HomeMy WebLinkAboutPermit Electrical 2004-12-15
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LEGAL DESCRIPTION 17 0 z. ). '1' 'Li I .
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JOB DESCRIPTION
P.UV-J.A (L/ C..A M ~U: / Or".DfL (,"~L
I. ;
. Permits are non-transferable and expire II work is
not started within 180 days of lssuanee or if work is
Suspended for 180 days,
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2. ~r, ~.f :~'JIr':'!JIl'l.;;i..v:-~~llfJ:1!'.i'I~~'i.,j.""..i.fi~I.'ll'~:~"~~'~#' 7"";:\:'f.;~:"
Electrical Contnlctor AnT
Address
tj(.,{,o
<:Ft" L'P-fry
ct. ~A 1M
MAI,JJ
CitySPt2WI.FIE"LD Phone 51(.(. 7~ t.. '1973
Supervisor License Number '=? ') 7/ LLA .
.' - -
Expiration Date
Itr Id 5
J
Conslf. Contr. Number ~9 q tf tf
Expiration Date. _ "'/ a .c;-
Owners Name STrV\ ~)~ u-rv-hc-s
Address 7= (? 0 ,c . 5'3 ')
City ?~ 0 2::,!,1J> Phone
LA
OWNER INSTALLATION
The installation is being made on property i own which
is not intended for sale, le_ase or rent
Owners Signature:
In.peclion Request: 726-3769
~~.
~OO III
j
UOSPIA"<I g.l":'>
~OILOIZT
1000 sq. ft. or less
Each additional 500 sq. fl. or
portion thereof
"
Each Manufact'd Home or
Modular Dwelling Service or $50.00
Feeder
B, rfi~*~~~l!~~1drfrt1Mj11iilJr.Al;~~~jl;B7~~'R~I~c;ti~~;:'"
,,, "No{flid;tT~~=le:hbftfJe breg~;'u~;1Z ,-,.
200 ~R'"9~-OOl . ose rules "'" Mr~<rt'
20 I ~.1l(6Bqrl':l~JPtOl ~ through OAR ~3?8ael"
401 ArOpi;',\q.J;QIl.Arims btaln caples of the ItI!~OO,
. l:T e 'Ct:llter. (Note' th ,uy
601 ~billOI1\l /ltRJIe '. e te'ep~I:6>;Po
Over 1000 Ar!iPsIlt'9!ljS ;~O~a';':"LY NOlifiiS3U&.<I0 -
Reconnect Only ""''''+4), $ 50.00 _
C. r!~-;;;~~~;<ITe!~I;'.~m~ii~'d,~~~,:)'~?:,:,\;;J~':':"I;;:'::\;il'r' .i
Installation, AJteration or Reloc.stion
200 Amps or les.
201 Amps to 400 Amps
401 Amps to 600 Amps.
Over 600 Amps or 1000 Volls see "B" above.
D. t~~~i~:~.~~~_~~~~H~;:~~' ~:;f~;~~:'1~f;i::<b..::."~:\:~':'.;" ". .-~?;.~.:
S 50.00
$ 69.00
Sloo.OO
t~~:.~:";!"
.:......
'..~.;' "
....;;;"...
New Alteration or Extension Per Panel
One Cin::uit S 43.00
Eaeh Additional Cin::uit or with
Service or Feeder Pennit . O~R'OO ,
tJ~:nc,E,,~"'iW\1:\\T~~f'.\HE It1I;\t.~ ~\0J ..... . .....' ."
E.~,~Miscellilj;.eou~(Sen'lceJreeder;.notlilld\Jded) :"Each Install.tion .
\~~;1~6R\IEli ll\~\JE\-I.\rllvOON~\)rO'" . . . .
