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Home My WebLink AboutPermit Miscellaneous 2005-8-16 ., I .'3PRING;FIELD ~~ b~'~o:>~t.'ID~ ~~' I"'", 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 /,\ ,.~ ' - , "~ iI ELECTRICAL PERMIT APPLICATION ~%~ .... City Job Number GO lYlWOS/ 0 III C7 Date S - \ ~ -<- () (J .).~ ~,,~,,0 ~ 0v ~'\..... . 3. 1!66MPuuflE?SCiikniJt.il;ififti:f' ..;'!ia.::,e-~!'?.A"~~':I~i'i ~~""-~'-i"""'::-'''''''''''''''' '.,._.........-'. ~'>.' .~~~~(f""'~:a:::..:?-.-...:J;:;J ~~.r;"."._. .."l", ~\o' ~o ,0 '/j -~.9"i.-f;.'~~.:"ie4'::': "Oi~..._ i:>~~'_'" .,"-V ".,_..~un.. . .'~ A. ~J~~~!~,~ii41~~ii1>JitM~l~:~..:J~~...h~.~~~?SJi~l~.~.,;ij Service Included . . / (> ""~- , <;.,'1'::\1-0 ,p' or'>' 1. Ld!OCAfi6N6F.iNSTAi1iATii:iN:~;:~"i\i;' t...,.. . '. ,_.'" _-,.~. ".-, .. '~{_' ._.,---,...-.'.-.....~." ~"'''''. _..."x_."~'t...,.J:l J<'"J4 ffi';l; "'.. . . LEGAL DESCroW JOB DESCRIPTION T~ ""' ~I:l (" (' ,\\{'-:!f{ ,'c S: (''''" \ . Permits are non-tran)ferable and expire iNvork is " not started within 180 days of issuance or if work is Suspended for 180 days. 2. P~~QRt~g~i{:~~ri!!J:t1!q~:Q*g~ ElectricaIContractor C~~ .-r~ C~'J '(\<2A(;.: Address \ 5 ~t, ~<'IJ 5i. S E. City S;:J ',?", 9'18o("Phone(SC3) 66C:;-&;()() Supervisor License Number \ 3 is ~ - S Expiration Date '0 - \ - o. 7 Constr. Contr. Number 9 I 6 6 3 7 - CO -\J 7 Expiration Date Signature of Supervising Electri'cian ~~W\4~ Owners Name C :t '1 ,,-t 5",'\ \-. C. \; ~ \ d Address ~ <"-5 5."" ST~~ V City Sf ( ; ...." -\-;' ~ \J Phon~S '\ \ ) 7 <.(;- 3~ 33 -J OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 1000 sq. fl or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufa,cf~f1q~F.~rXPIKE IF THE WORK Modular Dwellmg ServIce or Fed:lerA1'LcL! LJI~tJtH I HiS PE.:l~~IT Ie: ~lIl~50.00 "." ,',I'CI\ nn 1(' ,'U^~LCH:.l.bJ.f..[LI;n[) l~'~A:~~1'"%\;~'W'.':"'~:"":-t<'C!_i ':~ri':tr\..,Pff1~,:'~,'P(~-J"I',l- .r; V"'~' ,'>1hR...t'>~t:".. 'J B. .lSer.vices':'o. r..Feeiiersj~Installati6n; AlteratH:)ns"or,:Reloca. tion.:>~., " 'W'.f'1~"'II"q~"",;,:-~""",~"~'~"~(~.J..;,~"'~l:'j-' -;~:~ ..""L"d:tiIoa.';::;;;: ~;<i,,:,:~';J 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 tll:t'7~;;;,tto," 'lc';:,':'.;.;:""'Y7;;;!~""P;S$:.r~:.-,"W~f\I~';': i\?r,,*?{1.MV;'it"$t:$.r":1<~1t~-:i'~'ffttJ~t';t;\t:;,.\ti':'" C. ~r~.mp<<;Jr~ary S.t;.~YJc.e~'~_~~.Fee~~!st~~ .,\' :Y.,~~' ~1;ff';.'Jt;.i::,:; ,;.,;(.~~y:~;'::\~ Installation, Alteration or Relocation 200 Amps or less I $ 50.00 .sC).~ 201 i1f'f~l.'H\~W~)gon law r<>nlllres vl$1i1lX)O . 401 Amps t~ '60n AmP:Sted by th" Oreaon lSl!tib!oo TOlluW rUleB "U~I-' h ~~R9.9~t.!ItPS 0'i'10112;.'/"bltS'~€:r4wSa~e7et lort, D. h!l~~~~~t~~~~~~~-'~~TlflS~~i'.'tii)t"F;.1 New <1teration or'Extension Per. Pane!3lephone "ailIng {ne Ct::H IlCI. \1 ~......... ."- . . . One Cii;:ui,t'er for the Oregon Utilitv NotlflCSlJiiP-OO Each A'dllitioria1 Circuit or with.332-21l44). . <' ~ Service or Fee\Jc?i p~:n'iit I.VV.... \ $ 3.00 U r~.~ '''''';'''''''.''''.'''~'.''."'''~~. "',,,,,'(,"".,"',,,,,'x'';''.'" '~.~'T""'.'.'.~''''^''':'''~.'';J!'''."".,."" .~. ',,' ','" 0'.~'" ~ -'" '~'''''';''''''';':'.''''''.' ~ .,''iil.r., """,~.,''''",,,'' .,'~.""",: " "",...'C~p'.!>- '~"M" ":"'''':"-J'='''','~~''\..:' E. )J\!iS$.~l!a,!'~~lI~,(S~ry?f!;!f'l"J1<e~,,,ot. U1~Iu.d,~d) ;,,!,asli-1I1~tall<~ t~o,!' . Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~t..,,~JliiCffi. ,p.,:- j _.-lIi'f?..;f;,J.'*.,;;r....';~ .'~;:A:Q:,~."! ~'.;!i4. '.1:.I:~.':H.'''' '".".;,)"..:.'.~~"~\...1.-1r.. "".1. '0 0".. 