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Home My WebLink AboutPermit Electrical 2005-1-28 " 225 FIFTH STREET. SPRJNGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541 1>},689 0..,. 0"" ELECTRICAL PERMIT APPLICATION ~.o/,'.9 '6",_ . 0 'q -"" City Job Number tO~"l.OO~- 00 107.. Date /- 2b -6 <) bq~ "O':P.o, . 0'09 g,G LEGAL DESCRIPTION 170 '13bq L. JOB DESCRIPTION l1~v c.\(2.(.~-\ h ~ '6-h.L..~~A-ny Permits are non-transferable and expire ifl~: L.//!(YIN-ach Manufact'd Home or not started within 180 days of issuance or if work is ~- /Modular Dwelling Service or Suspended for 180 days. Feeder 2 t'}';;oi\iiffAA'GT.W1{!I&:~rJi'.T1('t~.~CJ:.~~ca.~y;;il B. ~i'S~~:VW~~6'rfEm'€;::?!i' '~'l-:iii:ti~rtar~{fe,\:~l-ilrti'~;%J~J'c"Rtit'.;'iMilll . ~"'W:~J:.+~~:.";~:\'l'\\~.,r;t;ls~l..'WJl"1(' ~.; ~ ':-.' ,.~ t~'h""~~"j.1!!S!~" - ." ,. J5~'~~'~~~~:flI Electrical Contractor t 0- S fk('.In,(' / Wz~t~~ ~~~gOl\ I,)(\~~'l\ $ 63.00 ~o;t. ~~_\'l~ ~Q~ ~e\ $ 75.00 pfJ &X ) lfCld f~~~~9.1~\f~~~~J~~O~; $125.00 ;p' r~ u ~~ .001..en'~St\lEl&0j\~P~Ol\9 $163.00 City 1"'1/1 ~J7C./(J Phone 7 t!j ~fl a'l~'IJ&pillJ~~I.lMY6h~~ca\iOl\ $375.00 J ()O90. Wd ll\ ~~;;-GtK\\'I NO\\ \. $ 50.00 ~\\l\gU\9 ~gOl\ Z~4). Lj09ljC) c:a ......\Ot..\\\,~lit!., . ,s~','.1~~tt~f"'d"-"'~"': '" . ~;U" ,. ;/Jil"1 D ....I"t\ugt C"d'l:: I v., er~lces 0 ,ee ers'r \:. 'f~V;'l . '\!.!" cetl\oV""' ~. ~I .~ ...... )0 -0 /-0'1 3<gLjq 9 -/- DB 02-700 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof 1. mtI0c;U/(;r(jNl()E;1NS11A1'i~i"4lr.'&N1W,~~~\\,~ ~~~~".Qo.'l'Ol"..~~...f!!it~"i_."....'lf'~~ -Z i \..Ie 'g' WI A (,'11' 5 I $50.00 Address Supervisor License Number Expiration Date Installation, Alteration or Relocation Constr. Contr. Number 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.60 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. . D. ~i!lf~Gi.]!c'iffir~il.~~tJi.~iJW.\\\II'ii;.~'~''1l~;~!a~;i'li!!]i'll ~~:..~~ ~~~~~~\.fl...~ New Alteration or Extension Per Panel One Circuit , $ 43.00 l( '3 Each Additional Circuit or with 2 I ~ n ^ I/'I _, Service or Feeder Permit .J $ 3.00 h Owners Name t{.-,,-,,,,,,MO,-,,<\"'" L.-6'-~ . 1;\1' '/II\J\'\" Address ~ J-:> 0 ~ ? /(2 .- ME..w~.ffi~~5.~mr~{~1P1;lt'cThVJiUq~Err~~~t~iI'n'i'fblt,~ .,--. u ~ <-0 J 1..\l1~. "S ~~~~\""'"'~;r=!Jh...~....."tt.",,,,,;,,,~.... City C'lA-L-C-d't""' Phone i\-l~~}~fLiff>gh\~Q~i f>,Bf>,\'lDO\'ltl) f $ 50.00 _ f>,\.Slg~9r\Utli~\Ltg~ting'D $ 50.00 O\'J\WC-"V oj ~\-IIu . CI::inlltedrE\le'r.gyIK1:sidential $ 25.00 ~~'( Ill" LImited Energy/Commercial $ 45.00 OWNER INST ALLA nON Expiration Date ,)n:::~;e;ng~ , The installation is being made on propeny I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Ov:ners Signature: r~;,r-~"""\,o""I'/:'''''''''I~'~~;~'-:.'\i.'::\.::A~i:I.~. .,JI\.'~. 4. ~ISl!JBTOT.A:fj@FJ'ABON1!.; , ~~~f(:~&l.tti'l.;.~~"'t;ji(RI~S.t .~~... . 'I', 1t . .-,~ .~1': .'. ~ ;\1.'