HomeMy WebLinkAboutPermit Miscellaneous 2004-11-15
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2251'''' In STREET. $PRL'lGFIELD, OR 97477 · PH:(541)121i-3753 . FAX, (54~~ ~~~~ / <Al~%f4:r 4~'.~~;;;
ELECTRICAL PERMIT APPUCAll0N ~~~>2";i:.U. '/rYJ::
City Job Number COI41 Z 0'04 - 0 /""3, 7 '7 Date /1/ 2;/0 '-{ .
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LEGAL DESCIuPTION ," -, ,"- -"- - , ) / /) A. it~,~j}~~~Ji~~:i~~~~~~~~~g:~w~~~~iiW~~~ff~~1t~~t~7~~{~i~1~
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JaB DESCRlPTIONV . .,' . .. ...
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V"Permits are non.transferable and expire ifwoll r.
> not started within 180 days of issuance or. if work is
Suspended for 180 do)',.
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2. "0:;""ii':td,~;':~;t';'-'.f,::!"I;",,' _'.:,..::~~:.!a;;';!r;~~~&-[,"c.ltt.(!l:'-"--,t..'
Electrical Contractor ~'.h/1 ..
Address fl? d ;;mlit-d
/d / / j. '. 601 Amps V:Jil}jil9~s $163.00
City rbJ.#A#pf Phone~3 ;;?J?j-yJ.J' Over 10OOf\IjjMl81~\1IT SHAL' E"- $3}5.00 .
. Reconnectp87HORIZED UNDE ~ M'IHEs'50TooE WnRI<'
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Supervisor Licimse Number i >'7 u - J-.!--CJ C. if';fen\pq-;',"'Y S;ri':ioM))j'iieiil'~rS'~~~:I'iNEID~tih:;rhrl:\~:x!;''";):~\;:
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Installation, A.lteration or.Reloeation
11/08/04 lION 10: .31 FAX
.
Expiration Date -f} /-9!~ Ir?;Y
Constr. Contr. Numbe, ,j; ~ I iJ 7
Expiration Dale _ 'J ~ If) If
C/ / I
Slgnafirr~ing EleCtriC~
. / ~'--.. r;;
Owners Name W(J'l,~I"..J-.,-- . Ilt.ulk(
I .
57 u? 1/??,,4 (/.r"
. Address
City
<::; \:> l~b
Phone
OWNER INSTALLATION
The instiillatioo is beinz: made 00 proptrty I own which
is not intended for sale, lease or rent
Own"" Signanrre:
Inspcetion Request: 726-3769
CITY OF
.
Servke Included
1000 sq. ft. or Ie..
Each additiooal 500 sq. ft. or
pOrtion thereof
$106.00
$ 19.00
*"
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder .
S50.oo'
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B. ;:,Se-o'lces or ,I.eeders:~:,JnstallationyAlte('ahons or.;Re)oc.anQn:>+"-'~
jg;;';':;;'J:;;J:'-c,"'. . .'i':i:2~:._.:;;-;;::.:..I:a;'.:.).Ij:;;;::.:t:..:'i.'h::f:rS'::.;:.:;;;,;?.:-~iti:j". -:.; :-;:::'~iL~;;>h-...;::-~~;:.;dd
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
S 63.00
$ 75.00
$125.00
200 Amps 01' loss
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D: ljfP:t~~:~~f~~~~~~t~;r~ii~W~(~f~~;1tl~~~i!~~1Zi~*ilii{;~0;llt~j~ijt~(~;~~~J:.m;I~1~i~i~lli~1~~J~8~~
$ 50.00
S 69.00
$100.00
. New .~tcr:tti(ln or Extension Per ~~~~J+
One Circuit. \ 1\'
Each Additionnl Circuit or with
Service Or F eerier Permit
$ 43.00
ljs
b
z
$ 3.00
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:!~:;"~.:".:o:.;;-:: "':1';';:': '_ _ ,... ;':i;.;;;;.:;~~;:;j~.~'.I'..:::~!:J~~'.sc~::._:;::.~J~.:i~!i:::~:,~-:';'.', :'". -2,~'~\- ~ ,:;;,..: :i~,i;~>.;~'.~:~:,;;;]!'f!<~< '.l
. ATTENTION' 0 I
Pump orf6'il8\l(on J . regon aw requs'~o.QQ,u 'n
SignlCMjflrjbM~:mt ad~ted by the Orf$~5fr.OQ)ti'if~1
. Limit~R'~_wf!&r. Those rules S,23.00t forth .
