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Home My WebLink AboutPermit Electrical 2004-8-24 ~ ~PRINapU1LD ' 2-25 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54.P~6-368~:{~ ELECTRICAL PERMIT APPLICATION . % ~, ~ <1o!g" ", ~" ",,:, City Job Number r f"'IuVf 7 {')n 3 - C> //7 ~ Date 6/r'l 'Ii} V~, ~ '\ '. . I I V" I ~ ..' ~ "..' \A- .........~-1,:~ . 3. r:t:QM1::t,EtE'F~~~~H1':W - "." .L(ht"'~<lo, . ~ --Q""8 c;. c;. ..... (l) ...."?,. A. ~~Ii!:~d.~Mi.~i'E1~)ti~~;r: .lih'". " ytp,~~~ii;ig~Ei!?:.~ ~ ~~l ' '" " /~ ~/ 1000 sq. ft. or less _ $IO~~ I ? r.1'7 /" . .l- Each additional 500 sq. ft.,or ,~ y (0 ~ 'i2occ""V\csc..X- ..:> '-' 'L.L.J,^."S portion thereof '\ \$ . 9.0~ ,;, 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 $50 00 Suspended for 180 days. Feeder . 2 l;'CQNjAACT7)R;rNstALiXtroN~~JiCe:R.MJT B1J Se[vi~es oYFeede~s'-:~Insialiatioi1, Alteruiions or Relocation:' "1 . I. .-.....,. .' . - . -., ~". "'~ ~R 5nAtt-eXPJRElFTREWORK'!"" ..",.. Electrical Contractor (f:kY.....Akd1.. <C cm,~ZEO UNf3liRtIpljSr~MIT IS NOT $ 63.00 -~ ' . \ CEO OijdS~NOOllf&POR $ 75.00 Address f, 0 \ <<?'o)(. '2.<'0 4 ANY 180 DAY PE.ftIlIDnps to 600 Amps $125.00 , I . ,./ 601 Amps to 1000 Amps $163.00 City VJ\4-l-ktl.lI\ (~ Phone 71.{ L( -07 o~ Over 1000 AmpsIVolts $375.00 Reconnect Only $ 50.00 .! <"-':; ~::. 'aTYOF ~JiNGFiELD~.'6REG6~.' .( J/"; " \, . . ~ .'~.' ,'-.' , '... ' ." . . ...._ . R' + ". . . 1. r;i)6'iSfTjQNQf.Iij$tiiT~:ij.fjN'(~.1A'1 22S;I r11~ q;~ LEGAL DESCRIPTION 17033. h4Z- 0-:'/00 Service Included JOB DESCRIPTION x..J Supervisor License Number 3<:0(; ~ - S _ c. ~,~~~p~~a'ry'~~f;~,i~.es:~r~~~eil~ts "~~ {. r~~~~",-':~' ";','~' '. ',,,':, " Expiration Date to I/O/fie.;, I 2..0 -2-'=t"lC Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Constr. Contr. Number Expiration Date I 0/101 cJ U Signature of Supervising Electrician Over 600 Amps or 1000 Volts see,~:B:above. D. F-'B_f~~~~(Giic~its :"<L{':T(:'/~ '~"'. ',~' ;':"~ ~,> :., ",', ,~I"",:,~ ,'"'''', ;':,"1 " . '. . M-ri \ ~ ~rW1 1 ~O}lp~JO~Stllf'~ I 101tr.~~lUtIldopW'_"~~ 43.00 Ndiif~\Wi@n~ilt~-~' . '... .00 In~..&!~~--~- ' ~.,......,., , .,. ...'.'1 E.' . .,. , ., ,.' ~.!i1.iII(iy"Ej",ch}}ist:ill~ti.oJ!: ~fb\'''''OtQClItUlllr~ f_ PO~ii~A $50.00 Sign/Outline Lighting ~ $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Comnierclalh , $ 45.00 <=>t Owners Name AAilA,Cd [h,Q.l,j Address z..z."\ 1M r4-r1l/ '> I City c;.pF~) Phone OWNER lNST ALLA TION The installation is being made on property I own which is not intended for sale. lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: . 4.!&~TQ.tAL(jFAIi?Vf' "" . .: j 57 ~~ s:te sU~~h~rg~ . '.' . if 0 n.~~ '\S~ 10% Administrative Fee 5'70 Inspection Request: 726-376~ A~ \.~ TOTAL ' /-, /9.}.. ~ 'J~~ ~~::~ElccbicnIPenniIAPP17~B;~L ~ '\ .. . 'f , . .. I C/V"... M l(.V1 VW ~3GGj ~ . '; ---- Vi 3() -7 . ~~G~l~c.J' :3:mma ow 3HT 113Rlqx] JJAH2 Yl~.1n~q 21rtT )IF! " 3G 2lHT iPGlA1J Q3'iIROHTUA TO\Jl2~;~OO:1A6A il 110 O:lO~13jJl.mil fhn I . .oo~q VA!! (l~f VAA .' "" " 'l'~\~="~~mam '!E- "'L...~~tvCl'.ol . .. .\11~"Itf ~~~ .~ ;.r",lIAOff;l,tOmIO~~AAOnt _tmut....~Ilfat@~Udt .oeDl) ~''''~ a!llOl)otf$~ ~1--.ft(llff'lGt~ ~~"'~:l. .,- I '~ -' ,._~ . . . ,-' ~ .'. ~ '\ . \ ;:;- , t o .-!) tL ~ t ~ ~\t~ '1.. ;Y,~ ..;J " t; Q,., '--.) ~ ~ 'f'1-1'~ ~\II'" ,.'. '."' ~ u ~ . 'I '. ~ ~ & 'I' \\~ ~ .~ I) '\) ~ \ C9, !(J,. ;.;I'l'!!I. ' '~ ":',,;/ J~ So;? ~f~ 99(f...tf' /' , , . , " . . CITY OF SrK11~hH~LJJ Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11125/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2251 MAIN ST ASSESSOR'S PARCEL NO.: 1703364203100 Springfield TYPE OF WORK: Restaurant TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Interior renovation & site work - for additional parking see permit# COM2003-01210. Applicant is N & S Enterprises -Added $20.00 credit to be applied to future fees, since applicant wrote check for $20.00 over required amount. SWB Owner: ASAYED YASER Address: 12932 S W WINTERLAKE DR TIGARD OR 97223 Contractor Type General Engineer I CONTRACTOR INFORMATION' , Q,\\;; Contractor ~ ,,\\\'t.\l'I: ~~nse FRED GREENINGER t"'\l\~~~"'~\' \~~0284 ACCESS~E~~y;),..\._ '<"\'S \l ~.