'L~M"""''''-''"~iiii;iijj)i!l\l;A%;;"%M0~=-~~''''"''=''''''-E -+IAlJUlO0\-hq,L~" I ..,,,~l' LEGAL DESCRIPTION: ,702 34 ~Z ~(i\A O\A~(,^ JOB DESCRIfbA {> fA--~___ 3. 10@i;%lli1l"'R0%'27.'P'1llii"$"''''='''G$'''1!l?'s='''-''''",,'1''~''''~'M"'' _ "''' '" '"' _de,," .," "'M 0 " A. "Ne*~ResiilentialfE'!'Sin'"le$or'Mulli'Famil"z'c'F'uwclliii ,uDit:~~ 001 00 hh~_'C.._,. ....,....._"l\~"k.;!......."..$.~......):tIL&.y$..... g... Permits are non-transferable and expire if work is Dot started within 180 days of issuance or if work is Suspended for 180 days. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $]21.00 $ 22.00 $57.00 2. B. Electrical Contractor SS'b ~ ('1 ." Address \'i:'fD 10 -.,,'...., 200 Amps or less . t. O,VO i:> " ;, ~ ""'L'S . rGt~1 Amps to 400 Amps ~( 1.. '" f :.'.: '1/0., C qdoPI~&17 Al1>Pj to 600 Amps ~09D. ~o""2'00 eli)oler. 60]6x.rii~.~gliirOlg Amps r {( f' . 0 'fOs V( YOU Phone '1*'-1'1//(;. ,0,5"liqy 06 70~e/100Q,s\Jlpst,y~>> to $426.00 ~"Iber f~'''' cenle IEilnP,ec'ifnnl5ctoIDy Set /Ity $ 57.00 C I Ihe 0 r. (AI uP/es o~fj 9$::;.n~rtl) f5 enter,s reg,€-I)i]"'[tii!l-~-.e'liJTM~~~~i'F'!IlJ?.:',j"~Nlljiil,TD'i t .'WJtI!!iil\'~~I1fuIl" , 7 8 . ~tcm q .-vise or", ~"CUersjWb -~- 705iL ~ ~***" - 00-33;IIfT%tJ!"a/); !Y~"~ ~ . ..- Insta'iJ1a~, ~iltt~ion or Relocation 200 Amps or less 20 I Amps to 400 Amps 40' Amps to 600 Amps $ 73.00 $ 86.00 $143.00 $186.00 City 'S, rO"l...., '\',1:\ \) Supervisor License Number 10'7 !> id'lolD Expiration Date Constr. Contr. Number $ 57.00 $ 79.00 $1]4.00 Expiration Date Over 600 Amps or 1000 Volts see "B" D. Signature of Supervising Electrician NorICE' _ -- Tl:!l.~ Q~,,' One Circuit _ $ 50.00 '::>c IJUT/-fO ~/"fMIT SH Each ~?ditional Circuit or with ~.~\) J:~~~d~D.0'Ll~~_~~~~8~;\iii~;;;~;~f&M~~~~~;;~;~~~'fii1lIiififut. \ 7; Q() N. -'--r :-i:mo ,., "'ND'!f!fIVfI)WIS~"ZY""~7~"''''''''"''~"-~~-~''. . .. City <; f' ~ oJ';' Phone I"H '4- G,17> D. puYflJ.,F'@frpalIol $ 57.00 Sign/Outline Lighting $ 57.00 Limited EnergylResidential $ 29.00 Liniited Energy/Commercial ~$ 52. Minimum Electric Permit New Alteration or Extension Per Panel I"l. rn~ ~ OWNER INST ALLA nON The installation is being made on "'V"",j I own which is not intended for sale, lease or rent. ] 2% State Surcharge 10% Administrative Fee 5%'Technology Fee rcharges '-'52 _b-z:t:f _'~5i-o - 7f.= .= 4. Inspec Ion Request: 726-3769 -01"""-'.- TOTAL --bt 0'-1 Shared Drive(T:)lBuilding FormsfElectrical Pennit APplication 7-08.doc Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01618 ISSUED: 11/05/2008 APPLIED: 11/04/2008 EXPIRES: 06/1712009 VALUE: $ 5,200.00 2i5 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line SITE ADDRESS: 333 58TH ST ASSESSOR'S PARCEL NO.: 1702343200100 . Springfield TYPE OF WORK: School TYPE OF USE: Alteration PROJECT DESCRIPTION: Remodel of bathroom to accessible standards Public Owner: SPRINGFIELD SCHOOL DISTRICT 19 Address: 525 MILL ST SPRINGFIELD OR 97477 Contractor Type Electrical Plumbing Contractor OWNER OWNER I CONTRACTOR I~FORMATlON' fOlio' ""iflIO lvotifJ;'" rilles /1;,. Or"License Expiration Date Phone ;1) O-'1,/J' E1fiOI)C E1doIJ/;Of7 IElw 090. .".!S::'Of7:l)ter. 7"~ by fA!:eqllirc_ Burubl&G' rNfORMATIONT rllle~rego/~tll to !! fOr -'life \, Co '9h O}re Set illty . I'~ the r. (IV. 'PIes "1Fy 9 f,f;,' # of S"'''''I1<1r . Ore Ote: t Of the :'iJ-IJ ;>.Ze: Height of Str~tJ;%OI) !.JtlZ' 'he tele rll/~K,! 1st Floor: Type of Heat: 0'88:::; lvotifholf1fJ'Yt 2nd Floor: Water Type: :344). CEitio5A Ft Basement: Range Type: - Sq Ft GaragelCarport Energy Path: Sq Ft Other: ' Sprinkled Building: nla Occupant Load: # of V nits: Primary Occupancy Group: E Secondary Occupancy Group: Primary Coustruction Type VB Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION , REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: . Solar Setbacks: N Overlay Dist: . r. OnCE.. # Street Trees Rqd: HIS PI:.' Paved Drive Rqd: AUTHOR RMlr"8f!1A Lot Coverage: COM IZeD u il fXp 1,',,~ l%~~;~::;!fr~WOBI( -~ I/OD. vU1VeD FOR NOSidewalk Type: Downspouts/Drains: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Speciallnstructiou: Notes: Pae:e I of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01618 ISSUED: 11/05/2008 APPLIED: 11/04/2008 