HomeMy WebLinkAboutPermit Electrical 2009-11-5
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'CITY OF SPRINGFIELD, OREGON
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SPR.INGflI"D:LD ~" ZON
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225 FIFTH STREET . SPRINGFIELD, OR 97477 . PU,(54t)726-3753 . FAX., (54t)726-~689
ELECTRICAL PERMIT APPLICATION
,C~l-:'9:-}:c;C 1117'3 i
City Job Number
~ - . . . - '-. . ----:---,
1. ; LOCATION iiFINSTALIATION:,'
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~'5 4 'S G-11-rew "'y .s~ .
LEGAL DESCRIPTION:
JOB DESCRIPTION:
WI III "''', .(1..; E>v' tj'''5 lW~rJ re4 ~a;l~i kif<,. 5
Permits are non-transferable and expire if work is
Dot started within 180 days of issuance or if work is
Suspended for 180 days. '
2.C;ONTR4C'[ORIN$TALLATIO..IJ:9NLY
Electrical Contractor : (.:S 5' A .$'5 VI .Ii a...-"":"'j
Address '8"1975 fJ"""iric (loe.
City ~VI. 9?Lln Phone '-/~5-s51ib
Supervisor License Number" sq l./ S ( <1
Expiration Date
j'l.I,olw
Constr. Contr. Number
) <b3l/70
Expiration Date
3/''''},11
Signature of Supervising Electrician
IQ~ Ct I-J
Owners Name .GItfsE
Address ~'I~ 6etb.-y s./-.
I '--
A~IijITI~~9 /ifN requi~ to 7cillclwZ 3' c e
rules adOj)fEid oy' the l.ir'egon Utilily Notification ' '
Center, Those rules are !lllcUQ(lh In eJAR 952-001-
oo~~~1Ws~~Il1!dl1'9o. You may obtain
coPffi~ 1lfJ/;l!lrullwi~lbeill!tW;/!J8 M~I}:dl9ll which
~~h~~~rs~.~J~~ID.~~Qft ~!!Y Notification .
Owners, Signature:
Nt If-
~) .
. {A~
Inspection Requ:st~ ~ .~ \\ 'ff{
W'"' ro~ ,~~
Date
/ 1/ r.;- / D/
.
3. f COMPLETE FEE SCHEDULE BELOW---~ ,
'-_ . " ~~ . . .. - ~.... . ,- .--.------...:---.....1
A. I~ew Resi~entiar:'S!!'gle ~ ~u(ti-Famii~ perd';'ellingu'~i~.
Service Included
1000 sq, ft, or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106,00
$ 19,00
$50,00
B. Sen.ices or Feede~s.-:Iristallatjo~, Alte'rJtirins or Relocation:
'".. ,':'~'L'_' ~. ... " - _ .. ...''; _ ,:",-':~C:'. __ ',,;. _' , " -
200 Amps ,or less
201 Ampsto'400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63,00
$ 75.00
$125,00
. $163,00
$375,00
, $ 50.00
c. ; Te";pora~;;S~;;'s~o; F-;ed;;:ir---'-- ' - - ---:-: -"--1
~--~,--<'- --- - - .....~
Installation, Alteration or Relocation
200 Amps or Jess
201 Amps to 400 Amps
401 Amps to 600 Amps
. $ 50.00
$ 69,00
$100,00
Over 600 Amps or 1000 Volts see "B" above,
~ _ ".---- -- ...-,.----.....~--...r
D. :. Branch',~!rcui'~~--2- ~.~~.jL___~~~
New Alter~tion or Extension Per Panel
One Circuit '
Each Additional Circuit or with
Service or Feeder Pefl11it
,..-............---,...--;"1
~--~
$ 43.00
$ 3,00
r, ;., ",', -:"":"~-:--:--;:-:";, ' " _"- --u------'l
E. l~isc,e)lan,~ous (Servi~~/feederniit included) -E~~h'lnstallatio~J
Pump or inigatian $ 50,00
Sign/Outline Lighting 'L ,,$ ~1l0'" Iii9 &3
Limited Energy/Residential ' $25,00
Limited Energy/Commercial ' $ 45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.jsuBTOTM-OF.ABpirE------1 /2&
~tate-SUl'GhaFg'" / 2- "'hi r;:- ? "2-
HJ%-Administrative fee
5% Technology Fee t;- ~ ,
.. NOTICE:
TOTAL THIS PERMITSHALL EXPIRF~~k~ 'i 2-.
",,,nv A1ITH()RIZED UND, ' . ~_
Shared Drive(T:)!BuilOihg ForrnsJElectricahP.ermitfAp'p'licaiiOh'S;'o6.doc
PERMI, 1<; ,~u I vV"""-"- . - - PERIOD
ABANDONED FOR ANY 180 DAY ,
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CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01634
ISSUED: 11/09/2009
APPLIED: 11/09/2009
EXPIRES: 05/09/2010
VALUE:
Status Issued--'-:::'--~:- /'..~:'""':-'
" " ..,.... '~;;
225 Fifth StreetiSpringfietd, OR,
541-726-3753 Ph.one, '"
. 541-726-3676 FaxH', .!.:; .,;; .
541-726-3769 Inspection Line """4':;,: .
.. .
