HomeMy WebLinkAboutPermit Electrical 2009-10-27
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 +FAX(541)726-3689
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Permit no.: ,) II
I Date: I(} ~Z 7-0'1 I
Electr-ica\l Permit Application
.
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
1,*J.!!I~~a:~!i}I!():CALl\1~()VERNMENrrI-ARP-R0VAL~~il\1j(tilt<~~1 1\iW~@J!i;~i{~\li.t~F..EEWS.cflED,Ul!!E~i;E\'fl!;i,~}}~is.'til~1
1 Zoning approval verified? DYes D No I l'I^N"';i!'O;b,c~1i~i''''f'''',:'''\1'')\i<'.'!l:''''~~''1'J)I!JlJ~''''''-''<';1',"~t"'Is'I'i!Meost~I'~TotliIt\\
't' _ urn er-:;.o ;mspectlOns,per:'ltem~{}'):'f:~;t. Q y.' ~~'."-:\1~~ ~~'fr;;.+~t,-;.;r.
1~1~~~~~~~~EGr~i~~~::;;:;TRU=::::~~:;lfuW: 1};:~'i::::;:t;~~::.::;:;,::~::;~.;:::t"''''C ik,"~'~>i, ;~,~~s I.t~
1:~r~'ll;~t1()B'I!SlrrE~INF,,()R.MMIQNwrANDlil1()ct>.f:ION!ii:~~!;!i,j\~1 11,000 sq ft. or less (4) $134.00 $
1 Job site address: I L{ S'I W f\L# "'-,-- ~J I I ~~i~:fddilional 500 sq ft or portion $ 25.00 $
1 City:c::;::t>pU J State:olL- 1 ZIP: ~ ?'I7:P I Limited energy (2) $ 32.00 $
1~~:;~~~~\~U?~~T~N\;pF;~wJ~~~~&~~~~!~1 ~~~~I~~S~~~~~~~~ fe~~:r (~)odular $ 63.00 $
I L.e> W ...r o( +- PMl.- 1., '^ ~ ~ M.-I Services or feeders: installation, alteration, relocation.
I C-A"'o~ Ct\-NA-L- 'l-\."'-~~ T-$11200ampsOrleSS(2) $ 81.00 $
1~~:~~~~~~:~i~~;NE~'~~'~;r~~'f:,;r;t.1ff'\ I ~~: :::~~ ::: ;~~ :1::::: :
IAddress:2S0 S. "$2'-.l s.t 1 1 601 to 1.000 amps (2) $205.00 $
1 City: '5 fF b. 1 State: oiL. 1 ZIP:Cj 7f(?4; \ Over I ogg ~H15 volts (2) $469.00 $
1 Phone: 1 Fax r..~Tr:NT!~~~~;;,~~re~d b t~~~gtrn~IYJ\il)ty. $ 63.00 $
1 ..)....".M.__" ., l~.ilIriO"ffiOP.TlU"\" d . II I
E-mail: H.:~...::....Center.11 \O~tiJUII..~~pjm'J~~'lr lee ers: msta alion, a teration, relocation
"""I, ,,,lion - hrf;l!'6MhM~'! -1';::;-' . ' "I
This installalion is being made on residenti,i\ Q.,r1farm'i5ropelT}lU I ~ 'c -i---,;nli'.! ru, re:$>.>, Y . _..f $ 63.00, $
owned bo: me or a member of my immediat'e'C~11I.ilY[.21:hisay ?btall:N ~it!\ls400\l14l~~,,- $ 87.00 $
property IS nol mtended for sale, exchange, 'iea;;g.;,i~!g~!1\J l7P.iRer. ',~T,\JI-"lOMJ{<.i"i~'<'''
479.540(1) and 479.560(1). n~umberfor the. Or~' 19 _.\J1.~~ 8~): ps ILl . $126.00 $
Signature: Center 15 1 f ver ~o amps or 1,000 volts, see services or feeders sectIon above
1?~:4~iY~~C:~NrrRACmbR~IN.S1:Alfl!AtIONfi~~~1~~~~~t~?tl Branch circuits: new, alteration, extension per panel
I Business name: Su r1dbL.r:~ j '), JZ.\<c:...\,(L..'\ 0 I a. Fee for branch circuits with purchase ofa service or feeder' fee:
1 Address:? D .~..>< \ 2-'1 I I Each branch circuit I $ 6.00 1 $
City: Fb~'5-& G,ObC>=- I State: C:>\Z- I ZIP: 97 J It.. I I.b, Fee for branch circuits without purchase of. service or feeder fee:
Phone:S!>> -~q - C>664 1 Fax:S"b3 -15i- D'U:>b. I I First branch circuit (2) $ 55.00 $
I E-mail: C!,c. 1'\<:.. QZ s,~-.-If"'--""" (.Jccba.lG ,CDMI I Each additional branch circuit $ 6.00 $
I CCB license 00.:b7L\Y-z. I BCD license no.:37-Ll'-l5 c:I I Miscellaneous fees: service ocf~ed![.,not included
I Signing supervisor's license no.: ? 4 Z 7 _ S 1 Each pump or irrigati()'n"2ifcl;ti25':~Qd.<. $ 63.00 $ 1
I Print name of signing supervisor: b\S. hE. c. ~IS~~':l':'~~~ Each sign orot~~~t\~"\J1! \z ,\101. _ $ 63.00 $ 1
I SIgnature of,slgnmg supervIsor: ~ _ c.. ~ ~\._.'~ ~tf.~f:tttt~~i~~e'~l, ,r' $ 63.00 $ 651
",\l\\10~ \t~'I:l'i'itba~hiecti~n: (I) , $5B.00 I $ I
CON\~; .t&.;j~paR\~...!l'~AB~j)riC.ANJ;IUSE{~~~~~J,1~~it.1
Ji,N'I ' '(A) . Enter subtotal of above fees 6 "3
C)\.,'V c5'- (Minimum Permit Fee $58.00) $
'\ '':::Jf\,,~ 1 (B)E,nterI2%SUrcharge(.12X[A]) $
'\ \.. ,Ib'\(' I (C) Technology Fee (5% of [A]) $
'0-').., I TOTAL fees and surcharges (A throngh C): $
~;tt
75'," I
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73 "7~
440-2584-J (9/08/COM)
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769In~pectionLine ,"
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT,NO: COM2009-01579
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
"
Status
Issu~d
..
