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Home My WebLink AboutPermit Electrical 2008-12-19 ~ ZON INITIALS DATE SOURCE ~ F'~ b~ 225 FIFTUSTREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726~3689 ELECTRICAL PERMIT APPLICATION City Job Number &"if - /1) X 9 1. "5 f(O P't~ FIC.WV LEGAL DESCRIPTION: /")0 L ""ODD /')/'-''-'0 JOB DESCRIPTION: C4hl.,,! +:~<' ;2"u~'. iJ,rjJ.,1ch Permits are non-transferable and expire if work is not started within 180 days ofissuance or if work is Suspended for 180 days. 2. Electrical Contractor Oem Lv, 'v<,(" ,) 5//( j...",,} I / Address 5 I f q s~ CJ / J /1/ . 10'-'1 ) I{- City 7:<"c'-~/ Phone'i<fF926-lltf'?" ,/ Supervisor License Number if / ') J{-L. E;f Expiration Date 10/ " 1/ 2. 0 II Constr. Contr. Number 0 4- 9 .7 0 Expiration Date 1/ - ~ - )...,0 II Signature of Supervising Electrician ~~~-;7~L--' . ~ . Owners N~h 3fi\:~ 0 ~ 0r ~ Addret:\_ v,u~. \4 '2:>W City~ Phone OWNER INSTALLATION The installation is being made on property] own which is notintended for sale, lease or rent. Owners Signature: Inspection Re'luest: 726-3769 )'.::2//%//1 X Date 3. A, Service Included 1000 s'l. ft. or less Each additional 500 s'l. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $121.00 $22.00 $57.00 . B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps . 401 Amps to 600 Amps $ 57.00 $ 79.00 $114.00 Over 600 Amps or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 50.00 $ 5.00 E. Pump or irrigation Sign/Outline Lighting Limited Eneigy/Residential Limited Energy/Commercial Minimum Electric Permit $ 57.00 $ 57.00 $ 29.00 )(. $ 52.00 C;;;' ~ <.J Fee is $52:.00 + Surcharges 4. 12% State Surcharge 10% Administrative Fee 5% Technology Fee. / 'l.'{ 10- <~ L c.t.I TOTAL (~C, .o'{ Shared Drive{T)lBuilding Forms/Electrical Permit Application 7~b8.doc Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-01789 ISSUED: 12/18/2008 APPLIED: 12/18/2008 EXPIRES: 06/18/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3110 PIERCE PKWY ASSESSOR'S PARCEL NO.: 1702300001000 SPRINGFIETY~E OF WORK: Commercial Miscellaneous TYPE OF USE: Alteration PROJECT DESCRIPTION: Low voltage wiring from server room to dispatch station Commercial . . Owner: STATE OF OREGON MILITARY DEPARTMENT Address: PO BOX 14350 SALEM OR 97309 Contractor Type Electrical I CONTRACTOR INFORMATION' f " .... .., .." ." ">I"" 18W rcqtllres YOU to Contractor N~i';~\V :,:'It''' a'lal;!t:.~UicertsCiregC'E~p..\!lation Date DICK ZIMMERMAN in 6';.., ~;,;~,;~~ :1>:;.,.1 ',~49so'Jles are set f04rn5120 II f').....,,- . - -"'-"H'lu,"\r'~"'UU1... BUILDING'INFORM1\TION:I:s of the rulas by --''''':::J \11<"; vt:,'rHtJF. {1\iO.te: thet I" -n r:lUmfS~or fe" the 01'8(" . 't'I' e ep oLoe S' 1/ 0 tor,I!~:t'" '. , ;;011 ,'~ 1 Ity Notific&,;2,h Ize: Height bfCStructure800-332-2344), Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: . Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Phone 541-926-7788 # of Units: . Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B Frontyard Sethack: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I~:DEME'~PMENT INFORMATION' THIS PERMIT SHALL EXPIRE IF THE WORK AU TfJO foverla~DJst' 1 Ii''sfru e II{~~IlJ.l\S PERMIT IS NOT ~~MMEpItVe\~ '.IM':R\\il'ANDONED FOR Y 18Jlitf1~HjiQl;}.,age: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: . Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation DescriDtion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 2 , ; Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Low Voltage - Commercial Indus Total Amonnt Paid Amount Paid $5.20 $6.24 $2.60 $52.00 $66.04 Total Value of Project Fees Paid I I Plan Reviews I Date Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01789 ISSUED: 12/1812008 APPLIED: 12/1812008 EXPIRES: 06/]812009 VALUE: 12/18/08 12/18/08 12/18/08 12/18/08 Receipt Number 2200800000000001756 2200800000000001756 2200800000000001756 2200800000000001756 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/lllired Insnections I By signature, I state and agree, tbat 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 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 of the property, and the approved set of plans will remain on the site at all times during construction. Q/~--~ Owner~tractors Signature Palre 2 of2 Date 12~ (<i-oS-- 225 Fifth Street ' . . Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-0 1789 COM2008-0 1789 COM2008-0 1789 COM2008-0 1789 Payments: Type of Payment Cash Change Job/Journal Number COM2008-0 1789 COM2008-0 1789 COM2008-0 1789 COM2008-0 1789 Payments: . Type of Payment Cash Change cReccintl RECEIPT #: 2200800000000001756 Date: 12/18/2008 . Description Low Voltage" Commercial Indus + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By DICK ZIMMERMAN Item Total: Check Number Authorization Received By Batch Number Number How Received cjc In Person In Person Payment Total: . Descr~ption Low Voltage - Commercial Indus + 5% Technology Fee + 12% State Snrcharge + 10% Administrative Fee Paid By DICK ZIMMERMAN Item Total: t:heck Number Authorization Received By Batch Number Number How Received cjc In Person In Person Payment Total: .1 Page I of I 1I:56:26AM Amount Due 52.00 2.60 . 6.24 5.20 $66.04 Amount Paid $70.04 ($4.00) $66,04 Amount Due 52.00 2.60 6.24 5.20 $66.04 Amount Paid $70.04 ($4.00) . $66,04 12/18/2008