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Home My WebLink AboutPermit Electrical 2005-10-31 ~w~ \0\\0 0 ,;..,\\00 :~('o~~~ ~s"l'?:!.i.,.l\?~~j \'0 ';.o..>S 1'. . ~ . (\0\ ~~ -.l:;'d:''''~' .1 ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54i~61<&.~~'w 1~>":' c ~,J " ELECTRICAL PERMIT APPLICATION ~"e'~~."~ ~' -"'-~' y, " . Kb {,\ ~'a:' ~f\~ CitYJO~NU~ber._.(o:,~c>~ '5,~. ,.~~ 8' r;-'" "_~',,'" .~5~,Q~.I,,~:t, ..,~. ,,\~~~,~c,~, _~,7n,;.",,;, 1.- LOCATION 9F INSTALLAl'ION. "j .:,: 3.' c;q!'!rPLE'{EFEE.$CHI+Q.rf(Effio~ow\",~'!'3-:"j,".~,c: 'r.! ......t...., .'. '.'. . ".'t ...-' ......_...... _. .~.;-'L..:...i.. ,.._.....'-'.._...... ....~~...,O(l'-'..~..1fi>v.-.-'.,..-_......,.~.~~.-a..J~J..-,.~ ~ ~ c::; 5<::. ,^-w(.<1 -nrt' C!&...w '."'~' ,_. .'_' ,c ,.'. ,.,-,~"'.~~::<: -.ry ~~.T'7._.".."'.>"."'<''7., LEGAL DESCRIPTION A. ~ Ne" Re.sid~ntial.-'- Sjngl~'~fN~I!i.FamilY. pe(~.. ~'.ellinfunit. ';;.,2 "",-.1t .." ,,,..!,~.. '" .".~ ,~.~.~-"""""..._._....e." .'"__1< .M~~"........,.._.L'-_.._~.~,;...~. """"",,,",,,,u.,l,_,,,,,,",, '3z.Cft./ ~c_ ST SpHJ 9)'/'78' ~, 1000 sq. ft. or less $106.00 fi, c n \ J Each additional 500 sq. ft. or A r ,"-fe. lr \).r~ ..,.. S~.,...'\ portion thereof $ 19.00 -.. "j Permits are non-transferable and expire if work is Each Manufact'd Home or ~ not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder $50.00 - - . ."'-~'- ". :'~;..;.n:' "'. -~ "I ''''''','' "": ....,':-., tt-:r~'" ...,...,~..~ .," ~:~':/::"'~'.~'~";:I~kl -:'"M......p"r\.:::h:r.;...&.'i'rA~Tii"eS -VDu~tO"",'~'~~'1f:'-::.,~:f'~n 2. : Cq;V.-iR.:1CJ:OR.~N$T4p:Al}6!<01Y~~' B. ~;S~c,es:'lr....e~er~.~,\~s'l:il!atioil, ji,lterationsor:S~lo~~II?'n;,;;\ _c'. ,.~,~ J.~...._'_ ,_.. ".~".~~..~"'~C oT()J[ov.,rrGli:iSad(jpted'by.the'8fego"'.U:I;ll~~ ,."'-''''-~~.- Electrical Co, ntractor ~,,,e. Sec......h.,s...d!,~ I 2QQrff,mpslo,jlJsr,enter. Those rules are f$Q63:o'oh ,-- "'" " h - il"~lJI11 2QhAmps fo5WOlitlnpj;')1 0 t rougn Ur\n $ is.oo . Address 'Z.:YlS- ~\Vel"Vle..,.J ..s-r- 40i)(.('mps'ioI600WiTIp~tain copie~ u, "~~ r$'li?6'oV 601 ji,--II'r.tn I~O"OO- CA."ntPr. (Note: lit" ",,~p$nl06n3eOO mps OJ mgs ,.,', "'-"'f . Phone~""'/-/ "'U-~7'-'" --b~"nr^tc"~ Oregon U'''''I ..-" Ivu"u" ''I J:><r7 v ~,r Ovdl1000~mpsfvolts 8003nnM^^', $375.00 ReconnectOrlly'lnterlS 1- - ~- --. '" $50.00 J08 DESCRIPTION ~'Ja-e~~ City EVI:\4J- Supervisor License Number 'Z l(lfS LS A 10101/0 f( Expiration Date Constr. Contr. Number I S- ~ 7 '31 Yh1!ob Expiration Date Signature of Supervising Electrician ~~ Owners Name Lc-s S~.......,+~ Address ;>" U OfC '--6, City ?r....f:",,~dc.. ~ OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: inspection Request: 726-3769 Service Included t~..~~~; '-';:~;t:" ~':-"~'":.~ :-~;;:.:'-:." ':'.-::r,r;;-...,n:r......:."_.. _.-'~ ,'J .,.,-_I.~-CC""\.-:;-:-':; C. .l~T~mpor~ry_:SerXice~.or;,.F~e.ders\.'~ "-2"'~~:;':!'},. }~~'_ "'..~{~....~'t~;,', -"':~ _.~ OJ -<:.__l...,.___,,-,""~ ._,~).,.:.:,.lo.r:;.....o',_~."."-" - ~'4 -'-. Installation, Alteration ~r Relocation 200 Amps or Jess 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "8" above. D. ::~~i~n!r9!c~~_i!_~~i:i~'._,.'i~~~'g~J\&i~;i;!~:':~~I{;jllli~;,.~~:if] New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 '.". ,.,"~,'-:'n;:..~.., --:Z:": '...~_. ~.. ~T"'":~.,~-~~;"',~L"::""..;-~G~"~.::\:.,..7., :.,F^.<:;--:.~ E. ;,l\..iscella~~;~!J,s)~ervi~~~fee~~r_ ~ot ~.iidude~r-Ea.ch}ns~al~a~io!t~ .,...'!t...._1 ~..._.......;;<.-...,'" ,....'..:.>.4 _.~ M..I:;~.._..";i.""~.~~Of\~,..r...,x"'..-.'--<..<::~..,CL...- ;...... ."'-~ NO~ irr!$a~' ~\.lt1-F\Rt If 1~J \~ ~~lo.oo 1H~\I"9iI.\l!M Sl ~ 1 HIS flt.~1'J~' \~ $ 50.00 ~\WI'\~~ s\~'1\\;A~\)ONE $ 25.00 _ CGi'JI\\W~ ~~ial I $ 45.00 '-I J Minip.\li)j, tllIQt~~ ermit Inspection Fee is $45.00 + Surcharges '_ l;,!t"~.\ ~:~,f'.-"'_. '" :1..-;.._'?....~~"'.,,"F"''''~;r...~_..;_''~l.....n 4. fSUBTOTAL OFABOvE,::,,';.'.",i':';':':-:'\:; to' '.1., :..~ ;~. ',::\, :~;,._.:;":.' " . t .J',., .,:';':;,,~;:':j:, ,0',,~;,;'J'5':~}-.;.. 