4 'SUBTOTAL'OFABOVE;~'~i.; ;":li;';'~'A;" V - . ~,;~" ,...,.~ ~:'\,1';~ ,;,..;_..:,;'.;r ':':....~..;-*"1:;.;':;".f..;:'",~ :.~:.:;..\'j;'<i~;t'./'.,: ... .":;1.2-!- 7% State Surcharge U 10% Administrative Fee \5 .<3 I:) .f1G?Dl TOTAL Shared Drive(T:)IBuilding FonnslElectrical Pennit Applica~ion 1-o3.doc . . CITY OF SPK11~uNJ<.,LD .. Building/Combination Permit PERMIT NO: COM2005-01115. ISSUED: 08/17/2005 APPLIED: 08/17/2005 EXPIRES: 02117/2006 VALUE: Status Issued '.. 225 Fifth Street, Springfield, OR 541-726-3753 Phone .' 541-726-3676 Fax , 541-726-3769 Inspection Line SITE ADDRESS: 3214 MAIN ST ASSESSOR'S PARCEL NO.: 1702313104700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRIPTION: Temporary Traffic Signal at 32nd & Main. Owner - City of Springfield Commercial ". ......1 n~". Owner: Address: LES SCHWAB TIRE CTRS OF OR PO BOX 667 PRINEVILLE OR 97754 Tf,;S P-ERlilIT SHALL EXPIRE IF THE WORK ~: 11 tlOR,ZED UNDER THIS PERMIT IS NOT ['r\'.t'Nl:Fn OR IS ABANDONED FOR /1 Q' ill\Y PERIOD. I CONTRACTOR INFORMATION I " , Contractor Type Electrical Contractor MORROW MEADOWS CORP License 91668 Expiration Date 07/20/2007 Phone 503-399-7609 BUILDING INFORMATION I c # 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 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: I\TTt:f\ITIf"\f\l. nronnn l!;itA' rorll,ir,oc:!: \lnll tn Frontyard Setback: Side 1 Setback: Side 2 Setback: r, Rearyard Setback: Solar Setbacks: I DEVELOPMENT INF0RMAifIONolted by the Oregon Utility , I~O[lIlGallOn venier. Those rules <REQUtREb PARKING O I D. 't'rt OAR 952-001-0010 through OAB 952-001- ver a IS : .. t~?fa]. # Streei Tre~fR~d;rou may obtain caples of ttfaJM1~.i' ~~d: Paved Drive RqiHling the center. (Note: the tf(:6~~<iQR % of Lot Coveraife~er for the Oregon Utility Notllicalion Center is 1-800-332-2344). I PUBLIC IMPROVEMENTS I .. Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descrintion I \ Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated " Paee 1 of2 . . CITY VI< ~rK1NGFIELD I Building/Combination Permit PERMIT NO: COM2005-01115 ISSUED: 08/17/2005 APPLIED: 08/17/2005 EXPIRES: 02/17/2006 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....~ P3i!U Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Temp Power 200 amps or less Amount Paid Date Paid $5.30 $3.71 $3.00 $50.00 8/17/05 8117/05 . 8/17/05 8/17/05 Receipt Number 3200500000000000496 3200500000000000496 3200500000000000496 3200500000000000496 Total Amount Paid $62.01 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. I R"ollir..r11~..~tinn"" Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Final Electric: When all electriCal work is complete. 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. 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 Page 2 of2 " '! ii5 Fiftb Street Springlield, Oregon 97477 541~726-3759 Phone Job/Journal Number COM2005-01115 . COM2005-01115 COM2005-01115 COM2005-01115 " j i: '.:Payments: ,,~'Type of Payment . Check " :. ''. ...... ~'''' .".... [- ,. ..\ } . , '{ ;1 ,,' \,y ,'\. ....1 ~ F 8/t 712005 . RECEIPT #: .~ Wit 3200500000000000496 Description Temp Power 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By MORROW MEADOWS CORPORA nON Received By ddk Check Numher Batch Number Page I of I ,Jij,ity of Springfield Official Receipt .velopment Services Department Public Works Department Item Total: Authorization Number 18865 Date: 08/17/2005 1 :30:06PM Amount Due 50.00 3.00 3.71 5.30 $62.01 ' How Received Amount Paid In Person $62.01 Payment Total: $62.01