HomeMy WebLinkAboutPermit Signage 2004-9-8
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225 F1ITH STREET. SPRINGFIELD, OR 97477 . PU:(541)726-3753 . FAX: (S4t) I ~~ ~ DD
ELECTRICAL PERMIT APPLICATION ' "9 "6}"" .
CilyJobNumber~2O'04 - ()/I s<.{ Dale ~O'1 "o~"
I. \fQ~t~!g~~9.f:lS~JM0'ijQiX!f;,(~1:;~;. 3.
J401 Mo..&.+- <":::.hu.. ~
LEGAL DESCRIPTION ,70"3 Z 5':n
~~vci~\ IOOO~
JOB DESCRIPTION
Each additional 500 sq. ft. or r,,"O "'"Cl ""..
~CLL",,;-\-.... A1.""" :rn~kJl,,*;~ portion thereof 1 00 %~~_
"J ~~'O
Permin are nOD-transfel"2ble And e.xpire if work is Eac.h Mnnufacl'd Home or 0' ~
''"oJ' %. '
not started withia 180 d.ys of iosu.nce or if wlIrk i. Modular Dwelling Service or " .~
Suspended'for 180 day.. Fe<:der
2. ~"Sq8l#li€tli~~~~ft~,~ii;.w.l\lj::.~=~~~~r)~(\{Wii,~t~~:Cti~;:'i~i~,~ff~;;
.EleetriealContrllCtor ~P-C.. ~."L"m\\'i /n.tn?OregonUtility S63.00
.."IoMft := ~ llP4lJO'~M!e set forth S 75.00
Address --ZD ~E. Mi4,^ ~~:: 4 ,!XR~~..Q~~ 952-001- $125.00
ntllf C;W,U,hm.lIJles bYS163:oo
Ci.lY AI ~"" Pbone ("S~I)Q~ Pfi~:J.~J~.rePhone. $375.00
.) ~f01 lltyNotiflcation $ 50.00
, 0mIer -2344).
Supervisor Lieen,. Number qN-l Lf.-A c. !%;1f.@~$~fX11€lK~~Jfi~;ri~f~;~'ff~~~~if.~~~1ft{H1~~?i
Expitalion DB(e 10 III OS Installation, Alteration or. R.elocation
COl1Str. Conlr. Number
22 OS TCL E...
,of lIo'-i
200 Amps or less $ 50.00
20 I Amps 10 400 Amps S 69,00
401 Amps 10 600 Amps $100.00
D.i~1~~i1gi~;)Wii~~~~;~~~i~~i\P:?~j',i\~~?,r:;Ii~iilg;i
Expinltion Dale
V;Z;;rv~mg EICCmQ.&'
New A1~ratiou or Ex~n,ion P.,. Panel
One Cin:uil
Each Additional Circuit or wilh
:::: Name AL~ ~~: ~. ~~T/C~ ;;'~i~~;~~7;;;~;~~f~~~#'~?rJ~iM~i:~~;~tl;f~'i;kh~fi@Y
1<-10 I HIS PE~M~I1~lt EXPfAEfF TtlEW6 '., '~~"""'~'"' ",."""."L'.',,,,"
. City ~;..~C;<..1.l PI1(Jne Slj/-~'i'3-aijJfI7ORIZPi/;l,/JMffif@>i1#1S PERMIT IS N~: S 50.00 '
wMMENGiigMl~\1le A!;vtIVSONfl) fOn S 50.00 ' '
OWNER INSTALLATION ANY 180 OIl!JIiRll/llI@lgylResidenli."\l S 25.00
The installation is b~i.o.g: made on property I own which limited Energy/Commercial S 45.00 ~~ .CJZ?
i!' not"intended fOf sale.. lease or rent.
S 43.0U
MhWnum Electric Permit Im;pecrinn Fee i'i 545.00 + Sun~hllr:es
OWlle~ Sigmlture:
4. !(~g~{~{~1~t~~~t~:t.i~tt~~fif~I~~~~iL--3~ ,00
7% SClte Surcbat'g:e
10% Admioistr.\li\lt: Fec
____'3.!~
4.S0
.$ ~2.b5"
Inspection Reque", 726-3769
TOTAL
SharaJ C>.ive{T:)/l3uildin;; l:onm/l::lt:Cuicllf Pennil Applico.tion 1-t:)J,dnc
.
