HomeMy WebLinkAboutPermit Electrical 2003-10-9
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DEVELOPMENT SEnVICES DEN,m MrNl
The following projecf as submitted has the following
ioning, and does not require specIfic land use
approval. ~ (l
225 FIFTH STREET Zoning"-
SPRINGFIELD, OREGON 97~4..?J 10-0'1-0)
INSPECTION REQUEST: j't(j-J/69 ct'lA. )
OFFICE: 726-3759 AuthOrized Signature .
1. , LOj;.~TION OF INSTALLAT):.ON
I ~ ';{ q Q Ilj YYl-:,t:::J ~
LEGAL DESCRIPTION
1703~::> 5 f 02700
JOB DESCRIP1;IO.N.
r -P/X:Ii_-if () CJ I f(::'-I
ili.d 3 rr /1 J:.i; d)
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor Ku.Jd.eV''\ f.1e:::-lvIC
Address /q G Mac\iSoYl
Ci ty t:.U0jen-P
of Supervising Electrician
O..ners
/11../_/ -
Name '5cort ~vA 1\
iJ1,{otMwlc:. gL"d.
Address
,,70
City
s~f~
Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent. n~~~\Q ~
(hmers Signature: ~.~ ~~
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
;';';. /1(' III 8 "IF' ,
SI',.UNl-~rlEI.',l, elf? n-;.Il,-
(54" 7;:(;.37r-.1
FI\X 1'5."} 7:::('..1"n,o
~LECTRICAL PERMIT APPLICATION
City Job NumberCOWl'Z003- 01003
3. COMPLETE FEE SCHEDULE BELOV
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Sum
Items Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manllf'd Home or
Modular Dvelling
Service or Feeder
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
B. Services or Feeders
Installation, ~~~~?~tions
or Reloca~hQ.a'l' \')\\\\\'1....
>II \0 ~o{\ iI. ~e"
2qQ>\'aWp~,uf~\iiS'Su~ ,.()O' $ 50.00
c ' ~pi~~($I'il1pse#0 ~m-;~\O \ $ 60.00
Phone 4~0-o Id;;~~f\\O 'c}.6491-~j\~ I;,~'(\ ~~ ",0 $100.00
~ \~ u\eS ~()j' w~Ot~'iJg~\~<YJllP~ 'o{\ $130.00
Supervisor License Number ~q 0 - ;),\\O~ \,O{\ C~ \v.e9~.l\~QO)Q,lf11I!P~d'-~~J 5300.00
, ~\~,,,e; r:,'l-.o lE:~~e~o'i%~~ _06.' $ 40.00
Expiration Date /tJ-j- 0,/ \0~l>..~9 .0<\0>'1 il.e~' ":\J ,,~'1'
'Y' "",u ~';".r.e{\ ~". ""~,,
-'I "\,.. , 90. -';-. W=mp'o<;)ll~ ",f?,€r-lrices or Feeders
Constr Contr. Number ""O'-IdC- lJ 7f:.\\{\Q, .,tPm\-lJ"lr' on, Alteration or Relocation
C f"-'00\ (\\e,\ \
(\\) 10"0 amps or less $ 40.00
201 amps to 400 amps 5 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 vol tjjCl~'f,.e "B" above
D. Branch Circuttt"'?\~t. \~~~ \'21 \'ICl\
,~n""-' ~~\, S\-\f\ ,\-\\S?C fCl?-
\\t:!~..?,\:.\'nt0",#i~~ %f.,\-.~~~lon Per Panel
\ \'i\-l\J~\Lt. ()~ \'21 f\ I . If:>
"~ne,.<,:i\ifc'it~t"I'~\()Cl,- $ "f3. 00 7':>
\E~~Ii~&,QtWt'iblial
1C~rclllt or vith Service
or Feeder Permit ~
SUBTOTAL OF ABOVE
7% State Surcharge
\0 IX Administrative Fee
TOTAL
5.
$ 85.00
$ 15.00
$ 40.00
- ......
$ 3 ,00
'7
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
52 ,-r->
;5b'1
S'zo
i..", IN
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF ~rK11'it.Jt<mLD
Building/Combination Permit
PERMIT NO: COM2003-01003
ISSUED: 10/03/2003
APPLIED: 10/0312003
EXPIRES: 04/03/2004
VALUE:
SITE ADDRESS: 1889 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703253102700
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Relocate outlet and add 3 circuits
Owner: SCOTT STOVALL
Address: 1570 MOHAWK BLVD SPRINGFIELD OR 97477
Contractor Type
Electrical
, CONTRACTOR INFORMATION I
Contractor
BUILDERS ELECTRIC INC
Phone
541-485-0922
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
License
4296
Expiration Date
12/10/2003
! BUILDING INFORMATION I
# of Stories: Lot Size:
Height of Structure \l \0 Sq Ft 1st Floor:
Type of Heat: o,\llt0S ~~\ii\W Sq Ft 2nd Floor:
VN Water Type: (\ \~IN la Otegon \49t'Sq Ft Basement:
!ta\\~~fd '0'/ \"e all ate se2..ooSq Ft Garage/Carport
~E.~'}j(Jr~g\ltw. ose t\li oP<f\ 95 lIlS 5.q Ft Other:
p.. ... l\lieS (\\el. ~"'1>'to\l~" . \"e t\li dmpervlous Surface Area:
.nl\O'<" _ r,e _ ~. (\ ,\' . ~4 0\ _nnt\
'lcDEvl'bOEMENiJNFofu\iA'I'I{)N-:~\\\iGa\\OI'
J .~ V
\ v" ~o\l "'-. n\el." \)\1\1" -.11,). REQUIRED PARKING
090. Inec0 e9,on 2-'l~
o \\(Nllrhi?{ \li,UPI oo-?)?> Total:
C~~f~~~~~S!R'\jr, Handicapped:
n Pavell-'Drive Rqd: Compact:
% of Lot Coverage:
_."r..,_.nC \~ 1 \-IE 'l'J0~~
I PUBLIC IMPjioYi~'I1S;I\-Ip..~'-R1HIS PERMI\ \~ ~.v '
" olLtU uNDo. " InONEO 1'0"
1\\)1\-10" OR \,~WJvah{.ll'Ylie:
OMMH-lC\:O . "'''
C 0 01\'1 \>\:\\DliwnspoutslDrains:
I\N'I,1l
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Description
Type of Construction
Value
Date Calculated
Total Value of Project
Paee10f2
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Lu r OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2003-01003
ISSUED: 10/0312003
APPLIED: 10/03/2003
EXPIRES: 04/03/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I FI'I'~ Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid
$5.20
$3.64
$43.00
$9.00
10/3/03
10/3/03
10/3/03
10/3/03
Receipt Number
1200200000000002262
1200200000000002262
1200200000000002262
1200200000000002262
Total Amount Paid
$60.84
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.
I R~olJirl'd ~
1 Rough Electric: Prior to Cover
2 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 ofany 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
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 I 003
COM2003-0 1003
COM2003-0 1 003
COM2003-0 I 003
Payments:
Type or Payment
CreditCard
~i
Receipt #: 1200200000000002262
Description
Add, Alter, Extend Cire
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
KELLY OBRIEN
000186 090218
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 10/03/2003
9:27:58AM
Item Total:
Amount Paid
43,00
9,00
3,64
5,20
$60,84
How Received
In Person
Payment Total:
Amount Paid
$60.84
$60,84
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