HomeMy WebLinkAboutPermit Electrical 2005-11-8
n1Tfittetl haS1ntl' ,...,.- -
1 Howing project as SU,~tiC \and use
as not root \ -0 f5 __ 1)S
. . ~F"nINOIII'IIIU - j'J M' i ~
225 FIFTH STREET". SPRINGFIELD, OR 97477 . PH:(S41)726-3753 .:FAX: (S4,I)726-3689~:,:,,~/1-~
ELECTRICAL PERMIT APPLICATION \ \ - 6,. .0 s- ..- . ,"4"- ",""M<::_:':i.j:.-'t.'.,y;~'~
Cityl~~b.~~:~e:_~,~_~~:,~ l":.:"I,.;,,Da,le lo/2r.fA": '. .. .~<".' '" .
1. LOCATrO,,"-pF INSTAJ,JATrON .,: ':;",':';': 3. \c:QMPLETE::FEE SCHEDULE BELOW.
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5703 MAIO.sr;
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LEGAL DESCRIPTION lL O'"Z.. 3.? A- \, /:) '34;,CO A. hj'l~l" R~hi~;J1tinl ~ ~ing1~,or~I~II.I-l'allilly j,~; d~YolHng unll.
WASI{I~t;TtsP tv(VTUAL&Nk:
JOB DESCRIPTION
., .
Pump or irrigaliQn $ 50.00
Sign/Oulline Lilihting $ 50.00
Limiled EncrgylResidenlial $ 25.00
Limited Energy/Commercial l >< $ 45,00 4:-S [)C>
Minimum Electric pclrmlt Insprctlon Fee is $45.00 + SUI.charges
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4;'~~;~r~~i ·
~ S' TOTAL!. .
Shared Drive(T;)lOuiJding FonnslEIa:trical Pconil Applicalion !-OJ.doe
r 4.M~Q..A
<" ~.s:reM
lJ DGAAf)~
.
Pcrrnlls nre non-transferable .nd expire if work Is
lIot st.rled wllhin 180 d.ys of issu.nce or If work Is
Suspended for 180 d.ys. ~
:,'CONT..'r'CfOR'1Ns:r;'i'f'lnbr/o'N.' .1~'lJ<<' ~'\
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...; Electrical Contractor .AN <: F (.A~J.! /':p.~ \\j~
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. " /1. /\ X-~ ~ ~.
Address ID. U ~\~~ ; 1fY)
r<C> ...<:-. S ~\j~ S ~<
Cily SPt2I1J{, FI€i'D~Phcif)~) tiir{..~Y3 t- "1'173
. ~"2> '< . ~'\.'V <:<...~ ~~
'\~ :,.:~C::S c~\,j ~
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SupervIsor LIcense Number,",' ,'(:.~ 7/ LEA .
. l:~ .-
Expiration Date 11\ I ()B
1
Conslr. Conlr. Number _ r;:;9 9 ilif
Expiration Dale _ ~o5l' _ ~ ~ 9
Signature of Supervising El.eclrici~n /. A ~
/i $)~Jlj~q .
r .. V
Owners Name .;t1-tt' E"tVZ '.<r c....120=/~v/".
Address ')A//'P <;'T' .sUI r?--. I'f
City ;c"c/t'EtOf
Phone
G4
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OWNER INSTALLATION
111C ins lallation is being made on property J own which
is nol intended for sale, lease or rent.
'Owners Signnture:
IlIspeclion Request: 726-3769
COO~
I"" .
Service lueluded
L S106.00
~ $ 19,00
P '"
I 000 sq. n. or less
Eaell additiona,ISOO sq. n. or.
portion thereof ..'
Each Manufact'd Home or
Modular Dweliing Service or
Feeder
S50.oo
B. (~~~~'i'~~~'~~' te'~'~1~~71 i~~:t~'"I"I~ii~~~: '~It~;a't}~'ri~~'~~~R~"~ca:~'I'~'~~';
.V;' .......... .-f,.~ c ...:-.'...\:.....':........ . ~ .....:..,~ '.'.
200 Amps or le!ss
20 I Amps 10400 Amps
40 I Amps 10 600 Amps
60 I Amps to 1000 Amps
Over 1000 AOlJOslVoll<
Reconnect Onl:(
S 63.00
$ 75.00
S 125.00
$163.00
S375.00
$ 50.00
\.U
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C. '; 'Tenlporary ServIces' or 'Feeders'''.\\\;' {,\Y\ . ,~~.. , ...: .~
1.1 . L . . .. . ,.' , .\f.I~' ~.'" \0" ~
'Oo..~' Q,o ",'o\. R:JC>"
Installalioll, AJter.Uorl'orCR~oeftion)'l: r_'O'\
,,'. 'S'v '0"" - 5?'Y 0.'0"
200 Amps or le.sP .>.'0'\ 'o'~ o~ ",\l' ~,,<s 50.00
("."1''<> D'" ,,'<:' ~....' <\\' ~"
201 Amps:to 4C!9:"llIps ,o\)'" ~ 0 _\'0'< _i$.69.00
-<\..,.) rf"\ ;\ ~"e,"-' ,,- :\\-
4010mps to'600l">mps, r::P~' ,:-,'0 _\o~ $100.00
.!o,'\ . (\)\'" Cp', .':')'0' ,,{\ ,l\e' ..,,-\' ,to.,.