. ',.
SITE ADDRESS.: .'. 1~51 WALNUT RD SPRINGFIETYPE OF WORK: Electrical Work Only
ASSESSOR'SpARCEI:NO.::' .1703334100101
-',....,.
-: 'i' TYPE OF USE: New Commercial
PROJECT DESCRIPTION: low volt path lighting for canoe canal under 1-5
"
Owner: WILLAMALANE'PARK & REC DIST
Address: 250:S 32ND:BT ''-'' .~: ",. .
SPRINGFIELD OR 97478
''. :-:1'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
~
I CONTRACTOR INFORMATION I
,.n-''Ef\'T10N: Oregon law requires YO~Q
ContractoI'; rules adopted by the O~j;lon U 11,lcense
SUNDOWN:EEEO:I'cRI~lr%Meq~!!ffl~~ ~M2
f/lVAN Ub:C:::~U"~ '<"'t'1tf . -:- '\.? -~-
0090.. You mr~U1 :;n~,~~jX'~1
callmg the cente~r Itl:' h.e telephone
number for the 0 teJil. N.qijPration
Center is - -5 _.l.i~II).
Type 0 eat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
07/31/2011
Phone
503-359-0604
Contractor Type
Electrical
.'.
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
, ~; ! .
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compacl:
. Frontyard Setback: "
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
Overlay Dist: . ",'" "",c. '. ..
-. v, '-", "_,,,"~C""i>-.""'-""'-'
# Street Trees Rqd;"'.'.,.,."....,-,.,
NOTICE: Pa~~q.Q~i~~~'E 1HI-II:. WORl{
THIS PERM~l lfttl-llt'CYRml\'lI:RM\1\S NOT
AUTHO~I~EO_ U~NO~ ^QIl!\\r\ONEOFOR ..i
~~~!rlV~;ii'5 .MmrnxEMENTS I
Street Improvements:
Storm Sewer Available::.
Special Instruction: '
Sidewalk Type:
DownspoutslDrains:
Notes:
/:.
I Valuation DescriDtion I
"
:~!
Description {' Type~f Construction
:f f .
$ PerSq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 2
;"
Status . Iss~ed;: ,
225 Fifth Street; Springfield, OR
541-726-3753 Phone
541-726-3676 F~~.:;;t..3,:' '.
541-726-3769 lrispectio.iUne\ "
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Fee Descripti~n'\' , .j:, '.
+ 12% State Surcharge
+ 5% Technology' Fee
Traffic Signal - Panel
.,
'f,
.,; Amount Paid
Total Amount Paid
,.
- ..
i : 1'!'
:,-
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c,
$73.71
Total Value of Project
Fees Paid I
I ' Plan Reviews I
Date Paid
CITY OF SPRI~\Jt<.!J!,L1J
Building/Combination Permit
PERMIT NO: COM2009-01579
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
10/27/09
10/27/09
10/27/09
Receipt Number
1200900000000001197
1200900000000001197
1200900000000001197
To Request an inspection call the 24~our 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. , '
~, " ,
,". \' $7.56
$3.15
$63.00
,
'.
Low Voltage: PriOl: to cover..
I Re<l' uired Insnecrions I
. , IiIIi III
By signature, I state and agree, that I have direfully examined the completed application and do hereby certify that all
information hereon is true and eorrect, and) 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 wo~k described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Servic~s Division, Building Safety.
I further eertify 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 locate~ at the front of the property, and the approved set of plans will. remain on the site at all
times during construction.
Owner or Cont~acto.rs. Signature
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,.
Page 2 of2
Date
225 Fifth Stre~t '. ,,',
Springfleid, Oriigon)7477'
,. . '" !-
541-726~3759 PIi~.ne
City of Springfield Official Receipt
Development Services Department
Public Works Department
. RECEIP1:.#:
1200900000000001197
.Date: 10/27/2009
3:02:34PM
Job/Journa'l Number
COM2009-0 1579
C0M2009-01579
COM2009~01579
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Item Total:
Check Number Authorization
Batch Number Number How Received
23090 In Person
Payment Tota!:
,Amount Due
63.00
3.15
7.56
$73.71
Description
Traffic Signal-oPanel ,.
+ 5% TechnoJogy Fee
:+ 12% StateSurchiuge
,,'. -, '- "
. -'
Payments:
Type of Payment'
Check
. . , ~
.lpaid'By': "
Received By
Amount Paid
SUNDOWN ELECTRIC CO
$73.71
$73.71
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cReceintl
Page 1 of 1
10/27/2009