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HomeMy WebLinkAboutPermit Electrical 2009-9-15 - . ", . Electrical Permit Application 225 Fifth Street+Springfield, OR 97477+PH(541)726-3753+FAX(54t)726-3689 I C(}~2.bo?- 0 13b Z Permit no.: I Date 7-/; -04 This permit is issued under OAR 918-309-0000. Permils are noutrausferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I Residential, per unit, service included: 11.000 sq. ft. or less (4) I Each additional 500 sq. ft. or portion thereof I Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) 1t\1S~ IL.t..,..(./IA W~ SlhN A')JO I Services or feeders: installation, alteration, relocation I I L.-t....J~ "'I-l:m,I V !;OA ~ 1 I 200 amps or less (2) $ 81.00 $ 1~~:~~'~Og~T;~26WN6~=~t~~t~C:~~~ i ~~::::~~::::~~~ ~1::::: ~ I Address: 1870 yr/1tIA/ c;.r 1 1601 to i,ooo amps (2) $205.00 $ I SJ) ~ I _,n 1 97"77 1 lOver 1,000 amps or volts (2) $469.00 $ City: I" r->> State: V- ZIP: ., I Phone: ~, 1 Fax: ' I Reconnect only (2) I $ 63.00 $ \ E-mail: I Temporary services or feeders: installation, alteration, relocation This installatiou is being made on residential or farm property I 200 amps or less (2) . I $ 63.00 . $ owned by me or a member of my immediate family. This lQ\.,.t?-100 amps (2)_ _ ,r -rll~ \~ Of-\lI'".OO $ property is not intended for sale, exchange, lease, or rent OAR ~\t 479.540(1) and 479.560(1).. I" I~O!:i.9.~Q,Q,i'I"~!\~:p\..l E^Y':'~:~;nI11 IsI ~M\;.OO $ Signature' ~ I A--' T\ "&vJr'6bb.',;;mp"hr~CtfoD'.vbJiM~eb t';;'ices pNf\:ders section above . . ,._"r\LIl r-I.~\J, _ .~l~-0i\\F-rf V1 r~~;::.~:~~~~~;:O;:~M:~I~~~~. ~1~t~~{~~;!~~~~~~:~::~:':~::::f":S~:i::e~r feeder, fee 1 Address: 9.>'1 "11 S- ~ i tn'.... l2t4. ' '''Each branch circuit I I $ 6.00 I $ I City:,\:1Lbte:N 6' .' I Statet/IL I ZIP: "I")</-O1..- I b. Feefor branch circuits without purchase of a service or feeder fee: 1 Phone:"'~ tf~- 6J;1.llo I Fax:~-I L/A~-~J'2, 1 I First branch circuit (2) I I $ 55.00 \ $ I E-mail: 1!.--n.i..JLI-I-e.v-Cbw<..--.LN)t.sa......n6. c..w I Each additional branch circuit .. $ 6.00 S I CCB license no.: \f" ';'-11.0 I BCD li;ense no.: ?1}."~~ll..{; I. Miscellaneous fees: service orfeeder not included I I Signing supervisor's license uo.: t:;'1'I Sllr I Each 1l\'l"pj9r,il'i~~t!911}!r.!'!f..@law r"quirpf$\il~~b.~.~ $ 1 1 Print name of signing supervisor: ~I'"el.... Rb~~n!) I Eachlo!gh:or <ilitliiie1ligRtihg'f;'). bY tn.E ,':t;I!;'X~~qp:~ h$ 1~-1 I ;0 r' S' ""a~ltl""8Tl(\r..l'~""II.t::I. lIIV-uv"'---'- I Signature of signing supervisor: .. 1.4 IL'J.....I 11 ~ _ , I al\~n~:.c.!!"}u.l! ~,ri:.,hml\t~(~~fe1ml~rBt1g 1 OP R$16~OOO l~$ _ /__I!I/''fIA",~ rp.)on,or.ex nston }, . __:,:",,,,",+~.,nrtdoc:::IM , . EaciP&'d1J~~~~'t.~i~~!P!lt},~~~;llllt\~~~~ ~h~. t ~le~~~JQ!l3 ~ $ I 'ii1Ii~Ii~~Ii',I?j$I~~NmltiSEtml!!I8!!g:JilJl\IUlilil (A) E~;;;;ubtojjteofialio\fe fuo';00'332'2344). I (Minimum Permit Fee $58.00)' $ l?k-", (B) Enter 12% surcharge (.12 x [A]) $ IS'1;. I (C) Technology Fee (5% of[A]) $ If. r I 1 TOTAL fees and sorcharges (A through C): $ 1'#1.411.. 1--,,"'""X'O""'it ,'. . '. .,' ''lP' .... '''a'''~-'-'''I _",lli-All."'!.! . .c~!.!..g.O.\lt::RNMt::Nifn'f~~~RO.vAl.!Ili!4t..",,1l?""S7 1 Zoning approval verified? li9 Yes 0 No 1 lilh.J0JI!II....'!i:;;;;;;4lo:"iCA:TE:GORY"10.<;i%CO.NSTR.UCTIO,N' 1iili~.'"'liililll'...'Jl ,'-<*L, M5?3i""",~0"" '". '.' .. ,. ,.' __,-". ..rdt<.. " __"'_'_'_' '__ L,_'.. --. .J;;;'1:;;fi~1ffiIi"j'40S.1iiiJ 1 0 Residential l 0 Government .1 QS-commercial 1 11i4llli!li'J,0I3'J!S.lmE:'!l.INI7(:!RMJ.\:r;IO~IA:NP!!JI!:(jCA::r;:Il:5~14IIIi!Ii'1!1 I Job site address: fen 0 MmN s-r. 1 I City: ~Pe."l b6l::1..7) 1 State: 0 fl- 1 ZIP: q7<.f'''''' 1 Reference: 170 ~ 3.6. if l I Taxlot.: DO 800 r "'....QJ ~ \JJ"'~~ ~_.lx ~$ 440,2584-J (9/08/COM) $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ _6:f!!!ll;!~'!lI"~,!ll! ~;".,;" t;~;'" '.