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Home My WebLink AboutPermit Electrical 2004-12-30 ~)~( · · · I .. · ~'- S'j.:a....:.LD tlIII 01< 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689/> 0$> c~ ... ELECTRICAL PERMIT APPLICATION'. ~'- 0$>( '?,~ IlJlDI ;2 0 'f" ~ ~ 0~'3-~' City J.Ob Num. ber eo""ZOOq -00,.2.. 9) Date iZ, 2-7: (:)1., ~O"',\ 0",. <1'''.'''0$>'' ... .' . ~"? -a, 0.... U'lfI/ I. 'I!~~:71!!:iw@Fj~s'Fj\'Tjr/~~@~_ 3. 1€@1l-w~.l'~'~~~;~";~~i~.;!::.\." ,ill 90,~") . 2/0Lj W/!+fN ST . "',,<-,~ . .l"'~!"J 'I ,. ." " . 1 ,.>,;. ~ ~ A. ~ ~~ident!aII;;;;.Sing!!)?~JM':'!i-~~ml _' Service Included LEGAL DESCRIPTION 1703 3642 02. 700 JOB DESCRIPTION i2-t::;f~c;) tC- ,"4,..,+!.. ^ V\.': t- Permits are non-transferable an/eXPire If work Is not started wltbln 180 days of Issuance or ifwork Is Suspended for 180 days. 2. t~:""i~'~"''' ';'-,:,.~~si~,:'m~'~p:Y:I~^:L^Y~ Elecbical Contractor BURRELL BROS. tLtL I NIl.. P,O. Box 697 YJQI~urvlii",. u~ 541-747-2724 Phone Address City Supervisor License Number -1l:L~ I " Expiration Date ; 0 It:/; J Constr. Contr, Number 70 -4YLfI Expiration Date I I () G, J:D~" ~.~ t OwnersName 0<LA-~~,+- CIa.. Address :;> C> 80)<' 2.b f Z "" City (--0.. G-crfe: Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 1000 sq, ft, or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder .- , .' ' $50.00 200 ~IDN: Oregon law reQul~tD 201 AllI/i8Wl qdol~i1I\lSlpted by the Orego$l1Jltlily . 401tNn\\flAOtlmo ~lller. Those rules arf$lflUro'th 60119..~Ifu~cP,Q,l,jQ010 through OAR ~:601. ovJl9goo XIllM7V&'cPbtain COpies 01 me$YJ51,li<llY Reconftel!liofi'I}he center. (NO'd: 109 t9Ies>15ll',lllJ number lor the Oregon UtUIIY Notificatlon c. .Temph~~~1~~~.2~:".~. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. Brandi Gir:cuits S 50.00 S 69.00 SIOO,OO New Alteration or Extension Per Panel One Circuit / S 43,00 1("3 NOTl~ac)l Additional Circuit or with I <- THIS ~rn~lrs\'f~rcl~~\RE IF THt WUHK $ 3.00 AUT.H 'fM"\",j'II'''\''''''t'S''''''''I'-'''''~''''I;,'el'''I'\i1,r.d)\!-'E hll" II I, It 'Co. i Isce ;1 [eou~~(~~;}ot~ DC u e ai ae nsta atlOn, COM R 1$ I I~ }url ... . ANY fI1{!1n:q~'Mill~qPYD. S 50,00 Sign/Outline Lighting S 50.00 . Limited EnergylResidential S 25,00 Limited Energy/Commercial S 45,00 Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges 4. '~~,,"'..' I.{b 'J'l. 7- t{60 5J 82. 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:)lBuilding FormslElectrical Permit Appliclltion 1-03.doc: . . CITY OF SPRIr'l\d<U,LD Building/Combination Permit PERMIT NO: COM2004-00295 ISSUED: 12/30/2004 APPLIED: 03/18/2004 EXPIRES: 06/30/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2104 MAIN ST ASSESSOR'S PARCEL NO.: 1703364202700 Springfield TYPE OF WORK: Heating System TYPE OF USE: New PROJECT DESCRIPTION: Tenant infill- bldg on COM2004-00269. Add gas pac. 10/25/2004. Commercial Owner: PARAMOUNT CENTER LLC Address: PO BOX 26125 EUGENE OR 97402 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor C & SELECTRIC RONS HEATING AND AIR COND License 3849 159648 Expiration Date 09/01/2008 04/29/2006 Phone 541-741-2236 541-343-6829 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: !l:'.I'e of Heat: ~II Ft 2nd Floor: NOT'~a}e~ !Y.?I't: EXPIRE IF 1HE WO~~~q Ft Basement: 1HIS ~!,jige\Type:i\LL 1HIS PERMI1 IS NlSq Ft Garage/Carport U1h~J!W:YLP8ih!)