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Home My WebLink AboutPermit Electrical 2006-7-17 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726,3689 ELECTR1C~ PERMIT APPLICATION City Job Numb~~" -- rf)~c;)i.f ;_ .,'.~ ~:" ".','_ _,_,,_,:",'.:'_ '. :'. ....,.,.~v.....:r.;...'.~..,._,.~y~~~,~,.,..<~~, 1, ; LOCATIONOF.'IJIlSTALLATION:.,i:':-',ll'S:\;' ~6i"'~'~~"";"""''''~''''\':'~'''''''''' LEGAL DESCRIPTION l'7o-;:)" .~':l 4).., 00 lOc:5 200 Amps or lesi $ 50,00 201 Amps,t0400'AnipshAlL EXPIHt H' I ~f69YOO% 401 Ampsto,600/Affip'siNDER T\4IS PtHMIS1'oo'd611 O 60'0'"A' ,,^,':~trrl'OnOOnVr, '1<; ARnB'\\l(blNtU FOR ver mps or ..'. o.ts see a ave. ~,gnatur, o~ su:peerrvist1EleCtriCian D, ~B~~'i{~htGW1nit~l~~~~_~,l:!S~~~ifi~~~1~~~ . K)NN)J \J WVJ l ~ ~?!::~;:~~~;;";-::~~~- , Each Additional Circuit or with. Owners Name h\ i ~~ f\;1_}~ C fu)1 k~~~::'~:'::~;::::~:~;~'~"P~"'~'Q:'7^~,~,'~l:~:~:~""'~.,,-~~{~; :~o :'~,:' ~;r"0Ao '::::~~"~'~~~~~'=~);:!":~}~",~~' "'" \vQ Sign/Outline Lighting $ 50,00 OWNER L'IST ALLA nON Limited Energy/Residential $ 25,00 The installation is being made on property 1 own which Limited Energy/Commercial $ 45,00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45,00 + Surcharges Owners Signature: . _t\\> 4 i':sur;fOTAL~F~O:vE~:~~","c~'~!~f~~.~i,~;~~";~<\i 00 ffl""l ' rk'~,,,'f,,,e;';ic-'-"1c~':"';5,>:';;h~:;h:~t~?'~'3;;! ~ 3,. ~'<. '8' 8% State Surcharge 5, 0,/ . ~Q;) fh~ ". 10% Administrative Fee (., '..5 (j \Y'lV~\Y TOTAL JJ 7Lf. 3 ~ (;)JOB DESCRIPTION 4Q.fr'\1 ~ r_~fl/Vlc-.Q, Permits are non":transferable Ifnd expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, "'~. ',..: \'~:"',I"r:',""!"r!. ':""'I:,o:~,,:..,..::~..,.,.,:;,~ ,~.'.;I.,,;,,'.~;:;.:m1../":':(lt'-J....'.,:::.~,;~ 2 ;; CONTRACTOR INSTALLATION. ONLY;: . ".;~' 'l~'::.J.,~,.;-,."I'i""~""~~V~\':.r:(r' ',?~ -.-iI ~;\~:,;.~<.,"~_;':i~iiuQ~r;....",'\."",:"q Electrical Contractor r) V (Y'1 II () v 0 5 Address p 0 bo -J - (p OJ 7 City ~ r-1I1{fV;I}f Phone ED - ;)7" + Supervisor License Number Lf 7 ,") J j , Expiration Date /0/0 7 Constr. Contr, Number ./ -=l (p L/ ~ ~ ID (07 Expiration Date Inspection Request: 726-3769 Date ZON (,(./ INITIALS t-.JTV\ DATE I-'I-?.m)~ SOURCE "i' f'lS,zw-l'} l-I(-2~ S,PA. ~IELD L--L.J!l ',. .~~' i.~" ':,. ",.", '.' " ^ . "~ ,,;,;,-,,,.<.-' ,""t:.."-"",,,_-:;~~...""'?!!;.-,;,:.!' : . ...",.~~,~".:, '~'. ""'-~I:".;<:;'J'':ll ," ~ ......--,.;...~ 3,~;CQ1I1P'LErE FE.ESC,1:IED,ULE" ,.BEL,OW?r;,c,,:;?~,,":,:.,,"~"',; h ,,:.:I,-J'~"l ,},,",..,.,...,~., "~Il~,..""",~.^.,.~..,:,;..~" .....,~".,'" ,', "...",~~'t.ri".,"l:/.,.".:..,~;.....;.t."t.,.. ' 1"'='':''', .:....~j.,....'i?1;-~:ll'l '?l''''*'(~ '" .':~~'r,:,.,_::::".,~.,:<.',.l:"r;.,.:,,?':.,!'!..~";" ~J',(.t';':!-;::'<~,.\;;Oi{,"- .' ",:: A. ;Q.~eiv R~~id~ri~iaff:~i~g~,e.:or. !'1ul,t.~~ ~ a_~l,iI}',::pef:JI'feli!n-g'.uh! '~""'.' _".' '.l.,_,~",,,,,"'>o _(\...~I: \,;"'...."..,,,,":.._. ,,~,,~.,..,. <""_~....~,,.....,,~~....'r-.".:,.;l.....:.;<.-.;,., ,~..:.l." Service Included . 1000 sq, ft, or less $106,00 Each additional 500 sq, ft, or , \1 to portion1Il)~r~?f',ON: OreGon law requires Y? $ ,19,00 t\ 1_.: ..,.1,~_ ~"~()r:'scl by the urt,;~~Ul1 JHIIlY EachlManufa,ct d Home or Th se rules are set lorth Modular:DwellinwSO'Mite or \0 \1 OAR 957$5nO~;00' 52 001-0010 t 1roua ' Fee~,~rOA~ 9, . " "... t '. .' oies of the rules by B. :':s'e~~t:~~~ft~~~~;I~rg~W{~l~~~1~J'R~g;'"~;:r*~fn;~1~ 'C"-'~:~~~;i~tth~6tt!gifn;tJti\try"f'fOllf\{ja\lCJl1I"""'"'':;';'''~~~ 200 Amps or le~Jnter is 1_800,332l344), $ 63,00 _ /,., S. 201 Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps $163,00 Over 1000 AmpsIVolts . $375,00 Reconnect Only $ 50,00 C It'T'~~''''''''''''~S',~:,?:;1''''ITf''~F'''~d' ;~~l,i'i,~ij~~~~1.':\;~"_' "'~:!l . ,: em orary.. ervlces.or, ee ers..:;.. 