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Home My WebLink AboutPermit Electrical 2006-7-10 Date Cc., INITIALS k.J........ DATE (_10- ~s.. SOURCa-Aa {J~ \ .,,;L"J '1 -I 0 ~ 2<:JbCo ~ S~itlA '~~.~" ' ", ~"" " \011" ZON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTIDCAL PERMIT APPLICATION City Job Numb~?/j7')CO - ru[{SCf '. . .'." ,'-' . '{'." '..,.:_ :_. '.'. "',,;__"h,,':'-1o;;.,_':;~";'_::v;>~:':&" 1, : LOCATIONOF>jNSTALtATION::;':::~::S:i~,:': ':~', . .,~1' ~..:"';i. ~'.\.~';"':-"~_ ,:,'f~"'U..,' ,> ,-_,~,,',:"_~'.:; .::.::..:..;:....~!k:.iD.:..,:;.:,;:..:', Lrlo if ma ,tA0 ~ ~+ LEGAL DESCRIPTION \ '1 o~ ~2 d.'-I no 105 JOB DESCRIPTION ZA (1 ~ (ifY1 p"",1' ~tL - l "f> .i'?mits are non-transferable and expire if work is ~~iarted within 180 days of issuance or if work is Suspended for 180 days, .' ~ ";~~"'l.-_.'t>\~!"..!. '>-",,:,~>:.. -'~"""'~i~..f!~A~~.';:;.AA:=:;;'~'~;\.','.;h,";<';l'\' ; CONTRACTOR IJIlSTALLATION. ONLY? 2. ".: ":i 'l.'L:f:,Ki,:-A~S;~', :'i,.,~~..~yttt..'ti:,t\:.n..~,;t'i"':I";.~".~":J;:';:J~'iivo.'.':"''''<>:,';>';''q, Electrical Contractor () V (Y'f II 0 to 5 AddressP 0 bo'l (pq 7 ' City vJ rd1.frv; J}f Phone 1!iJ -- ;;. 7;' + 47)/ j Supervisor License Number Expiration Date / 0 /0 7 Constf. Contr, Number ./.,., (p t./ ~ ~ /D (07 Expiration Date -Od;:;"'~" - Owners Name~2..J G ~Q.~ c:qu ercn Address Or:-.,'@ r'{VI {!V\ S'T Su.;:"'tc.. {\- , , City ~riJ ~one '(<7-<0 ~ OOL/:i OWNER INST ALLA nON The installation is being made on property I own which is not mtended for sale, lease or rent. ~1 Inspection Request; 726-3769 ~ Owners Signature: s.~ ",. .,".".,' '. '. . '.- ,,,;:""<I':,,,~:"',:,"""''''~;(:''''''''':!';"'-.:::'':: ".""'."">""" .....l~-~/-."'<f',.~A'-.'. '~''''''-..~'''.~''''''' 3, ';;COMPLETE FEE SCHEDULEBELOW?}.~:y,'::;,;X\\;"it:,:,':~i" h'.;."..-!:..~.~t II" ....,;.;.}.,i>--:-.~~,'~~~;:..\ '~;".;it.-\.~",.'.;,~C;.;;'..:.: .'," ,....:,~:.~..::.i:.b!;1'B:tJ...;t:_~, !\~'1b-'~f~.~'l' ~':;: iI':':~' :,;.':~""-'\7:~'~'.~~~">"?~~:?'--:"'r"'-'~..:'.'\:-~;..~~?7-<i'~:~',:;~~_~",'!.'i.:r- ~O'. .., A. ii:!i~~~,~t:i..~$.~J!!l~~~~I~~~2:~~~~:~,~tP]!~~~~~!;.:?~.t~!H:,-...~, :..... Service Included ' . 1000 sq, ft, or less , ' $106,00 E chi-A"' '-'~1'505l--nftn ''1W re4u,,"~ ,,:,;; to' a" af'"mona sq", or U Tt pO[lj~\~-,!\1~\},Qf, adopted by the Oregon t1,' ~ J 9,00 ~t~ t:J:i-.~ti~n Cr;-nter. .Those rules cut:: ;:)t;lloftn Eacli Manufact'(! Home O[th ough OAR 952-001- M'''d''I'>1D''''''II(\nJS'Hl1.u r o u ar . we mg ervlce or ' S of the rules $'= 00 Feedef), You may obtain cople . )U, .\'<' QqlllQg.t~~~~~,,~,oJ.~~t~;r.te.I~~~~j~.e fi,:'';;-'" ",~k-,..,!"Fr.'""" B. ';!'S~IT.\5~~!'Jdf s,ef\.~,:;@J_~J!~li,onfKl~ratt?%:~9r'~eloi:~ti9n:W~ -, '"-''''''c~nte;iisr:8\JO:332:Z3lt4)';;''' ", "'''''''''-,,", "". ",~,,:!;,& 200 Amps or less S 63,00 201 Amps to 400 Amps S 75,00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps S163,00 Over 1000 AmpsfVolts S375,00 Reconnect Only S 50,00 C ~T,'.(~:e'~'l"'~'S""""'~"""F"'~--d,,,,,,-r~~;-"-l"~'. ."",,~, ..... "~ Ii' . . . em orarv-' en'lces-or, ee ers*;..-; ;,,~""&:z:~)"." 1 ~\~.. '.' ". . "'~,-' l,;.,.'::~.R."".~\~~~~;Ilo"hll"";"-:'''''~'t:.io'''''~' '~'l/;;.;;<d..ol't:.~:i"~;' t:!fl-- _ S iM'..:~;:;', ...:i: . I 11:'\ DT lAir. E: , R I' E WORK mta allon, terallon,or" e ocahonE IF TH I rH~ I"thlVIII ;:,n"LL. L.A' ". " .. 200 Amps OHless\ZED UNDER WI" PFRMST50:000T ~UI un ~~~ 201 Amps tol\OO\j~mps OR IS ABANnONHS 62,00 GUIVII.IC' vLCI , 401 Amps,to 600()Amps PERIOD SIOO,OO t\l'ill 10 Urd . Over 600 Amps or 1000 Volts see "B" above, '..' .; .;!;~t ..~~, ;-.:;,~JY~~J3I':~~'!:':"'~<;~',",-.t"..->t."f'-~'i~.';;"'....~~t:f~';~-~.:a-:,-('~i.~- D. ~Branch,ClrcUltsih ,,~\:1,""-FlW'~~J~l\.0t'!;:i;d;.<<';':;--!%;~'iI.r":~&_~ 1>.o'~~':'",~,,:....,~,.:;:~~,~..n~i"'.