~ 'k; " -I" l.V AJ \...n q ~ ~~(fr ~(V'- CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01362 . ISSUED: 09/15/2009 APPLIED: 09/15/2009 EXPIRES: 03/15/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Pboue 541-726-3676 Fax 541-726-3769 luspection Line SITE ADDRESS: 1870 MAIN ST ASSESSOR'S PARCEL NO.: 1703364200800 Spriugfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Sign electric Owuer: Address: SUPER POLLO GRILL LLC 1870 MAIN ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor E S & A SIGN CORP License 163470 Expiration Date 03/16/2011 Phone 541-485-5546 I BUILDING INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Lol Size: . Height of Struclure S~11SI Floor: Type of Heat: \\'C. '-NCSl I 2ud Floor: Water Type: ?\\\'C. \1'"\ :'i \S 1$ I Basemeut: "Itf~,:t{ge ~r.~'S\-\!'-\..\.. 'C.~\-\\S 'i''C.\\w,\ rGl'l'q FI Garage/Carport I' Ene(gyiPat~I~\Dt.\'I"\ DONt.D Sq Ft Other: "\\-\,Si?riuklealBuildiu,,-: !,-'O!,-N uta Occupaut Load: ...\n\-\\J\\'-~1"r\ u\"\ '?<..... . , . ~ ." - ,,,. .... ....".. ...... I DEVEI;OPMENTdNFORMATION I , !,-I'l' .. "', ' Overlay Dist: # Slreel Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING # of Uuits: Primary Occupaucy Group: Secoudary Occupaucy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Total: . Haudicapped: Compacl: , Street Improvements: Storm Sewer Available: Special lustructiou: . eS 'IOU to _ 10'" leC\\J11 __ "liliN I PUBLIC.1M!'.ROVE'Mi~i.s:,'o'l tn~u~~~:r~ set I~g~~ , Ii '/'i .....-- I "lOse n~B 952. 10 o. \"on cenle " 0 \nlo,S!dewaU"a1[ype:; '0'1 l'4o\l\ICa .00'1-001. 0 ',eS 0\ \\1 ",')ne \n Of>..R g52 ma'l obtaIn ~ f~OlY~.si"ciuiSYI~Irj!\s: 0090. . '/o~ne centel. ~ ~ \Jtili\'f l'401)\\IC callIng 1 lIne Olego 0,332-2344 . numbel c~nlel \S '\ -eO Notes: Description. Type of Const~uctiou I V aluat~on Descrintion I $ Per Sq Ff Square Footage or multiplier or Bid Amount Value Date Calculaled Paee 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01362 ISSUED: 09/15/2009 APPLIED: 09/15/2009 EXPIRES: 03/]5/2010 VALUE: 225 Fifth Street, Spriugfield, OR 541-726~3753 Phoue 541-726-3676 Fax 541-726-3769 luspectiou Liue Tolal Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Tecbnology Fee Sign - Outline Lightiug Each Amouul Paid Dale Paid Receipt Number $15.12 $6.30 $126.00 9/15/09 9/15/09 9/15/09 1200900000000001063 1200900000000001063 1200900000000001063 Total Amouut Paid $147.42 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Relluired Tn.snections I Sigu Electrical: After couuectiou is made but prior to euergiziug By siguature, 1 state and agree, that I bave carefully examiued the completed application aud do hereby cerlify that all informatiou bereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance wilb the Ordiuauces of the City of Springfield and the Laws of Ihe Stale of Oregon perlaiuing 10 the work described herein, and Ihat NO OCCUPANCY will be made of auy structure without permissiou of the Community Services Divisiou, Buildiug Safety. T further certify that ouly coutractors aud employees who are iu compliance with ORS 701.005 will be used ou Ihis project 1 further agree to ensure that all required iuspeclious are requesled "' the proper time, that each address is readable from the street, that the permit card is loco led at the froul of tbe property, and Ihe approved set of plans will remaiu on Ihe site at all times during construction. Owuer or Conlractors Signature Date Pa2e 2 on 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ,Job/Journal Number COM2009-01362 COM2009-0 1362 COM2009-01362 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description .Sign - Outline Lighting Each + 5% Technology Fee + 12% State Surcharge Paid By ES&A SIGN CORP City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000001063 Date: 09/15/2009 lIem Tolal: Check Number Authorization Received By Batch Number Number How Received djb 015695 In Person Paymeut Total: Page 1 of 1 1:42:45PM Amount Due 126.00 6.30 15.12 $147.42 Amount Paid $147.42 $147.42 , 9/15/2009