HomeMy WebLinkAboutPermit Miscellaneous 2001-6-11
,
.......
.
~
225 North Fifth Street
Springfield, OR 97477
,
.~
Page 1 of2
TRANS#:01-0005764
DA TE : JUN 11 2001
AMT RECD:2 $ 65.00
CHANGE:
CASHIER: 061
I Job# 01-00593-01 I
CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00593-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3305 MAIN St Spr
Assessors Map#: 17023131
Lot: Block: Addition:
Tax Lot#: 05101
Subdivision:
Owner:
Russell Phillips
3305 Main Street
Phone Number: 541-870-2010
City/StatelZip: Springfield, OR 97478
New Value: $0
Address:
Scope Of Work: Commercial
Install cremator
Contractor Type
Electrical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Contractor
Stapleton Electric
2150 Buck St, Eugene, OR 97402
Registration #
41371
Expiration Date
2/28/2002
Phone
541-484-7278
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
NOTICE:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
-.--"':l.':"1
i HI0 1"l:HiVlll 0HALL l:Ar-IMI: Ir 'nl: "un"
To request an inspection call the 24 hour recording at 726-3769. ,f.lhin~p'4(stiory~J(~fl~~S\~.~~~ferlll,7,'iO,lt, NOT
a.m. will be made the same working day, inspections requested aft~r '1':00 'a'.'ii\. will lie made the followll}g
working day. COMM!:NCED OR IS ABANDONED FOR
R 'd I tr~~'v 1Qn Hav PlOl'llnn
eqUlre nspec ons
Electrical
Rough Electrical
Final Electrical
Rough Mechanical
Final Mechanical
-Prior to cover.
-When all electrical work is complete.
Mechanical
-Prior to cover. {,I :"r'T'f1(i:-:. ""\r~1onl::wre(Tuirssyouto
-When all mechanical work is complete~(j/ll'vl rllle1 u.o,.tild b; li1S Oregon U;ility
NbN,ItJollnn I :UnlHr. Ti10se rulilS are set forth
111 U^li ~;j~H101-001 0 through OAR 952-001-
bOllO. You m3Y obtain copies of the rules by
c:21/1I1!3 th8 (;~ntor. (Noto: the telephone
nUh1ber for 1:10 Orc;tnon Utility Notification
# Of Stories: t!~!I!~N!Il~t0-332-2344).
Current Units: Proposed Units:
Census Code: Does not apply
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
IArea (Sq. Feet)
I Main: Accessory:
Total:
--
.
,
Job# 01-00593-01
..
\.
Page 2 of2
Value/Quantity Fee Amount
Fee
Paid On Receipt#
I Electrical
06/11/2001 5764
06/11/2001 5764
06/11/2001 5764
1
$35.00
$2.45
$1.05
$38.50
Branch Circuits WIO Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Minimum Mechanical Permit
Administrative Fee - Mechanical
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Mechanical
06/11/2001 5764
06/11/2001 5764
06/11/2001 5764
06/11/2001 5764
1
$15.00
$.45
$10.00
$1.05
$26.50
$65.00
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 employess who are in acompliance with ORS 701.055 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 stret, that the permit card is Icoated at the front of the property, and the
7~set of ~s will rem~ on the :ite at all times during construction. /' _ f I~ D /
.~f;/, ~cfJ,. - b /,
Sigtlature Date
-_.' '~';'/ ~
,
. .
DEVELOPMENT SERVICES DEPA~C\ B leCl"I,e sP
1'n& '0\\0 - (\O~o:. ('\0\ /1('
.ionin9 enO ~ SPRINGFIELD, OR 97477
a.pPlov.\o9 0' (541) 726-3753
1.on'" 1-
225 FIFTH STREET if ~ I ---:;<iJ __--1h...........rCAL PERMIT APPLICATI'UN"541) 726-3689
SPRINGFIELD, OREGON 97477 c - ~ _
INSPECTION REQUEST: 726-fJ"769 .00519".\0'0 Ci ty Job Number ('")1 -00
OFFICE: 726-3759 ,",o\l'V" .
3. COMPLETE FEE SCHEDULE BELOV
1.
LOCATION OF INSTALLATION
3:S0S- mA-IN sl I/O
LEGAL DESCRIPTION
/7()2"]f"1 I
~ 5"f 0 (
JOB DESCRIPTION
7"/"0+ f---;""- (jy~1.ev--
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor '71Prft.-eTb,J ta-EarLlt/
Address 1,-1';-0
City ~/.H/:::-Vt:
f}v?{L '7'7
Phone 4- <J 4- -""1 'l- -:r Z
Supervisor License Number 'V17.-c; S
Expiration Date 10'" 31'-- 01
Cons t r Con tr. Number Iff 31/
Expiration Date v - v?J -07.--
Si~(}~trician
tJ .
Owners Name r;JV~i r f4.-.t d jI".e",,?'""'--.
f/-ytdv""'~CMd . ~YI/M.~""O>-.~ 13...~. S"'o-<A{~
Address '2-C? 7c) (!.JA.c> rM?'/h>'----- .
Ci ty ?:~/I.d. df1..7.:1y~e q f(l.{ ,c.rcr
vwn~ INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------------------------
DATE: Db (/0 I
RECEIPT 11:
RECEIVED BY:
57b~
~!.5
A.
New.Residential-Single or
Multi-Family per dwelling unit,
Service Included:
Sum
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts -----
Reconnect Only
$ 85.00
$ 15.00
$ 40.00
$ 50,00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
.Over 600 amps or 100u volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "Btt above
New, Alteration or Extension Per Panel
Miscellaneous {Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit (
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00 35"'~
$ 2.00
not included)
$ 40.00
$ 40.00
:D
$ 20.00~_:::!
$ 36.00 :D:D
;;0 '_
,..- rT1 m c.o
3d) g~:;
,. c: C)
(jJ t".,J :z ........
= ,
l--i(J~.......C)
--_. LC)
.-p<;:!l~ C)
__ _....... JUl
OG1- O-J
o-.rr1OOO"'-
........ -- o..........p....