Limite@~~~l'lm~1 0 Ulluugn U1F.i5'6{?--001-
M~...".:.,,_. :.''7.1~~. ~~~. 'fo~'r. i.~.tBi~r.~~~.....'.~~f.,.p.,s~~W~'i~es
4. '.;~~~8.tAL '!'l '.' ..,~"'e~~$1'Jctl#~(f!cation l.f '7
.,..,........."... .........-:lS, c:llfl~...:z344};"
. 7% Stare Smc\'3lgc . "3 If }
iO%Admiuisrrative Fee l{ 90
TOTAL 5"7~
Snared Drive(T:}lBuildiIl& Fonns/EJccnlcal Permit Appli~tiol1 1..Q3.doc
.
. CITY OF SPKll~ljt<U.LU
Building/Combination Permit
PERMIT NO: COM2004-01399
ISSUED: 11/12/2004
APPLIED: 11/12/2004
EXPIRES: 05/12/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5703 MAIN ST
ASSESSOR'S PARCEL NO.: 1702334103400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
Alteration
Commercial
PROJECT DESCRIPTION: 3 circuits
Owner: W ASHlNGTON MUTUAL BANK #234
Address: % TAX DEPT PO BOX 7788 NEWPORT BEACH CA 92658
I CONTRACTOR INFORMATION'
Contractor Type
Electrical
Contractor
MULTI LIGHT BROADWAY SIGN CO
License
64107
Expiration Date
0210212006
Phone
503-281-3083
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
# of Stories: Lot Size:
Height of Structure Sq Ft Ist Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: NO Sq Ft Garage/Carport
Energy Path: TleE: Sq Ft Other:
Sprinkled BuildiJ~IS PERMiilaSHALLOa:upant Load:
^IITI Ir'ln....___ t^rIH.... ,~ TUc \"...._..
I DEVELOPMENT INFORMATioi,i;'O~UI~K I HIS PERMIT-IS 'N;lr'
ANY 180 DAY PERtOtBANDImLQP'NjD J>ARKING
Overlay Dist: . Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
ATT"'~""'~, .
N to!'OW IlJ/e~'~d~~~2'1'Pf1B1Jl{QIMP<R.O.YEMENTS I
ot/fiCSt/on Ce "'., ..." Ure
Street ImprovementM OAR 9 nter. Those I gOn Utility
52-001-001 ru es are set(
Storm Sewer Availa~90. You ma ~ through OAR 95 orth.
Special Instruction: calling the cY obtam Copies of th 2-001_
nu enter. (N e rules by
mber for the O' ote: the teleph
Notes: regon Un one
Center is 1-800~"l"l~'!r.. ~~lifjcation
I Valuation Descriotion I
Sidewalk Type:
DownspoutslDrains:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Page 1 of2
.
. CITY OF ~rKll~\jl'mLU
Building/Combination Permit
PERMIT NO: COM2004-01399
ISSUED: 11/12/2004
APPLIED: 11/12/2004
EXPIRES: 05/12/2005
VALUE:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Ff'f'S P~id I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$4.90
$3.43
$43.00
$6.00
11/12/04
11/12/04
1 1112/04
11/12/04
Receipt Number
1200400000000001606
1200400000000001606
1200400000000001606
1200400000000001606
Total Amount Paid
$57.33
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 Reouirf'd Tnsnef'tions I
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, 1 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 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 ofany 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
Pal!e 2 of2
225 Fifth Street
Spdngfieid, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-0 1399
COM2004-0 1399
COM2004-0l399
COM2004-0 1399
Payments:
Type of Payment
Check
11/12/2004
.
RECEIPT #:
'~~.~""..'.."!.:
~!
~~-~ -
.. of Springfield Official Receipt
~elopment Services Department
Public Works Department
1200400000000001606
Date: 11/1212004
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Paid By
MULTI LIGHT SIGN CO
Item Total:
Check Number AuthoriZation
Received By Batch Number Number How Received
djb 37780 In Person
Payment Total:
Page I of 1
11:39:44AM
Amount Due
3.43
4.90
43.00
6.00
$57.33
Amount Paid
$57.33
$57.33