\~\l ~~., ,,~~ \>~\\~~kBt:lkDiN6\}NFORMA TION, '\"'~\\C1~\&...r ~ U~:! ~. . ~\S 'fA~'f;,~C€ ~ ~tories: ,,();~ \~\) l;)~ Height of Structure ~ Type of Heat: VN Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 12/20/2005 Phone 503-283-1914 485-3215 # 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 GaragelCarport Sq Ft Other: Ocsupant Load: nla Street Improvements: Storm Sewer Available: Special Instruction: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Notes: Pal!e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Estimate Pavine: Tvpe of Construction Estimate Estimate Use Bid Amount Fee Description Plan Review CommlIndlPublic Plan Review Fire & Life Safety Deposit Planning Final Ocey Inspection SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Return - Deposit -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Building Permit Fixture Inspections - Investig. Bldg Inspections - Investig. Electr Inspections - Investig. Plumb MinlmumlAdjustment Mechanical Paving Penalty Fcc - BWOP Building Plan Review CommlIndlPublic Plan Review Fire & Life Safety Storm Sewer - 1st 50 Feet Vent Fan Encroachment Permit + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Penalty Fcc - BWOP Electrical Service Reconnect Total Amount Paid . . Uly'OFSPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11125/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 $1.00 $1.00 Square Footage or Bid Amount 3,000.00 27,000.00 15,500.00 Value Date Calculated $3,000.00 $27,000.00 $15,500.00 $45,500.00 03/29/2004 03/29/2004 12/2912003 Total Value of Project Fpp<. PiIilLI Amount Paid $120.51 $74.16 $20.00 $118.00 $10.00 $976.27 $1,433.82 $571.57 $7,346.15 $1,665.23 $-20.00 $10.00 $87.75 $32.88 $253.65 $126.00 $45.00 $45.00 $45.00 $33.00 $154.20 $253.65 $44.36 $27.30 $45.00 $12.00 $120.00 $5.90 $4.\3 $9.00 $59.00 $50.00 $\3,778.53 Date Paid Receipt Number 1200200000000002511 1200200000000002511 2200200000000001919 2200200000000001919 2200200000000001919 2200200000000001919 2200200000000001919 2200200000000001919 2200200000000001919 2200200000000001919 VOUCHER #71290 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000000346 2200400000000001051 2200400000000001084 2200400000000001084 2200400000000001084 2200400000000001084 2200400000000001084 11125/03 11/25/03 12/29/03 12/29/03 12129103 12/29/03 12/29/03 12/29/03 12129103 12/29/03 1/7/04 4/9104 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 4/9/04 8/16/04 8/23/04 8123/04 8123/04 8/23/04 8/23/04 Pal!e 2 of 4 . CITY OF ~rKll~ul'mLJJ' Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11/25/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review Initial Review Planninl! Review Public Works Review Structural Review I Plan Reviews I 12/24/2003 OK 1210512003 APP 12/12/2003 APP 12/19/2003 APP 1211112003 WE GRG LLH EMM SB JMP 12/10/2003 12/05/2003 12/10/2003 12/10/2003 12/05/2003 Structural Review 03/29/2004 03/29/2004 WE TCM SUB Review 12/1012003 12/16/2003 APP JF See attached document. Kay Bork Planner DRC2003-00044 Received from Dave Puent on 12/1012003. 12/1112003 JMP called Wade Holaday at Access Engineering to ask for sheet C3, correction in accessible parking dimensioning, and contractor Information. 12/1712003 JMP left message for Michael Welshar at Access Engineering noting differences in Cl submitted with final site plan set and the requirement for a dimensioned drawing of the Interior. 12123/2003 received a scaled Ooor plan. 12/29/2003 JMP left a message with Loretta for Michael at Access asking for the change of use/occupancy report. . Mechanical not provided. Revised plans submitted. 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~ Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required Inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and Including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work Is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Final Paving: After paving Is complete. Storm Sewer Line: Prior to filling trench. Final Building: After all Conditions have been completed as required on Development Agreement. Pal!e 3 of 4 . . CITY 01' ~rRINGFIELD . Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11125/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlon 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 plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pal!e 4 of 4 225 Fifth Street I Springfield, Oregon 97477 541-7.26-3759 Phone . ~ Job/Journai Nomber COM2003-0 1178 COM2003-0 1178 COM2003-0 1178 COM2003-0 1178 COM2003-01178 Payments: Type of Paymeat Check 8/23/2004 RECEIPT #: ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200400000000001084 3:07:22PM Description Penalty Fee - BWOP Electrical Service Reconnect Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By GLEN CAMPBELL Received By djb Page I of 1 Date: 08/23/2004 Item Totai: Check Number Authorization Batch Number Number How Received Amount Due 59.00 50.00 9.00 4.13 5.90 $128.03 Amount Paid 3527 In Person Payment Total: $128.03 $128.03