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Home My WebLink AboutPermit Electrical 2003-11-24 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 b'mitted has the iollowing Th f Howing project as su ELECTRICAL PERMIT APPLICATION zo~m~. and does not require specific land use City Job Number COW\ZOoS ~ 01177 Date / 1-). c; -03 approval. (1 (V..J . Zoning - ,-- J,...I\~. '~,-,_.. .,__...~~~'r-'"",~T~-:'~;"I,--.:rr,~~z-:'I-I~~1f"'u~, .:-.... , 3. ';COMPEETE'E ' ,fTFnr.TT r;'BE1.Qr,;' J ,.., !.~" ,,'" ',' ~~"">,,,,,,",,~~!:;, ..."~,,,., ..~ ,_....~~, ~,~ I':'i.ltr.onzed Signature - . ll'!~f~:;':7W~.,[~"'"i.;:''':':--;~ffr5':''c'''''~~:cf';~''':'''i!#''';-:<~ A. .~~t~--~,~gIC:~lt:~IL~~!!l~~~'( teL~~y.~I,!~~~~I!~~~ 1. ~toCXtibN.'OFiNsDl'i,i;4.'lj'i5M',';;:mz:"fi.'{ ~~"il.Io~~~~"'''~'''''~'';' ""'"o'!..".s;;.,..J.~I~,,,l<i!'<X. .~,0~ 51 0 I ffld I V\ STr.ul LEGAL DESCRIPTION 170Z- 3'3 'i ( OslOI JOB DESCRIPTION -r:tw\p ~YV;c,l Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~'CO.zVT,i?Acrfjii'iNSTAiEA'n,'ONfjNi, :1', ',1 2. ~~~Qif""':'N"';"~ "~.,":,...,,,.,.~c'\iii:y;;,....,,;;,,,,,,-,~j Electrical Contractor~d- 'Bvvrll/J..- t::ucr .JnG Address "2..6"ZS" w,{lon 0\ 'b r. City e 4 Phone $wn'ls- Supervisor License Number Lf 7 3 4 - "5 Expiration Date I 0 - 01 Constr. Contr. Number ~ {J -:.j I c;- &, 1 (p ( Expiration Date I E:, - (J7./. Signature of Supervising Electrician ~pL "R~vv-L \ ' Owners Name Vt/lC.DOhOl.f6 ~ CoftP Address S 7 () I Vl1 ~( (1./ , s,,\ City ,:::;;>,~~ Phone l OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 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 $106.00 $19.0~ $50.00 ~ B. ~s'~:~[it:6'7~~FeWdii:~~~::Instfriiftioit;:A)'t~f~tiJ~;\~;;'_R~i6~i't~-R,'-;;:'},T1 1.~';"":>l"",p!'H', '..~-.~l.~":-' ..""~h "''''~','','.'r-._;;~,.I~'''+''.$..i-r.;.<_..~~~ .~." ',' 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 rtT:'~h";:(';~';'~~~'>:"'-:>-_-";'r;,-"'C:;,Y."'.,' -:;';''>j'''''-;;~, .. .. "~1<";r,->'~:;t;~;c"ll-r""J:I-_'Ko,','~~,,~1 c. ~p-OJ"a!Y~~ID"!~~orJl~W~~~~\':Ibi;:,:J21."f:.'L~~::~'~~-"; '~.. Installation, Alteration or Rel~&#-. r?l ___ 200 Amps or less \r ,\,\t. ~ ,,1\\1 S 50.00 :::J V 201 Amps ~~\t.~~\' \~. $ 69.00 ~,\C~I ~~:n(~wm)S Q~t.\) r $100.00 \\ I.1\S ~~~t:;~~~l\s.,O).,~\)Volts see "B" above. ,,, "(nQ~;Krn;.~~{I1~": ,~.:.;" ~."'f; '>'~,,3>i..:f. -.'11~ -. ..~.,\,,""'l ",\J\":Jt~\1jJ.1.o;n~{~i0.:~ ~'.~Wi"~' ,,,.,~.,: ,,~,. ~":iJ C.QW\l'\~~ation or Extension Per Panel ",~'10ne Circuit $ 43.00 Each Additional Circuit or with Service or feeder Permit E. fl~'~~~~:::~r~~':!~~i~idl.iE,~i;tn~t~~~.i~ P.umpI6r'irrigatioi11~ ~ \as a{e . ~ ..d)O $ 50.00 ..-1'E.~1 \ ,~. ',,\J''''~ ~e {ll "p, "'~- 1 p..\' Sign/Outline Lighting q\'\ Of', ...IPS $ 50.00 \0\\0'lV [,(';;;;[drEri\~~lRe~ili2dfials 0\ \"C~O{\e $ 25.00 "iCa,\lv' ",,~-"-' .<l\OV\~, \e\~r . (1 .. -"\0\\1 ~irriii'ed'EnergYiGornmercial(1e h\ _,',IiCa\IO $ 45.00 \{1MiC1r>: '~:'\'Ef'(\1 a'i:-p'''t. \NIU'~;",\"!:-l \~F-'~' $4500 S h Ol)'g~~m,w~tncl, ~rn~~I;IS;~~?1?20.~~.ellS ,,' _ "~. ~"_.