1~, '''::; 7% State Surcharge 10% Administrative Fee Cf~- "yr l{ f'O ~ZbJ TOTAL Shared Drive(T:)/BuIJding Forms/Electrical Pennlt Application I-03.doc Status . . CITY OF SPRINGn~LD - Building/Combination Permit PERMIT NO: COM2005-00886 ISSUED: 07/12/2005 APPLIED: 07/12/2005 EXPIRES: 04/28/2006 VALUE: Issued - 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3294 MAIN ST ASSESSOR'S PARCEL NO.: 1702313104600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addllion Commercial PROJECT DESCRIPTION: New warehouse and employee room Contractor Type Electrical Owner: Address: Owner: Address: Owner: Address: LES SCHWAB TIRE CENTER #27 PO BOX 667 PRINEVILLE OR 97754 LES SCHWAB TIRE CENTERS OF OREGON ATTENTION: Oregon law requires you to PO BOX 667 follow rules adopted by the Oregon Utility PRINEVILLE OR 97754 Notification Center. Those rules are set forth CORE OFFICE SYSTEMS INC in OAR 952-001-0010 through OAR 952-001- % TAX DEPT-LARRY HENDERSON PO BO~u~J. You may obtain copies of. the rules by PRINEVILLE OR 97754 callinq the center. (Note: the telephone number tor the uregon UIllllY I\lULlIIl,.;dUUII I CONTRACTOR INF0RMkliION3IO-332-2344). Contractor License LES SCHWAB TIRE CENTERS OF OREGON 61280 I BUILDING INFORMATION I Expiration Date 1110912005 Phone 5414474136 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: , Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay D1st: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer A vailabie: Special Instruction: 1 PUBLIC IM~PVEMENTS 1 T~~ PERMI1 SHAll EXPl$laeWaTRtt~RK AUTHORIZEO UNDER 1HI%f.E!\WI.lfu~~rs: , COMMENCED OR IS ABANOONt'I)"f ANY 180 OAY PERIOD. Notes: Pal!e 1 of3 Status Issued - 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Fee Description - + 10% Administrative Fee Oo + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Perm ServlFdr 201 to 400 amps Temp Power 200 amps or tess + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Total Amount Paid . . CITY 01< ~rKll"ul'1~LD' Building/Combination Permif PERMIT NO: COM2005-00886 ISSUED: 07/12/2005 APPLIED: 07/12/2005 EXPIRES: 04/28/2006 VALUE: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ]?PPt P"tW Amount Paid Date Paid Receipt Number $27.80 $19.46 $90.00 $63.00 $75.00 $50.00 $4.50 $3.15 $45.00 7112/05 7/12/05 7/12/05 7/12/05 7/12/05 7/12/05 1 0/28/05 1 0/28/05 1 0/28/05 3200500000000000422 3200500000000000422 3200500000000000422 3200500000000000422 3200500000000000422 3200500000000000422 2200500000000001516 2200500000000001516 2200500000000001516 $377.91 I Plan Reviews , _ To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. Oo will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day.' I I?rrr"irp,l r~ Temporary Electric: Approval required prior to Utility Company energizing pole. Electric Service: Approval required prior to utility company energizing service. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Low Voltage: Prior to cover. Pal!e 2 of3 . . CITY OF SPRINljl'l~LU' Building/Combination Permit PERMIT NO: COM2005-00886 ISSUED: 07/12/2005 APPLIED: 07/12/2005 EXPIRES: 04/28/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 of the property, and the approved set of pians will remain on the site at all times during construction. -I Owner or Contractors Signature Date " Pal!e 3 00 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00886 COM2005-00886 COM2005-00886 Payments: Type of Payment Check . Ii " - '1. o - " 1 .1 10/28/2005 . RECEIPT #: G.PRJN~. .~_.....~- . ..--', i Wi;:' ' , . ..,....... i , " ,l , . , .-.-,..- . . City of Springfield Official Receipt .velopment Services Department Public Works Department 2200500000000001516 Date: 10/28/2005 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Paid By DANE SECURITY SYSTEMS INC Item Total: Check Number Authorization Received By B.tcb Number Number How Received djb 798 In Person Payment Total: 'Page I of I 1l:47:39AM Amount Due 3.15 4.50 45.00 $52.65 Amount Paid $52.65 $52.65