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HomeMy WebLinkAboutPermit Miscellaneous 2005-6-1 {:::;"~:7"O:~,.: dJir.OF' .dNGFIEth';ORE'GON.:~: ':.n .~:,'.; ~~'<t"l!' ..... -:'-;..' .' '1- ..~~" ..':::.~:~ I '.., "~:" ..,....,.}~:,. ':;:l:..,..~;'!:'"--4,,,. .:" ';'PRINOFIELD, ........ l. l~~:~ '''~,. "" '",""',,,. . .6:!.. "" rMti."",'i',,,-.:,. ~". , :'25 F1FrH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COVl'\z..OO\'-\:)<::> bsb Date (/1 ~r.o S L..,-.,...~~.r...<._' ~""__',~_'''~~_L'_'''' ",".M,""-' ........ ,- '--',',', '~ "J>"":';' 1. rL.O~Tm~'o.F.l!,S,JA!-.MT!QN.dk' ;l~f.:i 4&8V \;VlV\1 roJ ~ LEGAL DESCRIPTION 1 70 Z. ;, Z4 Z I n{)>/F'I. ~A1'IC'_'C_ 00.0:t JOB DESCRIPTION c. j <;: 141z..W, t/l'i" 1 :::'1 l\( ~{\ 3. r€Q&ey:t#'lfitf:jS.~H.~Rut?\i!l[.c,:Q,'l;W:",:,,"k.,'~ '-:-""'-~"M"":"-:--::'~,- -"'?;,~------:--,:,-",~",,:,~..,......,...~-:.--=,.._-,,, A. r~~f~~~~~.i4-;m~~! ~,,~i~~t~~~'t!iim)l~~!:&}$ Jl~ fi",,,,,,,,_._.. .. ,.<.:l. .. '...... - -~_. Service Included 1000 sq. fl or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Permits are non-transferable and expire if work is Each Maoufact'd Home or ~ not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 2 I;CONrkAcroR''rNsTXLBt. "rloN'O&iy) B. ris~t~fiiG,3F{,q'.l~~~)inst~?ti;;n, Altei-ati~iisoiR~lo~ititn;'til" . . .. ^ "'C^'" ." c~o '...,'..... .'0. '~. OlegOl\ ~':o,'ego~fo~ft'~"""" ,. ',",' '. .' ," .' .' '. Electrical Contractor (/) 1'- 'B,\e~O .~do~ted:lO'bs~Wl!lO~~9?Z-OO\' $ 63.00 Io~D'>>- \~"0'l4 tU11l"cel\tel. 1261 ~ latllro ~ '0'1 $ 75.00 Address fo l>M L:>II-:'-'~ifICa.tiO'~')O\.oO\14o~l~tO\~~~e $125.00 "1\ O,,~ "'~~~~~'<\t~~~~~\~I\ $163.00 City 'T1'1~ Phon$0310go~-;~~bl(tOt\OO'liX~.0Ils $375.00 ca.'"'' \01 the OR~{'JIP~:ohW~I' $ 50.00 Supervisor License Number 4- ~;, I.{ Sfll\1:l1l1 cel\tel ~ ~iljnpoi-afy.s.e'n1c~ ~~F~(ie!s':. Expiration Date I 0 ~ b \ -"l...Do'7 Constr. Contr. Number ,y. 9 S C, 'L . Expiration Date ~ ~ l S -0 (p "t::"ij2'~~~ Owners Name ~ v' fr1v .-/-r.A L Address Z7 f(~ Qv'(:;{L"'" A.. I ~ Ll City t1A G-cr./e- Phone $50.00 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volls see "B" above. D KB.~.7l:;""'-~h-' lC"'~"w.~ts' -'~'-"f-~~'iJt~~!:;-:...>".'~:"'" " . .f, .!~,~c." )!'.~!H_. \ ~'~'O _" iN"':-,,". '. N"'; ,_': " ~<:~'1 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. f{~~qap:~'!~r:(S~;:Yi~~i~:~~~)I.~t,lilf!!fded),~E~.~h!Ii~t,;I!ati~J Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION MQi\CE: Limited EnergylResideiltiailORIZ $ 25.00 I~ . c'.l~.1 \ I'~\"" It: "- ::..,. '" 1'401 The installation is being made on property I own.whichPtRMllhllmted Energy((;;,9,'!1merclal $ 45.00 . . ',"~ ."~n \ INDI'\'\ I l1\u ~,'~r\ ~(')P, IS not mtended for sale, lease or rent. fl,C\.l0~3~~m(j'm,Jj~.,,,!;).~ ~\~~:~~:i,t~.I:S:~c,t:::..F.,,~e. \is. 545.0 0 ~.1' Surcharges Owners Signature: 4: . SUBT(!)TAL'OP:ABOVEi"')"''':,,~,. ,- I ~'<'~ . fl,N'l '\'00 '" " ''''.''..'n.'~''"''c'''' "'"r.. """"'""'"4 ' .':. LV";> 7% State Surcharge Lf l( I b'70 10% Administrative Fee - "7 -. 