EXPIRES: 06/17/2009 VALUE: $ 5,200.00 225 Fifth Street, Springtield, OR 541-726-3753 Phone 5;11-726-3676 Fax 541-726-3769 Inspection Line I Vat., ''[ion Descrip,tion I _nlll , Description Tvpe of Construction Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage . or Ilid AlIlount 5,200.00 Value Date Calculated Total Value of Project $5,200.00 $5,200.00 11/04/2008 Frp< PllW Fee Description + 10% Administrative Fee + 12% Stat~ Surcharge + 5% Technology Fee. Building Permit Fixture Minimum/Adjustment Plumbing + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ _ Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $13.94 $16.73 $6.97 $87.44 $51.00 $1.00 $5.20 $6.24 $2.60 $50.00 $2.00 11/5/08 11/5/08 11/5/08 11/5/08 . 1115/08 11/5/08 12/19/08 12/19/08 12/19/08 12/19/08 12/19/08 2200800000000001611 2200800000000001611 . 2200800000000001611 2200800000000001611 2200800000000001611 2200800000000001611 1200800000000001238 1200800000000001238 1200800000000001238 1200800000000001238 1200800000000001238 Total Amount Paid $243.12 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections req~ested 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.. pp(!ll!ir~~ 'ns>>ecti>>>>s I Rough Plumbing: Prior to cover,' and including required testing. Final Plumbing: When all plumbing work is complete. Framing Inspection: Prior to cover ~nd after all rough in inspections have been approved. Final Building: After all niquired inspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover ,'. Final Electric: When all electrical work is complete. Drywall: Prior to taping. Paee2 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRlNtjJ:<lEL.p . Building/Combination Permit PERMIT NO: COM2008-01618 ISSUED: 11/05/2008 APPLIED: 11/04/2008 EXPIRES: 06/17/2009 VALUE: $ 5,200.00 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 berein, aud tbat NO OCCUPANCY will be made of any structure Without permission of the Community Services Division, Building Safety. I furtber certify that only contractors and employees wbo are in compliance with ORS 701.005 will be used on this project. I fnrther agree to en~ure 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 tbe front of the property, and the approved set of plans will remain on the site at all times during construction~ Owner or 'Contractors Signature ..' ,. Paee 3 of3 Date ( City of Springficld Official Receipt Development Scrvices Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-01618 COM2008-01618 COM200~-01618 COM2008-0]618 COM2008-01618 Payments: Type of Payment Check Cash Change Job/Journal Number COM2008-0 1618 COM2008-0 1618 COM2008-01618 COM2008-0 16 I 8 COM2008-01618 Payments: Type of Payment Check Cash Change Job/Journal Number COM2008-0 1618 COM2008-01618 COM2008-01618 COM2008-01618 COM2008-01618 Payments: Type of Payment Check Cash Change cReceiotl RECEIPT #:. 1200800000000001238 Date: 12/19/2008 '. 1O:31:42AM . . Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee . + 12% State Surcharge + 10% Administrative Fee Amount Due 50.00 2.00 2.60 6.24 5.20 $66.04 Item Total; Check Number Authorization Paid By. Received By Batch Number Number How Received SPFD PUBLIC SCHOOLS D1ST djb 70422 In Person 19 SPFD PUBLIC SCHOOLS DlST djb In Person 19. SPFD PUBLIC SCHOOLS DlST djb ]n Person 19 Amount Paid $63.50 $3.00 ($0.46) Payment Total: $66.U4 ". Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee '+ 12% State Surcharge + 10% Administrative Fee J ,~. Amount Due , . 50.00 2.00 2.60 6.24 5.20 $66.U4 Paid By. SPFD PUBLIC SCHOOI::S DlST ]9 SPFD PUBLIC SCHOOLS DlST 19 . SPFD PUBLIC SCHOOLS DlST 19 Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid 70422 In Person $63.50 djb djb In Person $3.00 djb In Person ($0.46) Payment Total: $66. U4 'Description . Add, Alter, Extend Circ Minimum/Adjustmeryt Electrical + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Amount Due 50.00 2.00 2.60 6.24 5.20 $66.U4 Item Total: Check Number Authorization Paid By, . Received By Batch Number Number How Received SPFD PUBLIC SCHOOLS DIST djb 70422 In Person 19 SPFD PUBLIC SCHOOLS DlST djb In Person 19 SPFD PUBLIC SCHOOLS DlST djb In Person 19 Amount Paid $63.50 $3.00 ($0.46) . Payment Total: $66.04 ,. Page I of I 12/19/2008