HomeMy WebLinkAboutPermit Electrical 2006-6-15
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225 FlrrH STREET. SPRINGFIELD. OR 97477 . PH,(S41)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number C,(J)~;;:;lC'ht" - 0 07Lj.[)
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1. ',LOCATION OF.INSTALIATIdN,;'.":',;:",.~\;,
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LEGAL DESCRIPTION
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, JOB DESCRIPTION
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Permils are non-lr.nsferable .nd expire if work is
not st.rted within 180 d.ys of issu.nce or if work is
Suspended for 180 d.ys.
Address
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3. "COMPLETE FEESCHEDULEBELOW +.,:t;;.~;;'~~'i}:'"
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A.;;Ne~rRc;ident;J'} ~Siiiglc ;;r~uiti)amil?pe(~~eUino .uiiil.. ~')
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
E~'ch M'm4faCt'd Home or "
Modular DweUing Service or
Feeder
$106.00
$ 19.00
" ~.'
$50.00
/'" 691 Amps to 1000 Amps $163.~0
City 7" UC .p",{7 Phone t;'tll-~/'\- 1t?J O~er 1000 A~psfVolts $375.00
/ Reconnect Only $ 50.00
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~' 'SUHJ:OTA:F?f,~OV1J'~."
_I\~ "^ 1P ~~~~::~S;;:t:::~v: Fee
~ ra: ~- TOTAL
Supervisor License Number '. sf) &;0 <)
Expiration Date
fcJ~()f
Constf. Contf. Number
ISV8Bll9
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:7
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Owners !':l.me ~ l1-1I?1'YIf( /.;{('...
Address (.O~ ~O;( dO')({
City ~\evY'l elL. Phone Cr-p>-qL/q -770/
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OWNER INSTALLATION
, The instaU.tion is being made on property I own which
is not intended fer sale, lease or rent.
Ow~ers Signature:
Inspection Request: 726-3769
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-- Installation, Alteration or Relocation
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200 Amps or less $ 50.00 ,--~J
20 I ~fR9~1'egon law r'"'' .ir,," y~I9~&O
"401 ftmBW'l~Wpted by Ihp ()rpoon $1I0Q\00 ,
OvH<6ID'OCAllkp:s &EllotllT.v"blwsee f\ae."b~o"~eset forIl.
D :'JJi\t.ltW(;i~rllm!,~Q1o.;tht,QiJ~hiQ~~f)5~'~oi1'!ll);:rM<'~~.iit1;
. i5" 0(j"90:Y6u1ff!iy'861~W~6p~~'6t:t~1furiS~d\~<1t::\;Cc?:iif!;fJ;'Ili'
New AI.t....!inn or.:1i~tensionl:eer.P.neble )r~~'-
'calllny ln~ C61 HIJI. \' ~....~.... ~.......... ,"
One <fienIiSer for the Oregon Utililv N~'.,: ($.43,00
Each Additio'ehMi(.~u.i! qr.ll'j\!).-332-2344) "
Service or Feeder Pennit $ J.OO
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E. 'Miscellari"iii,s '(Ser"ice/feede"i- liotincl~ded) -Each Illsl:iihition'
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Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residenti.l
Limited Energy/Conunercial
$ 50.00
$ 50,00
$ 25.00
$ 45.00
Minimum Electric Permit Inspeclion Fee is $45.00 + Surcharges
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Shared Drivd;T:)lBuilding FonnslElectrical Pennit Application 1-Q6.doc
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.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00740
ISSUED: 06/15/2006
APPLIED: 06/15/2006
EXPIRES: 12/15/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspeclion Line
SITE ADDRESS: 5755 MAIN ST
ASSESSOR'S PARCEL NO.: 1702334400800
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Alleralion
PROJECT DESCRIPTION: Temporary Power Pole for Fireworks Sland.
Commercial
Owner: CAPTEC FINANCIAL GROUP INC
Address: % PROP TAX DIV PO BOX 544
ANN ARBOR MI 48106
Contractor Type
Applicant
Electrical
Contractor
DYNAMIC LIFE
SUNSET ELECTRIC INC
I CONTRACTOR~plikUlQNJILL EXPIRE IF THE WORK '
AUTHOR~~~DERilIS PE.RMIT IS NOT
~.fOO'~ Phone
COMME IS I 503-949-9901
ANY 18Q5lRl~fERIOD. 02/27/2008 541-915-4883
I BUILDING INFORMATION'
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Construction Type
Secondary Conslruction Type:
# of Bedrooms:
# of Slories:
Height of Slrncture
Type of Heal:
Water Type:
Range Type:
Energy Palh:
Sprinkled Building:
Lol Size:
Sq Ft Is1 Floor:
Sq Ft 2nd Floor:
Sq Ft Basemenl:
Sq Fl Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Fronlyard Selback:
Side I Setback:
Side 2 Setback:
Rearyard Selback:
Solar Setbacks:
I DEVELOPMENT INFORMAiI;J0NJ~jires yOll t~
1'1\\::1'I I IV'" - - d by the uregOIl Utili y h REQUIRED PARKING
. \In'" 'l,lpS adopte les are set \ort
@v~'!~r p~scellter. Ihose rll Ii 952-00' - Total:
NIJStreetITrees\Rgd:, 0 throllgh 01', llles by Handicapped:
"""^;i\!\t::"')-\'" l-:.IV . 1ther
i,Paved Drive Rqd:btaill caples 0 hOlle Compact: "
"'o~f Clit'cHVe~age~r (Note: the telep 1011
calling the ce"l. Utility Not\\ica I
'_M ,,,' Ihe Ore gall _ _n ,",,'All\
~ ~\".-v,-,-
I PUBLIC IMPR0V-EMENTS I
Slreel Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
Pa~e 1 of2
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.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00740
ISSUED: 06/15/2006
APPLIED: 06/15/2006
EXPIRES: 12/15/2006
VALUE:
Status
Issued
225 Fifth Slree!, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Fl
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
L-Fp.p.s Pa~
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Temp Power 200 amps or less
Amount Paid
Date Paid
$5.00
$4:00
$50.00
6/15/06
6/15/06
6/15/06
Receipt Number
2200600000000000839
2200600000000000839
2200600000000000839
Total Amount Paid
$59.00
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.
Temporary Electric: Approval required prior to Ulility Company energizing pole.
By signature, I state and agree, lbal I have carefnlly examined lbe compleled applicalion and do hereby certify lhal all
information hereon is lrue and correct, and I further certify lhal any and all work performed shall be done in accordance with
the Ordinauces of lhe City of Springfield and the Laws of the Slate of Oregon perlaining 10 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 10 ensure that all required inspections are requesled at lhe proper lime, that each address is readable from the
street, lhal lhe permit card is located at lhe front of the property, and the approved sel of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa2e 2 of2
,
225 F.ifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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Cwf Springfield Official Receipt
~opment Services Department
Public Works Department
RECEIPT #:
2200600000000000839
Date: 06/15/2006
8:16:53AM
Job/Journal Number
COM2006-00740
COM2006-00740
COM2006-00740
Description
Temp Power200 amps or less
+ 8% Slale Surcharge
+ 10% Administralive Fee
Paymenls:
Type of Paymcnt
CredilCard
Paid By
SUNSET ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
ddk 032990 In Person
Payment Total:
Amount Due
50.00
4.00
5.00
$59.00
Amount Paid
$59,00
$59.00
r
cReceintl
Page 1 of 1
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