71 TOTAL ~ Inspection Request: 726-3769 Shared Drive(T:)lBuilding FonnslElectrical Permit Application 1-o3.doc . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2005-00656 ISSUED: 06/01/2005 APPLIED: 06/01/2005 EXPIRES: 12/01/2005 VALUE: - Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4684 MAIN ST ASSESSOR'S PARCEL NO.: 1702324200103 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: 100amp service for Clearwire cell site TYPE OF USE: Addition Commercial Owner: HOWAN INC Address: 2783 RIVERW ALK LP EUGENE OR 97401 . 1 CONTRACTOR INFORMATION I Contractor Type Electrical Contractor License OK BROTHERS ELECTRICAL CONSTRUCT49562 I BUILDING INFORMATION I # of Units: \a."" (9O.Vi\t~~t~;" Primary Occupancy Grnup: \,\.OtagOll \'(Ia ~ii'rU~llnure Secondary OccupanctB"eliP~O . dO?\ed 'o'j a (U\WY~d'9J~\. Primary Constructio'!J~ tuleS ~ (\\et. 1'(105 ou't)IWilh'r'f~ '0'1 Secondary Constructi\ffi\l\~Rtl.::JlI ce \-O()\O \'(It ?i~dgl;"~lIe # of Bedrooms: ~ol\ ~I'o 95'2.-()() a'ola.ill CO \e~\l.erl!Y~i4aiO(\ i(\ 0 () 'IoU tl\a.'j (\\at. ~O . \~",~li''BUilding: n/a nn". .._n r.,e -;[''' v ~n^A\. ca.\I\~~:\ot \'(Ia J.~ijj.MENT INFORMATION I (\utl\ cell\et I. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Disl: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I NOTICE: XPIRE IF THE WOKl\ TH\S PERMIT SH~~~ ;\1IS PERMIT IS NOT AUTr\ORIZ~D UONR IS ABANDONED FOR COMMENCED ANY lBO DAY PERIOD Expiration Date 09/15/2006 Phone 503-780-5524 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal!e 1 of2 Value Date Calculated * . CITY OF SrlOl'\itJNl'.,LlJ Building/Combination Permit PERMIT NO: COM2005-00656 ISSUED: 06/01/2005 APPLIED: 06/01/2005 EXPIRES: 12/01/2005 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 FP~f p~ Fee Description + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Amount Paid Date Paid $6.30 $4.41 $63.00 6/1105 611/05 611/05 Receipt Number 1200500000000000715 1200500000000000715 1200500000000000715 Total Amount Paid $73.71 I Plan Reviews , 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. lJeouire~ In~n~~tinn~ I Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefnlly examined the completed application 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. 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 ofthe 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 Springfi~ld, Oregon 97477 541-726-3759 Phone .' . 1Jii~''''''''.'.'..'~..'.''.'.. L.."........'... i '~. . ,. "'-,0' . r ' ,.~' . .. ~ " ."......-..>, , Jl,tty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200500000000000715 Date: 06/0112005 3:35:02PM JI;b/Journal Number COM2005-00656 COM2005-00656 COM2005-00656 Description + 7% State Surcharge + 10% Administrative Fee Perm ServlFdr 200 amps or less Payments: Type of Payment Check Paid By Reeeived By OK BROTHERS ELECTRICAL djb Item Total: Check Number Authorization Batch Number Number How Received Amount Due 4.41 6.30 63.00 $73.71 Amount Paid 1511 In Person Payment Total: $73.71 $73.71 .J : '" 6/1/2005 Page I ofl