Ov~[~600. ~inp!;or I O<lO.yol.!-'<se~)~B..,above.
D. ~J,~~F?,~i~~~iii'~8:~+~~A(:~< '.';:'" ''':~,'':''
Ne..;AlleraUoJlI'or EXlenslo..-Per Panel
One 'ciri~ir~'\~~.-.' \0' ro.\.e\ '""
v' ',)'-' e" .
Each AddiliOlla~ Cih:uil 01" with
Service Qr F~+edt:r Permit
$ 43.00
$ 3.00
I"~/~'"'' ':"'i,':,"~'l_: ~:"" ":'".'~."''-' ','" ..
E. ';:Mlscell~neotis '(Service/feeder .1I0t IlIcluded) ':'Ench Installa 11011
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d;t:; ,19C)
'?>,\S
4:- ' SO
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UOSPlAna ,un~
996t9CLlt9 XVd ~9:Cl a3~ 90/9~/Ol
Status
Issued
.
. CITY OF ~rKll'1ljt<l~LU
Building/Combination Permit
PERMIT NO: COM2005-0I57I
ISSUED: 11/04/2005
APPLIED: 11/04/2005
EXPIRES: 05/04/2006
VALUE:
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: Camera system upgrade.
. Owner: MCKENZIE CROSSING PARTNERSHIP LTD
Address: 2811 E ST STE B
EUREKA CA 95501
I CONTRACTOR lm!'~ TI~N I
r 'I
:\\'i:. \~ ~~\\ \;) .
Contractor 'i:.i-'?\. ,?'i:.~\'" y.\)~ License
ADT SIj:S:lJRIn:$.~Y}~~~'i:.\) 59944
. ~~"\ \~~"'~~~-~\~illib~'fNG INFORMATION I
"\v..\"o CI",\t \) \)" ~C)\).
. # of Units: ~\J\V\ ~~,,~ ~ '?\.~# of Stories: . Lot Size:
Primary Occupancy Group: "C)~~ 'C\} \)'r' Height of Structure Sq Ft Ist Floor:
Secondary Occupancy Group: ~~'\ \ Type of Heat: Sq Ft 2nd Floor:
Primary Construction Type Water Type: \OSq Ft Basement:
Secondary Construction Type: Range Type: s '10\') .~~~q.!,t Garage/Carport
# of Bedrooms: Energy Path: ^-:,\~e 0'0'1. 'sH,Ft Other:
.... ev. :-'.0 ~\.... _.l"",
Sprinkled Building: ~'>ll ~ On/a e se Occupant Load:
...... ': ,~() _?\.'f.. ~,,?:v """
I DEVELOPMENTINFORMATION~.V>':~ ~~e~0e
~,\\V ~OV, ~ \" ':0~Ov.~ sO\" \e~'00 ~\00REQUlRED PARKING
-'\0;.. .\,' 0\e. \'0" ~\e e \e .~\c;o:
9v~,!;taY"D!~,t:le,,"'0'0 \0 c,o ~e\'(\ ~o'l. Total:
#,Str!;et}Tr.!'~"Rqd'.l'O\~ ~o "0\~\\\~Il.Il." Handicapped:
P,aved, ~.riv~,~qd~re0\e\eQl00 .~~'2: Compact:
% or-Lot Coverage: e a ~'0'0
\-, .,J' '.... '\(\. \.~
~ - '.' \ - \c\ (, ,'0
G'-' .,c\ _ ~('\\e
Contractor Type
Electrical
Frontyard Setback:
Side 1 Sethack:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
. Street Improvements:
Storm Sewer Available:
Speclallnstruction:
Notes:
Description
Expiration Date
05/07/2009
Phone
541-736-4973
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDrains:
I Valuation Descriotion I
Tvpe of Construction
$ Per Sq Ft
or multiplier
Date Calculated
Square Footage
or Bid Amount
Value
PalZelof2
i
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01571
ISSUED: 11/04/2005
APPLIED: 11/04/2005
EXPIRES: 05/04/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
. 541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Ff'f'~ P3id I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
$4.50
$3.15
$45.00
Date Paid
11/4/05
11/4/05
11/4/05
Receipt Number
2200500000000001542
2200500000000001542
2200500000000001542
-.J
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 Rf'rwirf'd In~n~
Low Voltage: Prior to cover.
By signature, I state and agree, that I have carefully examined the completed applicatiou and do hereby certify that all
information hereon Is true and correct, and I 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 of any structure without permission of the Community Services Division, Building Safety.
1 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 constrii!J L II j ~ s
o.~& ,,;....~ 0..
Paee 2 of2
. 225 Fifth Street
. Springfield, Oregon 97477
: 541-726-3759 Phone
Job/Journal Number
COM2005-01571
COM2005-0 1571
COM2005-0 1571
Payments:
Type of Payment
Check .
'J
:,
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r
"
.
"
.,
,
. . ~.
'1
~
11/4/2005
.
RECEIPT #:
a~~!N. ,!",1I1O_,.,.o' __.~._ .'.'.
Ilk I
-". ....A6:. i
__.___. ' ..,; .t
~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
2200500000000001542
Date: 11/04/2005
Description
Low Voltage -' Commercial Indus
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
TYCO
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
jmp 60590 In Person
Payment Total:
Page 1 of I
2:55:37PM
Amount Due
45.00
3.15
4.50
$52.65
Amount Paid
$52.65
$52.65