't.l,?j.~~lf;i':~...~:;;..'~" ,;;~ >..1, ' < &1",i""t;B.~~<..,;:..:~.-..;u;.~.';ilob!1M,,:-~'.t~;';';""i~g:.~~l,,~~,..~;~r;.:;r~. tt . ~~~ Installation, Alteration or Relocation Shared Drive(T:)lBuilding Fonns/Electrical Permit Application l-Q6.doc \ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . _~.....!1J!l".""''''', ..,., Wit. , : -"'... .. j ,. -,~ - CAof Springfield Official Receipt _Iopment Services Department Puhlic Works Department RECEIPT #: 2200600000000000987 Date: 07/17/2006 2:28:34PM Payments: Type of Payment Paid By CreditCard JOSHUA BURRELL Item Total: (;heck Number Authorization Received By Batch Number Number How Received NJM 04462B Phone Payment Total: Amount Due 63.00 5,04 630 $74.34 Job/Journal Number COM2006-00854 COM2006-00854 COM2006-00854 Description Perm ServIFdr 200 amps or less + 8% State Surcharge + 10% Administrative Fee Amount Paid $74.34 $74.34 cReceintl Page 1 of 1 7/1712006 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00854 ISSUED: 07/17/2006 APPLIED: 07/10/2006 EXPIRES: 01117/2007 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4708 MAIN ST ASSESSOR'S PARCEL NO.: 1702324200105 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Equipment Hook-np Owner: MCKENZIE DAIRY QUEEN Address: 4740 MAIN ST STE A SPRINGFIELD OR 97478 .~ :'C'on law requires you 10 " ,,:EG by the Oregon Utility ~c'nter. Tilose rules are set forth ..-'1.,-:r1 Lnn1 n thrl"\llnh f""'\A 0 Ol::0 ntH Contractor Type Electrical Contractor BURRELL BROS ENTERPRISES INC I CONTRACTOR INFORM~~IONOIV obtain copies of the rules by _ 3nter. (Note: the telephone nUf';'i'E:f for the OE'eo':m It~tilitYDNf'ttifiC2p""Iif) License , xptra IO'l> a e one 136446'II[er IS l-tJUosi2-01i00944j, 541-747-2724 BUlLDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Lot Size: Heigbt of Structure Sq Ft ist Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: ,", Sq Ft Otber: Sprinkled Building: (II)" ,'un/a, I ~" 'OccuJlant Load: \ 1'.(,0 7r,.... . 'f"\LL, t^fJl~C. 'f""r' ,_ I DEVELOPMENT INFORMJ\!fI0NriO O'A~tSH THIS PERf~it,;v~y~~ ", I 1('(10'''' PER ABA^REQUlREDRPJ\RKING . n, 100 --"~Utu , Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Tvpe of Constructioo $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 , .~ -r;;: ~..... Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 100/0 Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 10% Administrative Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid . Total Value of Project Fp.p.s PaW Amount Paid Date Paid eLll i' OF ~rKlJ'\jlJt<lJ<,LD Building/Combination Permit PERMIT NO: COM2006-00854 ISSUED: 07/17/2006 APPLIED: 07/10/2006 EXPIRES: 01117/2007 VALUE: Receipt Number 2200600000000000954 2200600000000000954 2200600000000000954 2200600000000000954 2200600000000000987 2200600000000000987 2200600000000000987 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. $5.80 $4.64 $43.00 $15.00 $6.30 $5.04 $63.00 7/1 0/06 7/10/06 7/10/06 7/10/06 7/17/06 7/17/06 7/17/06 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Electric Service: Approval required prior to utility company energizing service. $142.78 I Plan Reviews I By signature, 1 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 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 --:i11 be used on this project. 1 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 Paee 2 of2 Date