HomeMy WebLinkAboutPermit Electrical 2006-6-27
~
fold1/~mJG,
sP~~~
.
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
~~~~~~L~~~~~~;C~~~~ ~ 'f".yq__,....~~~~~.~y,~}~~. ~~.. .....___
1. LOCATION.OEINSTALLATION.:'. ;.:.. 3. ,ICOMPLETEFEESCHEDULEBELOW .' ..'..'.,...,:.>..'......;,.::
ijif3l( mAII(( S1-" '.'. ~"., ., .," , -'. <
- LEGAfDESCRIPTlON #31 ;111~' ..dr A. New Residential- Single or Multi. Family per dwelli.,j~ ';;~i~L"
J 702. ~Z.OO""" 60C{O'Z Service Included
'. ,
JOB DE~ON lJ /1 1000 sq. ft. or less $106.00
Each additional 500 sq, ft. or
A1>rTOJ\ fI:.21'.3 -c>L/t(k:> 3 -CX portion thereof
Permits are non-transferable and expire if work is, ~cpJM<gl!irp~!i~I!lioli}\:oi5FlS you ~o
not started within 180 days of issuance or if work IsTTENTIOModular'Dwcllinge~01f1 Utility $5000
S d d' 180 d I II w rulecF~"dC\I)lbU Y' t f .... .
uspen e .or ays. 0 0 . . ee er Those rules are se ~.
.. -' "y.' ,.,., - -.'r-~-'.'~ Notilicatlon cente~",_':;fi'()'~'9n2-001."- '-- '-'-"-7;r~',n
2 ~\CON1.RftCTOR-INSTAILATION'ONtYrlAR 9~!!'Q'~i@'lfWJB~a~ts - nsta atio'b,...lterati~ns ~r Relo~j,tlon:.'\'.
. . . ..',' '~T ~ ~.~ i' - - l~o~0.Youmay6btairiCOPleSOftl lep\:~e y. '"-''' ,0 .'. .
Electrical Contractor ecur ty , h:UJB Aws o(lllisSe: the e e. $ 63.00
"a~~~r\JP!~S~~400\A\WPY Notifical,u.. $ 75,00
nu C.#lM\IlP$~8l6ll~~344). $125.00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsNolts $375.00
Reconnect Only $ 50,00
Address
2815 SW 153rd Dr.
J
,
City Beaverton OR
~/UUO
Phone 503-469-7110
Fax: 503-469-7114
Supervisor License Number
LEA389
Expiration Date
10/1/08
Constr, Contr. Number
59944
Expiration Date
5/7 /08
Signature of Supervising Electrician
h... ~
Owners Name !l-^o:L...cvV' ~J .
Address (6r b At dc5-...r1.A-1 f-<r' ~I
City h &6-1\1("'-- Phone
O~RINSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
$ 19,00
c. r:T,~hr~bfrryts~~J~s~3~':Fecii~~ L'
-- .' ""--..........- --
Instal!ation, Alteration or Relocation
200 Ainps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100,00
O",,~~~ "~~~~~O~O-;V~!~_~<;7.':~~::~!,ov~,:.. ~\}r.'1'lG?-~___
D. ~HranChlGlr~ult~S~,.jJ... jK\:.~r.~\~~~,,^\l~?!~gl.,J
N;w'A1t;r:~h~~\.tro~lon 'i>~Dt'1l'I\\-\\S\("\{\~t.\) ~G\\
One Circuit \\-\\~un\\\lt.\) Ij f> \c; r>."r>.~'4j,00
Each Addition'!i.~ItCUit~\';\l.fi) G -,GtI.
Service or Feed~" \\ \)r>.'l ?I'~ $ 3,00 .
E. ~~~~i1'''~e),t'~~~i~l'ie~~;':iij;t.inclJ1;~d;~ifad;.;;;;;;JI1iii;;~~:
~"',""M"'k~~~.....::..:'I"'''.-_- ~_- - ,'d. ~ '.- :;.-;,;:.~_ _.~.....~ __~:-~"i~..i;
Pump or irrigation $ 50,00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial 1 $ 45.00 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. f'sf:}IiwrJitioF:A1JOVE. 45.00
:"'J.-. '~~"'f~'~Ji- ~~'4' ;'.+~' -....t;..t"~;...... ~ ~;,
8% State Surcharge
10% Administrative Fee
3.60
4.50
53.10
TOTAL
Shared Drive(f:)/Building FonnsIElectrical Pennit Application l-06.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00794
ISSUED: 06/27/2006
APPLIED: 06/27/2006
EXPIRES: 12/27/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4434 MAIN ST
ASSESSOR'S PARCEL NO.: 1702320000402
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Low voltage - security system
Owner: ANDREW HEAD
Address: 1616 ARDENDALE LN
EUGENE OR 97405
Phone Number: 541-
.,..
Contractor Type
Low Voltage Electrical
'':l'lllileS ~v-.\,~
I CONTRACT'oR,INFGRMAtI0N1 t\I;Olt"
.,(\'I.\\V'" Q \e(\\J~" ' I"safe~"'\ ,.
Contractor ::'~'O'i'J (IJ\e~a~ \~f, ,\"lOSe f't\~~952-qp~yiration Date
ADT SECURITY S~gy'Ig,"SINC;;~ nrrlO \\"IfQIJ5)JM\\\e lule~~ 05/07/2009
\i~'BUlLD-ING:1NFORMAiIAr-rf \el~~{~;i.iOl\
OO\JU'. ,- n6 cen'"'' . n U\\\\\'I \'\0
C2#1?~~%1't'ieO(eg~O_332-'2.344). Lot Size:
nuHe.ght, of\~r1Wi\f~ Sq Ft 1st Floor:
Type l.ffieat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building, n/a Occupant Load:
Phone
541-736-4973
# of Units:
Primary Oceupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: C01l.~~tG?"
% of Lot Coverage: C~: t.'/..I'I?r. W i I~ ~Oi
\,\01\ . :\ S\-\f:>,\'\' I'tW.[I1i
.' "f" DIOI1W11 . '"l\:c 1\-\IS . r" t:n?,
I PUBLIC IMPROVE~~NTS"llltU Uo''R IS f:>,BMIUVI ~-
. iil~C.t.O n
C.ONlM\: n OSid~M\Prype:
'i ,8u r"
M-4 Downspouts/Drains:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Tvpe of Construction
I Valuation Descrintion I
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
Pa~e I of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-00794
ISSUED: 06/27/2006
APPLIED: 06/27/2006
EXPIRES: 12/27/2006
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
F",,< P.'lid I
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
Date Paid
$4.50
$3.60
$45.00
6/27/06
6/27/06
6/27/06
Receipt Number
2200600000000000884
2200600000000000884
2200600000000000884
Total Amount Paid
$53.10
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.
Low Voltage: Prior to cover.
By signature, I state and agree, that 1 have carefully examined the completed applieation 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
th~t 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 complianee with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspeetions 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
Pa~e 2 of2
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.~-
caof Springfield Official Receipt
_Iopment Services Department
Public Works Department
Job/Journal Number
COM2006-00794
COM2006-00794
COM2006-00794
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
2200600000000000884
Date: 06/27/2006
Description
+ 8% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Paid By
TYCO FIRE AND SECURITY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
. 78673
In Person
Payment Total:
Page 1 of 1
9:18:00AM
Amount Due
3,60
4.50
45,00
$53.1 U
Amount Paid
$53.10
$53.IU
6/27/2006