~~ ^ NED FOR Sq Ft Other: 1\ "MSp'rinkled Biiililing!3I\NDO nla Occupant Load: r.\ I \~lt'\IU\-V =_......nn . \..... ,.... r, . ......_ I DElV<ELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special InstructIon: lies ,/oU to ._~,," la\'lle~U -7'n Utili\,! I PUBLIC IMPJW.d~T..~?ted b'/ \1l;U\~; ale set 1~~~'. lohu" ,- ntel. 1\10se ,.......n~R 95Z- NotilicatiOn ce ~ -00~ &\'ffln-alj< "ciI'tWe lules b,/ . Of>.R 95Z-00 btaDown9p~tm!WlllPipna \~090, :ou ~:~:ntel' lNot~~i\i\'l N;tilicatiOll callIng \ tne Olegon 33Z-Z344). nurnbBI6~~tel is ~_800- Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 00 Status Issued 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 10% Administrative Fee + 7% State' Surcharge Add, Alter, Extend Clrc Ea Add Perm ServlFdr 200 amps or less -Mecbanleallssuance Fee- + 10% Administrative Fee + 7% State Surcharge Furnace - up to 100,000 btu Gas Outlets 1-4 . Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add Total Amount PaId . . Ll1 i' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00295 ISSUED: 12/30/2004 APPLIED: 03/1812004 EXPIRES: 06/30/2005 VALUE: Total Value of Project l..Fpp< p"ilU Amount Paid Date Paid Receipt Number 2200400000000000261 2200400000000000261 2200400000000000261 2200400000000000261 2200400000000001331 2200400000000001331 2200400000000001331 2200400000000001331 2200400000000001331 2200400000000001331 1200400000000001805 1200400000000001805 1200400000000001805 1200400000000001805 $9.30 $6.51 $30.00 $63.00 $10.00 $4.50 $3.15 $12.00 $4.00 $29,00 $4,60 $3.22 $43,00 $3,00 3/18/04 3/18/04 3/18/04 3/18/04 1 0/25/04 1 0/25/04 1 0/25/04 1 0125/04 1 0/25/04 1 0/25/04 12/30/04 12130/04 12130/04 12/30/04 $225.28 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. IRPn~ Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energIzing service. Final Electric: When all electrical work is complete. Rough Gas: After line is installed and requIred testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover FInal Gas: When all gas work is complete. FInal Mechanical: When all mechanical work is complete. Paee 2 of 3 . . CITY OF ~rKlI~\.JJilt<.,LD Building/Combination Permit PERMIT NO: COM2004-00295 ISSUED: 12/30/2004 APPLIED: 03/18/2004 EXPIRES: 06/3012005 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 t~at 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, ond 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 tbe site at all times during construction. Owner or Contractors Signature Date Pal!e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00295 COM2004-00295 COM2004-00295 COM2004-00295 Payments: ; Type of Payment Check 12/30/2004 . RECEIPT #: 8i~~~.FllILD'.' .-1. Wit. .i '. ._'- - . .JiiL.ty of Springfield Official Receipt .elopment Services Department Public Works Department 1200400000000001805 Date: 12/30/2004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BURRELL BROS Item Total: (,;heck Number Authorization Received By Batch Number Number How Reeelved djb 4299 In Person Payment Total: Page 1 of I 8:15:00AM Amount Due 43.00 3.00 3.22 4,60 S53,82 Amount Paid $53,82 S53.82