Owner:
Address:
SITE ADDRESS: 3545 GATEWAY ST;'
ASSESSOR'S PARCEL.,NO"\,,,,VQ)153301200
}":" '::::'y., ,.,:..- "\ ;':. TYPE OF USE: Alteration
PROJECT DESCRiPTioN: Sign electrical for face change- Chase rebranding- New electrical cantrator (see
, .
"" C9-504)
, WESTE~'SERvitE.CO
PO BOX,7788 "':;,
NEWPORT BEACH CA 92658
SPRINGFIETYPE OF WORK; Sign
Commercial
".........r-~.;I--lr'\"l. r'l..",...,.."" I....., 1'1''''..lli..o., \/1"'\1' t,..
..f .J~,lIr.",... l.r._ .,t~^"_:'.-.! h,., tho nrc'1n~ Utility
,.,. :', ''; . Ir,CONTRACTOR.lNFO~MA.:pOO ~t forth
;. ; ~,~,:.':", , in OAR 952-001-0010 throuqh'OAR 952-001.
Contractor Type' , Contractor 0090, You may obtain copi<WceU#rules&,liration Date
Electrical' ,:, " :' E S & A SIGN CORPcallinq the center, (Note:l1\1llItGlephone 03/16/2011
Ii' '."-' ~... , ,..,.""m' '''\'I~H ;'1ULIiI\iClt.lUII
, 'BUIL'DIN?INlOl~.MA:f<I?N-fl4).
Phone
541-485-5546
. # of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type'
Secondary Con~truciion Type:
# of Bedrooms: .'
, .'
;~ , .~.. ,t:.
B
# of Stories:
Height of Structure
Type of Heat: .,~,
Water Type:
Range Type:
Energy Path:
._. !Sprinkled Building:
.d ~ L:r"
I DEVEC0PMEN'l'<tlll!'cmMJ\tj;.irllN"1 if WUKI\
!\U I HUKILtU UI~-U~n rrll~ rtllll"f IS NOT
uCOMfV'';~'I''''I-n DJ:l JS ABANDO,NED FOR
",V<)f ay 1IiS!., .
ANY 1 #lSGe'e'l f~~d:
Paved Drive Rqd:. .
0/. of Lot Coverage:
LotSize:
Sq Ft 1 st Floor;
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
-'
Ir'; ,ti:.
t',
n/a
Front yard Setback:
Side 1 Setback:, " , i ". ',.
Side 2 Setback::: ,,',d'
j' .
Rearyard Setback:
. Solar Setbacks:1}"' ,,: i.
~ ..:...~.. .
. .~
j:....,I'1)..'~!':
, REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLlt':: IMPROVEMENTS ~',
Storm Sewer Available:
Special Instruction:, ::
,j \)
Sidewalk Type;
DownspoutslDrains;
Street Improvements:
"f ..~... -
~~ ,~~
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Notes:
11\. ' t'
I ,valuation De~~riotion I
. ~::~,
..-.,._........._~. -
"
, $ PerSqFt .
or multiplier
Square Footage
or Bid Amount
'Value
Date Calculated
Description
Tvpe of Construction
Paee 101"2
1:'
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225 Fifth Street;Bpr,ingfield, OR
541-726-3753 Plioni,., .:;'
541-726-3676 Fa~")"'::".,
541-726-3769Insp~ction Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01634
ISSUED: H/09/2009
APPLIED: 11109/2009
.. EXPIRES: 05/09/2010
VALUE:
Status ',Iss'ied,:' ':
.' ":'<i'~
Total Value of Project
j. .
Fee. Pai~ I
'.
':,':.",;
!'~
Amount Paid
Date Paid
Receipt Number
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sign - Outline Lighting Each
$15.12
$6.30
'$126.00
11/9/09
11/9/09
.11/9/09
2200.900000000001265
2200900000000001265
2200900000000001265
0,
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Total Anj.Ount raid .: 'f,
$147.42
,.;'~;:;,;ft.\ ;_~~'/
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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. ,'., ,;t" ""'. '
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I Reollired In'pection.'
Sign Electrical: After con~e.!tion is made but prior. to energizing.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon i~ true and correct, and I further certify that any and all work performed shalj 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 ofthe property, and the approved set of plans will remain on the site at all
times during construction. .
.,
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Owner or Contractors Signature
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Date
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Page 2 of 2
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225 Fifth Street, j, :
Springfield, Oregon 97477
541-726-3759 ,Phone---"---" ..
:',~ ,~~.
City of Springfield Official Receipt
Development SerVices Department
Public Works Department
:. .,.'
RECEIPT'#:c, ' 220090Q000000001265
Date: 11/09/2009
8:11:02AM
Payments; ,
Type of Payment
Cred itCard
. (.,',.'c.....
.' ...'
Item Total:
Check Number Authorization
Batch Number Number How Received
Amount Due
126.00
6,30
15,12
$147.42
Job/Journal Number Description :):/.
COM2009-01634 " " Sign- OutliI\~Lighiing Each
....: ~.. ;'" ,;., -,...'...:v,;~., '~~.
COM2009-0 1634 ,'::;;','''-,;';..+,:5%' Technology Fee
COM2009-01634';; . }'fh"2% State Sur~harge
,"
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PaidB{": ,- Rec,eived By
CHERIE FLETCHER POWELL cjc
Amount Paid
009552 In Person '
Payment Total: ,
$147.42
$147.42
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11/9/2009
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