HomeMy WebLinkAboutPermit Electrical 2003-11-19
ojec! as submittad has the !ollowing
s not require specific land usa
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (S'1ff)'fZ'C!3689 {lQ...
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LEGAL DESCRlPTION
170 Z. 32"3 I
Over 600 Amps or 1000 Volts see "B" above.
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1 IN '''';t-- rt'.~~'<E~ th" I."'" pC'lrp.prlOI1\ Utlhty
o . eWr/'U era Ion or. 'x enSlOn er ane
"ot"0'; --';"'- t:"enter. Those rules are set I(lSr143 00
, ne",lrcult O'----OU.
OE-li"l"d~'.J'''''''' I~G......1n ft"'rn":"'tJ\h 1""\1 I ..,........
, ae '1n: ultlana. ...tTeUl or'WI
009SeiviceIOf'F<<edtr,Pe\fuiiOpies 01 the rule!$ 13.00
"C~/il;~t~I"I','i," "M, ~,(,S i~l-~~!~'~(,~ l~~,~f'~~I"~~~,,"')""E~' ',I ,7"lt',l''''I"srt",o\~,,"j
NtJ' ~e-<~9~us;, .ehV c~~~,!er\~l~, mC~2~);;;;~C ,I. ~~~, ~.}-~
("",..tor j" 1- - -'234'4).
Pump or irrigation $ 50.00
~.. Sign/Outline Lighting $ 50.00
..'
OWNER INST ALLA nON Limited Energy/Residential $ 25.00
The installation is being made on property I own which Limited Energy/Commercial X $ 45,00 '-i )
is not intended for sale, 1~1't~!. Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
THIS PERMIT SHALL EXPIRE IF T!;tE-itY,9.!i!L",-"" ",74,' '''''''''''~'''''t''( ,
~~1H~r~~E~o UON~~SR ;:~~6~~~7t~S'ta'f@.iI't' ,s.'t!f:h'9.1f~R~.-1'f!;~';i;~.~J
.... O~-i;)O '0 e urc arge
ANl IOV ut\' n;n. 10% Administrative Fee
OLf 00 I
JOB DESCRIPTION
~ UILf-.1 At:...
A LA-t2J'1
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
''(;, ONTJUCTORJINsrALrnn-,ol\T,o"NiY'1:1
2. ."....., ., ." - -'''''i''''-, . ~- "rl1
Electrical Contractor
A 1-./
Address
'Ie h (J
/'\A ( .v s:r ~ A <00
City ...5i i!r .v6 HEdJ
Phone 5l{1-75~Z3
Supervisor License Number _ll 7L-L FA
Expiration Date I O~~
Constr, Contr. Number
_<)"("1'/
Expiration Date
(,/0<;
Signature of Supervising Electrician
~ff7L
C-/' ~
Owners Name GMs ~(Z.(.":, ')
Z(20 'L-Atrl L;J
City (?tA.G-f::fJ G::: Phone
Address
Owners Signature:
Inspection Request: 726-3769
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A "N'""'~ ~"'R'''"'d''''''''''"I;'''''-~S".k '1"'," ~'I'I "'F '''''I'~~' '''d I"
.. - _ _ ew.' eSI entia '.~: IDU e_Orlll' u tl- ami y..per _ we IIn
, :-.iI.Z':ii;iA~<;';~~'r............b~'li"'4s.,~~""-' --'. .o~il!"..~
Service Included
1000 sq. ft. or less
Each additional 500 sq, ft. or
portion ~~reof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106,00
$ 19,00
$50,00
B. C:s~ir~Sffi~~a]fsx:firirt~iliti:.1~:'xi'~-:?:iti~~'~ri~:;Re,'"I\G~1i6~:~~~'1
s.~ ".r' ",-:,,~., _;:,,_'..1;;".""'.~. '...~".....tl.\~~,_,'1'",:\o;to...t".~_...-_~~Jt.~4"
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to I 000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63,00
$ 75.00
$125.00
$163,00
$375,00
$ 50.00
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C. !iTe,mpo"or,,,acr<v,.s..~~vLc:r~,or(Feede'rs,.," '" 'It, w'~' ~~i,,:k ,
l4i:t;.\~~' " .-~~~. to -lol<.....;;;.~-. ,...~~,
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
TOTAL
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Shared Drive(T:)fBuilding FonnslElectrical Permit Application) .o3.doc
,
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01156
ISSUED: 11/18/2003
APPLIED: 11/18/2003
EXPIRES: 05/18/2004
VALUE:
SITE ADDRESS: 4343 MAIN ST STE E
ASSESSOR'S PARCEL NO,: 1702323104001
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Alarm system
Owner: CORLISS CRAIG E
Address: 2120 LAW LN EUGENE OR 97401
,
I CONTRACTOR INFORMATION.
Contractor Type
Electrical
Contractor
ADT SECURITY SERVICES INC
Phone
541-736-4973
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
,
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
License
59944
Expiration Date
05/07/2005
BUILDING INFORMATlONJ
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
VN Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Impervious Surface Area:
. ....o~ \lUu ,,-
\a.\N p;.....,- U\\\u.)'
I DEVELOPMENT INFORMATION)'. \1a oregon _^\ tori
p..11\7:1'l ,,- dop\eU p~ \ \lIaS are RF;QU~RED PARKING
, '. ruleS a ,\10se r Op..p. 95~-u
Overlay(Dist:1 . "centar, \\1roUg\1 lot~t:S \
# Street'l1reeSlRqOd: oo~-oo~o op'laS 01 \\1 H':ndicapped:
....... 0 "to. 'f\e \e'J\I"""
Paved Dr;lve,Rqil? ;"'a.~ ob\al .., \a' \\1e \a Compact:
'~,,-;() 'IoU I" \ar. ~\...o '. 'h' NO\\\\\"""-
% of Lot,Gov'erage:\1e cen gon \)\lI\., 44)
call1'''l . t\1e ore 332-23 .
^"mbar lOr ._, \c. ~ _BOO-
I PUBLIC IMPROVEMENTS'
Sidewalk Type:
NOTICE: lSlDl1i\li IF lHE WORK
~~~~~~Eb':~ lHIS PERMlllS NOl
COMMENCED OR IS ABANDONED FOR
ANl' 180 DAl' PERIOD.
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
,
Value
Date Calculated
Total Value of Project
Paee I of2
.
.
UJ l' OF SPRINGFIELD
Building/Combination Permit
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2003-01l56
ISSUED: 11/18/2003
APPLIED: 11/1812003
EXPIRES: 05/1812004
VALUE:
L.Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
Date Paid
Receipt Number
$4,50
$3,15
$45,00
11/18/03
11/18/03
11/18/03
1200200000000002491
1200200000000002491
1200200000000002491
Total Amount Paid
$52,65
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.
I Reollired Insnections I
\
1 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 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
Pace 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01156
COM2003-01156
COM2003-01156
Payments:
Type of Payment
Check
Paid By
ADT
II
~. aFlIELD '
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, - . ,_K^_.,'
Receipt #: 1200200000000002491
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department.,
Public Works Department
Date: 11/18/2003 2:04:30PM
Amount Paid
Item Total:
3.15
4.50
45.00
$52,65
How Received
In Person
Paymeut Total:
Amount Paid
$52.65
$52,65
.
.