~ ~ ure arges i1;.S:._d'''I)~cI''''''",,,,,,, ~"c*""",., '.' ,.J. ",0 4.,SU.,B'TOT:AIJ,OE~, OV,Ek ,;;v;;v'Vl,," ;"; "'..:<il&t,'~'$;t'f.JI r.O - 'C"~~'l.~,,,",~.,;.::r~"":'.'i~~LA.t:.""'''i>,<$t.',:I :J l ~;o 7% State Surcharge .:> 10% Administrative fee 500 tS8~ $ 3.00 TOTAL Shared Drive(T:)IBuilding Forms/Electrical Permit Application I-03.doc . . CITY OF :SYKll'OjljNELU Status Issued Building/Combination Permit PERMIT NO: COM2003-01177 ISSUED: 11124/2003 APPLIED: 11124/2003 EXPIRES: OS/24/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5701 MAIN ST ASSESSOR'S PARCEL NO,: 1702334103101 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Temp power for tree lot Owner: MCDONALD'S CORP 36-113 Address: 2073 OLYMPIC ST STE 211 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor JOSEPH BUNCH ELECTRIC INC License 156761 Expiration Date 08/2112007 Phone 541-344-8745 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Ty~~,;,,~v.. Ene'W\tlitb: ~ _ c.'/..?\~~;rQN\\\ \~ ~O \,\\)'W'~~WI\\ ~\\~}iDEyEJ.{RM.iN't~'NFORMATlON I SETBACKS \\,\\'S? ~\1t.\) \) ~ \~ ,,"0,,1 REQUIRED PARKING Front yard Setback: I'-\)\~~t.~c,t.\) ~'t.~\O\)' Overlay Dist: Total: Side 1 Setback: c,O \'0\1 \)~ # Street Trees Rqd: Handicapped: Side 2 Setback: I'-~i Paved Drive Rqd: Compact: Rearyard Setback: % of Lot Coverage: qUlleS yOU to n laW re 'I.ty Solar Setbacks: _ -rION:orego oregon Uti I 1\"f,.~N, ,~...l.h\,'he _..,....rI I PUBLIC IMPROVEMENT-q~~;;_-lhOse ru\e~~R 952-00 \m\l'''~''-' O,,"C\thrOuqh les \ 952.-001- 'SIdewalk Type:! the ru , OAR obtain cuP". . 1",lephOne 0090. You may ,~?w\,,~pout~lDfainS:'I'Cation II'ng the cenl' Utility NOli I ca I h oregon 4) number lor t e. .Rno-332.-2.34 . r'""ln+~rl~ 1 VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: Street Improvements: Storm Sewer A vanable: 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 Pa[!e I of2 . . CITY OF ~rKll'ltJ1<IELD Building/Combination Permit Status Issued PERMIT NO: COM2003-01177 ISSUED: 11/24/2003 APPLIED: 11/24/2003 EXPIRES: OS/24/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line IF..... Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $5.00 $3.50 $50,00 11124/03 11124/03 11124103 1200200000000002510 1200200000000002510 1200200000000002510 Total Amount Paid $58,50 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 ~~ . I R..ouir..d I nm..ctinn. I I Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that I bave carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify tbat 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. Owner or Contractors Signature Date Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1177 COM2003-0 1177 COM2003-0 1177 Payments: Type of Payment Check Paid By TOMS TREES .... Receipt #: 1200200000000002510 Description + 7% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less Received By djb Check Number Batch Number Authorization Number Cily of Springfield Official Receipt Development Services Department Public Works Department Date: 11/24/2003 2:22:09PM Amount Paid Item Total: 3.50 5.00 50.00 $58.50 How Received In Person Payment Total: Amount Paid $58.50 $58.50 . .