HomeMy WebLinkAboutPermit Electrical 2009-7-6
Electrical Permit Application
225 Fifth Street+Springfield, OR 97477. PH(541)726-3753+ FAX(541)726-3689
l~wr;f;DEPARTM'ENmlUSer6'N~.~.~~.*l .~
i,>!:<.,,,:,,,'~":':"-"";"'-':;.i::;~,:;fZHi'::;tt'g.2!:t~W*",,,,,,,~k '\.U
I Permit no.: (V~ -li g=::, I
I Date: I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days. .
1~:;~~~f~~~~~~EB~M--~rr~~agR~~b~~~1
1~~~NI1J:G_~l~iY~ElFJI~~ElN$;!J~!!lPiIfIQ:rijjll:W~!ll!!j~'~~~~
=~~~~ffifEj'N~~~M;~~;,l{N~li~:~mr;~i~~#1&!~
Job site address: 36 'f'-f AJ/;fuplU, I
I City;... 4 !II n .ilGuJ l State: A)A 'I ZIP: Cf7'i711
I Subdivb~n: ,'\1D:3'ZZ 2D -. I Lotnon\C\~
r~' :. .... ~'r,\ESC:Rll?illleNlilei:)':WeRK''''''~%'''~''''''"~1
' '"~_ ". _-:.l(.l_ _ , _"_'__."M___,*,~~hjWJ!_.__w__~_..:~~&'1l;r~J!i/E:;'iTA?~}',:i'
"I (7.--""'" I! )(QjJ! S~ I
. L~ U I
""'~-""""""~ ..........-;n;\'i"'... .............,f._;:-.~,:.''''''''
1~:E:3:~';-"~'
I Ciry;....5Jhtf);,r I State: /J)/C I ZIP:t?7'f77 I
I .'
I Phone:-;& JiP . ~f 55 I Fax: I
I E-mail: I
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange; lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
f~::::~;~G,)~~~~:mQN~~1;~fJ
I Address: .9:;q975 fbi/~(C:!: ~
I City: Cl.cc;;GtJr;;. . I State: 6,)/L
I Phone: - tfi1'5- 55<1& I Fax: - c;gS-5'6/S
I Ecmail: 1 PAn ff~/ A CO' r514 Sr.::,oS Chv..
I CCB license no.: I/o 2/f-70 I BCD license no.:
I Signing supervis01:,,g,ncen~e'llo,;,. ~ y 3-:5 :S; G
I P . .. '.UIJO", ...,. .. HI ';igoltl..",J,~ i.
rm! name of slgIgI?-gr~!lp~rvlsor:U{l'(.Jt.; , -~QLlir(.lC'~
I . ....~"un C .k -. ';("'-"='0 ,-" <u
Signature of sigIj,Ji1gJs"tip,,-ryis-9r,:~::f)\~JI'AJI:;~_:fill1g'!:9n Utilitv
440.2584-1 (9/08/COM)
$
$/.::16. ~"
$
~l,
CITY OF Sn~.lJ"\JJ'lJ',LD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2009-00983
ISSUED: 07/06/2009
APPLIED: 07/06/2009
EXPIRES: 01/07/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3344 Gateway St
ASSESSOR'S PARCEL NO.: 1703222001900
Springfield TYPE OF WORK: Electrical Work Ooly
TYPE OF USE: Alteration
Commercial
PROJECT DESCRIPTION: Reconnect two wall signs
Owner: 3346 GA TEW A Y LLC
Address: 840 BELTLINE RD STE 202
SPRINGFIELD OR 97477
Contractor Type
Electrical
I. CONTRACTOR INFORMA T10~ I
OU \'-'
Contractor \/I \eo.\l\\e&(ce'ii'~~'1'n
E S & A SIGN CORP _.. ('\\e<:\00 ~~, ,\\e o~eJ.1i3"i!l\~~I'
r>-\\tj'~B'UiiDlNG-I1NFORM;\ T.ION'I'~,es '0'1
\o\lO~f' : 00 v"": alO \P' - \es U' .. \el1\\006
\-Io,\\\ca.~slt.8PSt~j~s::0 ~O~e" ,\\e ~o\W\ca.'\OO
\0 Op..1'\ ,/0!:Jeig#tl\![JltrUC\~lJ',\I\''13~~)'
aaga'\'0C.\l\ypeCofJI]a10~G_332-2
ca.' \~\ft'elJ:l\Ilel-'O
0\)((I RIUi'g'l!'fype:
.Energy Path:
Sprinkled Buildiog:
Expiration Date
03/1612011
Phone
541-485-5546
# of Units:
Primary Occupancy Gronp:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Constrnction Type:
. # of Bedrooms:
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: Total:
# Street Trees Rqd: Handicap!!'\NO?''f..
Paved Drive Rqd: c'!I'1~~.t'it- ~O\
% of Lot Coverage: t'/-.?\?"- \ ?-~\\ \S
"O~\~~~~~\\ S~0;1',~\-\\S:~~%t\) rO?
I PUBLIC IMPROVEMEN-M',~~a"'\lt.\l uO~ \S [>.'Oro"
rov .,.(,~\Ct.\) ,,,c?,IO\).
CO\-J\\"l>lg"tr~\'l'YVe:
[>.,'\'/ 'J'ownspouts/Drains:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I V ~Iuation Descrintion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 2
_~~Rt~~Ij;!~~i'
:h
AI'
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00983
ISSUED: 07/06/2009
APPLIED: 07/06/2009
EXPIRES: 01/07/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid J
Fee Description
+ 12% State Surcharge
+ 5% Techuology Fee
Sign - Outline Lighting Each
Amount Paid
Date Paid
Receipt Number
$15,12
$6,30
$126,00
7/6/09
7/6/09
7/6/09
2200900000000000758
2200900000000000758
2200900000000000758
Total Amonnt Paid
$147.42
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspec,tions 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'1.uired In~'l~c.ti~n~ I
Sign Electrical: After connection is made but prior to energizing
By signatnre, 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 1 fnrther 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 pcrmission 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 a4dress 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
:imes duri g constructi~~K ~ ? _ & ,. 07
,
Owner or Contractors Signature
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
54]-726-3759 Phone
Job/Journal Number
COM2009-00983
COM2009-00983
COM2009-00983
Payments:
Type of Payment
CreditCard
cReceiotl
RECEIPT #:
Description
Sign - Outline Lighting Each
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
EUGENE SIGN AND AWNING
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000758
Date: 07/06/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Ilh
006390 In Person
Payment Total:
006390
Page I of I
IO:52:53AM
Amount Due
126.00
6.30
15.12
$147.42
Amount Paid
$147.42
$147.42.
7/6/2009