. CITY OF SPKll'llJl'1J!,LD
Building/Combination Permit
PERMIT NO: COM2004-01134
ISSUED: 09/14/2004
APPLIED: 09/14/2004
EXPIRES: 03/14/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Iuspection Liue
SITE ADDRESS: 1401 Market St
ASSESSOR'S PARCEL NO.: 1703253310004
Springfield TYPE OF WORK: Electrical Work Ouly
TYPE OF USE:
Addition
Commercial
PROJECT DESCRIPTION: Low voltage security
Owuer: ACES COUNSELING-A CORP
Address: PO BOX 7125 EUGENE OR 97401
l}\0
_"0 "'1
. .~\J\''''' _'t'\ \)\.\\\- ....
l.Q\JNTli~'f6k llW6lfuA TION I
~01et- 6~' ~eJJ 95!--
~~~ ~60~\e 'f<\OSe 1~" O~~e rJ\eS 'o'Lcense
"",....tat. \"to\) 0\\1, ~0(\eAp591
.. . , .f'",,~,),,\~ _ ,_1""'0 _ '}:\"~ _.,:.--.
~O\\t~ ~7.$~ ~"fIIfiNpiFr~A i'ION.
. \1'OI...."lC)l)~ ~\6\. l\\)"'.'2,'i""I'
#ofUmts: ~. Q~ e01l/l1lfl~~:
Primary Occupaucy Group: ~\fl et,ot~ I \Sfl1~t~t~f-Structure
Secondary Occupancy Group: ~ ~ Type of "eat:
Primary Coustruction Type , Water Type:
Secondary Construction Type: Rauge Type:
# of Bedrooms: Energy Path:
Sprinkled Buildiug:
Contractor Type
Electrical
Expiration Date
09/28/2007
Phone
541-928-4544
Lot Size,
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENTINFORMATION I
REQUIRED PARKING
Overlay Dist: Til:
# Street Trees Rqd: ~qI\l icapped:
Paved Drive Rqd: ,~,'I\'i:. ,S ' act:
% of Lot Coverage: 'i:.i-\>'''\'i:.,,\l\~ ~\j"
,. ~L\t>..\.\.. .o;~'S ..f)~'1;;
I PUBLIC IM~.9~f~~~~'i)~~ 'r-<o'r-,"'iJ.
I ,,\ I 1,1) R- 'v
,'0\;) 0.,'\)"'1.-- x.'V 'i) ';;~'alk Type:
'r-\)\' , x.~\J ~ \>'i:.~
f:.J'\)\l\>JI. 'O~ 'V~ Downspouts/Drains:
'r-~'>l.\
Froutyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
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
Paee10f2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01134
ISSUED: 09/14/2004
APPLIED: 09/14/2004
EXPIRES: 03/14/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~ Ff'f's PaW
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Amouut Paid
Date Paid
Receipt Number
$4.50
$3.15
$45.00
9/14/04
9/14/04
9/14/04
2200400000000001158
2200400000000001158
2200400000000001158
Total Amount Paid
$52.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Tnsnections I
Low Voltage: Prior to cover.
By signature, 1 state and agree, that 1 bave carefully examiued the completed application and do hereby certify tbat all
information hereon is true aud correct, and 1 further certify that any and all work performed shall be done In accordauce witb
the Ordinances of tbe City of Springfield and the Laws of the State of Oregou pertaiuing to the work described hereiu, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are iu compliance with ORS 701.005 will be used ou this project.
1 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 plaus will remain on the site at all
times during construction.
Owner or Contractors Siguature
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
~41-726-3759 Phone
.
G....~.R1N'!!"..IlI"l!..__. '.
WiL'
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,.~----...--.
JiJ..ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
2200400000000001158
Date: 09/14/2004
8:37:18AM
Job/Journal Number
COM2004-01134
COM2004-01134
\COM2004-01134
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Payments:
Type of Payment
Check
Paid By
MARTINVEST lNC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 40616 In Person
Payment Total:
Amount Due
3.15
4.50
45.00
$52.65
Amount Paid
$52.65
$52.65
9/14/2004
Page I of I