Pump^or, inigation')R IS P-\3P-N S 50.00
r()" WILI"'~~ IOD
Sigri/gutline~ighting'l, . S 50.00
"~\l IOU '
Limited EnergylResidential S 25.00
Limited Energy/Commercial X $ 45.00
Minimum Electr'lc Permit Inspection Fee is $45.00 + Surcharges
4. ~:~~ffJfT4og1!J'{/f.!f!~A\:'.>,:';\' '.
.,
7% State Surcharge
100/0 Administrative Fee
)'_,.2... .<."
TOTAL
Sh~ Drive(T:)lBuilding FormslElcctricol Pcnnit Applicalion ) .OJ.doc
g96t9<~g XVd Tt:OT HaL
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01530
ISSUED: 12/14/2004
APPLIED: 12/14/2004
EXPIRES: 06/14/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5720 MAIN ST
ASSESSOR'S PARCEL NO.: 1702334101901
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: low voltage
Owner:
Address:
Contractor Type
Electrical
STM PROPERTIES LLC \0
PO BOX 1539 PASO ROBLES CA 93447-1539 S 'Iou .~,~
^,i,\e" \J~ ui\Y:\
\il~ '-,f)te~- _ c.f}' '-;,,,\-
1,(i(l)NT~eT,OR\}l'lIt(i)RMA:mON I
U "J' ,
O~. O<v\e OSe . - X\ Ur' e \\}'-, e
ContrllC\tgf.\;,e<; ~~ <"e\' '\"<' \y:\\OuC!, So' \"<' \e<vY:\'9,sense
ADT ~Q!RI"_Y, ~~\(\riKI~(jJ,e. ,'(\e \~ ,,\,\,(59944
;0\~'C~9<:>'2:\ ~l'IiLii;N(;-'.iNF(;RM:A'FION I
\~ O~ -{Ou' e ce'" le~~(),~:''''
",,,,q,(). ~,~<6 ~ 0\ ",*o~SIOries:
ci>! ~e\' e~!f'eight of Structure
~u~ G Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
05/07/2005
Phone
541-736-4973
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
.....~'1' Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
, Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
"I'l\l?~Compact:
,\\'t. v.\l\
d?\?~~?I;>!\\\ ~~?
I PUBLIC IMPR0VEl\tEN:fii.L? \\\'~v.~\lv.'t.\J ' -
,~- YV' (\ \J'"" \>-,,1'
,,\\\'0 o.\L't:.v '\? \'0 Sidewalk Type:
, :\\\\lP ~\) \J \\l\)'
\>-'0 ."I;>!\'\:.v.c, \>-'1 ?'\:.\'\ DownspoutslDrains:
c,\l'" \'O\) \)
\>-v.'l
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion ,
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paeelof2
.
. CITY OF ~rKll"u"'J<..LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-01530
ISSUED: 12/14/2004
APPLIED: 12/14/2004
EXPIRES: 06/14/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I FI'I'~ Pllilll
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
Date Paid
Receipt Number
$4,50
$3.1 5
$45,00
12/14/04
12114/04
12/14/04
1200400000000001742
1200400000000001742
1200400000000001742
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,
~ Rl'ouirl'd Insoectiow
Low Voltage: Prior to cover,
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
Information bereon is true and correct, and I furtber certify tbat any and all work performed sball be done in accordance witb
tbe Ordinances of tbe City of Springfield and tbe Laws of tbe State of Oregon pertaining to tbe work described berein, and
that NO OCCUPANCY will be made of any structure witbout permission oftbe 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
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726.3759 Phone
Job/Journal Number
COM2004-01530
COM2004.0 1530
COM2004-0 1530
Payments:
Type of Paymenl
Check
12/14/2004
.
RECEIPT #:
8Pj:~F'~~~' ".,
~'
..
._._'.. _.,.. i
.y of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200400000000001742
Date: 12/14/2004
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Paid By
TYCO
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 31555 In Person
Payment Total:
Page I of 1
1:47:36PM
Amount Due
3.15
4.50
45.00
$52,65
Amount Paid
$52.65
$52.65