\:11 . ~~..' ,\ .... . I!:l t{ '7 J43 It '0 5" 7 J') 7% State Surcharge 10% Administrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)IBuilding FormslElectrical Permit Application 1-03.doc . . CITY OF SrK11'l'-:.I'lJ!,LD . Building/Combination Permit PERMIT NO: COM2005-00102 ISSUED: 01126/2005 APPLIED: 01126/2005 EXPIRES: 07/26/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2148 MAIN ST ASSESSOR'S PARCEL NO.: 1703364202700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: New circuits for kitchen, batb, walkway Owner: PARAMOUNTCENTERLLC Address: PO BOX 26125 EUGENE OR 97402 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor C & SELECTRIC License Expiration Date 3849 _ 'r\~ 1!I9/0112008 BUILDING INFO~TI()~':b:~g~n \ltil~ ~\J~~i\UI'" dop\ed 'o'i \, {Illes ale s~ '~n.\' ~,~~ a I\1OSe op..i\ 9UlM1.!!~: !I~~lit blltfJililW&\O \\\lou9\\ at t\\e ~qlt Floor: ~yplB ~O\-O ainCOpies tele"~nd Floor: i ~"ilIa'i 0'0\ l~o\e'. tM o\i~g~sement: ~ .1)'.1.'\1;'6 C6ntet. 90n \l\ilit'!!:",)sq Ft Garage/Carport Enet~\\ili't. 1 tl\6 Ole orY33'Z"----' ~q Ft Other: SprjnJlle'il ~~:iS ,-~ nla Occupant Load: I DEVELOPMENT INFORMATION I Phone 541-741-2236 # or Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Constrpction Type: # of Bedrooms: REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: NOTICE: THIS PERMIT SHALL EXP~'t~sI/V!l!s{\>~~jRs: AUTHORIZED UNDER THIS PERMIT is NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERiOD. Notes: I Valuation Descrintion , Description Tvpe of Construction $ perSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paeelof2 7>it....;RJ... ~F.I~, - . . U i t OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM200S-00I02 ISSUED: 01126/2005 APPLIED: 01126/2005 EXPIRES: 07/26/2005 . VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541.726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Ff'f'~, Paid J Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Clrc Ea Add Amount Paid $4.90 $3.43 $43.00 $6.00 Date Paid 1/26/05 1/26/05 1/26/05 1/26/05 Receipt Number 1200500000000000120 1200500000000000120 1200500000000000120 1200500000000000120 Total Amount Paid $57.33 , Plan Reviews , 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. IRf'ollirf'~ Rough Electric: Prior to Cover . Final Electric: When all electrical work is complete. 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 tbe Community Services DIvision, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 wlll be used on this project. I further agree to ensure that all required inspections are requested at tbe 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 wlll remain on the site at all times during construction. Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street , " S~ringfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00 I 02 COM2005-00 1 02 COM2005-00 1 02 COM2005-00 102 Payments: Type or Payment CreditCard 1/26/2005 . RECEIPT #: ~GI'l_ ' ~' ."-- ,,'- '. .... ''".. '.'. 1 '. ; "'-'.a5r . '~;t . ,,,,." ,. -'Ilty of Springfield Official Receipt .elopment Services Department Public Works Department 1200500000000000120 Date: 01126/2005 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By MELISSA GEHRKE Item Total: Check Number Authorization Received By Batch Number Number How Received djb 302608 In Person Payment Total: Page 1 of 1 9:57:17AM Amount Due 3.43, 4,90 43.00 6.00 $57.33 Amount Paid $57.33 $57.33