-\1.",,". .. '~';;~t:;,4'.~o'W"""io"l'lIo:t~..!.~' . ; New Alteration or Extension Per Pan, One Circuit Each Additional Circuit or with, Service or Feeder Pel1Uil $ 43,00 43" cf'O I~,OU .S $ 3,00 _. ',~:;r-. ,}~1r;:t;'~';::'~'\~':{If.~t.1~~r;'j\"!J'}:~'f;;!(""":.;::~J::1;.t'",?"..;::t';r::;;:.:""-.)1~~'~~ ~.'"".' I:>' 8. '~-:':::.~i"(,~;i E. ;ifMiscellaileOliS ,(Ser,vice/fe'eder: Ilorinchided) ::'Each.Illsiallatiori': ;:;,;;....... ,)r.',,:~~;:.:~-;;;;';';?..'<~~",~~;;~;;'-:''''':'' . ;.;:.:(..:,.~;.,.:..!;!.,\.:..".'d,_;..I\i....."1 \i -:;',','0:;"."_,'..,.#-1 '::'.: ";;!11;;";.;~;; Pump or irrigation. Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial S 50,00 $ 50,00 $ 25,00 $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4'h~~f,~[1&~g~]il~fi{~;gl~~}i{.;;; 5 <;{ . ~ Lf ,(pL{ c;, go ~3-0/1 8% State Surcharge 10% Administrative Fee TOTAL Sharoo Drive(T:)JBuilding fonns/Electncal Pennil Application I-06.doc . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00854 ISSUED: 07/10/2006 APPLIED: 07/10/2006 EXPIRES: 01110/2007 VALUE: ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Owner: Address: MCKENZIE DAIRY QUEEN 4740 MAIN ST STE A SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Electrical Work Only ires yOU to ._ ,.. _. ,...~C',..,nn \r'.\~.' roqu ..~ \ Jf\ity . ^~',':i', ',,_TYPE OF USE:~ (AddItion I h CommercIal "I ' ^ j U" ,....' - t lort Id'O';1 ru:C . Ja.,," 1 h~S3 rules are se 001- , , '1 center. O^R 952- ..1...,+.hr.ntIOI ..... ~t-"""llnh r'\ . , O{\R 952,Uu I-VV' ~ ~ , 5 oltne IUI"'~-' In obtain cop Ie hone 0090, 'Iou may 'Note: the telep , calling the center. \ an Utilitlj Notiticatlon ,_..t.-....theOreg __ ....n""\ IIV"'- - I"'"ntpr is 1 _l::.UV-vV'" - I CONTRACTOR INFORMATION I SITE ADDRESS: 4708 MAIN ST ASSESSOR'S PARCEL NO.: 1702324200105 PROJECT DESCRIPTION: Equipment Hook-up Contractor Type Electrical Contractor BURRELL BROS ENTERPRISES INC License 136446 Expiration Date 08/20/2009 Phone 541-747-2724 BUILDiNG INFORMA nON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft ist Floor: Type of Heat: , Sq Ft 2nd Floor: Water Type: ", ,~: Sq Ft.B~.~~~~,!!t+\.l~ INOKK Range Type: ,', PtR,,'i \ ;l11,~.q_Fj.Garage/C'~rol~ NOT Energy Path: n.:>,. 7.~D UNI~.'Itft, q!!!er::KWI \ Sprinkled Building: \UTHOAn/a OROccupantjbjad:D FOR .....nll^"'^t:Mr.l=n 1;) /"".;nl .........-- , DEVELOPMENT INFORMA~I0NJIJI\Y PERIUlI, REQUIRED PARKING Fronlyard Setback: Side I Sethack: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: ,- # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00854 ISSUED: 07/10/2006 APPLIED: 07/10/2006 EXPIRES: 01110/2007 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.p.~~ Fee Description + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $5.80 $4.64 $43.00 $15.00 7/10/06 7/10/06 7/10/06' 7/10/06 Receipt Number 2200600000000000954 2200600000000000954 2200600000000000954 2200600000000000954 Total Amount Paid $68.44 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully 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 ofthe 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 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 s'pri~gfield, Oregon 97477 541-726-3759 Phone . \;:-'-';~.. .... u... ~~ Caof Springfield Official Receipt _Iopment Services Department Public Works Department Job/Jour"al Number COM2006-00854 COM2006-00854 COM2006-00854 COM2006-00854 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200600000000000954 Date: 07/10/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By JOSHUA BURRELLlBURREL BROS Item Total: (;heck Number Authorization Received By Batch Number Number How Received njm 02058B In Person Payment Total: Page 1 of I 11:58:07AM Amount Due 43,00 15,00 4,64 5,80 $68.44 Amount Paid $68.44 $68.44 7/1 0/2006