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Home My WebLink AboutPermit Electrical 2004-11-18 ) ... .... I~., S~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-'i6'h,:{~ ~ "" '" ELECTRICAL PERMIT APPliCATION ' () ~<>~ ~'\:?\. ~ -.... . ~.'. ~ o. City Job Number r~jOJ)L.i_OIDXO Date II-II-DU ' of"'t. .,,,~ ..,~7.,~" - / ~o . 11)6,. "o-~.r ;1;. .,'\ iI' Jt;'\. 3. r:(;'9wi.1!n,; F.EE:SCHED1W;~L~W. :"\>4i~'\ ,y"~i~" "G ~\9:~~\, A. !~i~1f,,~~~d~@~ri~~gl~.or~Mtillj"~ilyer:..- el!liig"6' ~~'- o Service Included "'~., ....19 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Expiration Date , () / r d In If I Over 600 Amps or 1000 Volts s"e "B" above. Signature of Supervising Electrician D. l]iil'liJ!~b(Circllits < " " ii. ". ' " J.-!'? r / () j)' New Alteration or Extension F'er Panel / JV--- Ui., ~ ./r"V I ''''T One Circuit I $ 43.00 ~'3c;:lJ I. .. oj ICE: Each Additional Circuit or with ( n(") \",...\( \ ....., ~ Q) THIS PER~Setvice'orLteeder Pe,t;rnit '2- $ 3.00 n ....- Owners Name ~'>- U), J. J. . AI ITHORIZi'..: :' ,'.", t' tI\PI.~~ IF T1:lE,~!{ . Address ~ ~ \(\ t A ~Q.MMH.'(J ~1I!]nry~~~S~nvi1eJ.fqe<#i;rl1!P,tlincluded) ':'~ach Installation 1 C \ ANY - -., Iv "Of\/VUUNtD FO City (lYJf'f)P _____ PhoiW' 180 D~iftigation A $ 50.00 ~ Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 1. ~'J,;o~.ti6Ro.FiN.ST;'.Jt4Ti()N 2'2- eq (') (V VlI\ f) Ie LEGAL DESCRIPTION I \ \ '1 cP-'fJ ffl)~ Om:; .;. JOB DESCRIPTION ,I c;k4 5j)-s~~G4-S '(~~ .......;v-+s Permits are non-transferable and expire If work Is not started within 180 days of issuance or If work Is Suspended for 180 days. 2. l.C9Ni:RAct61(ifv:$J'~ T,T 1t'q6N ~~!'l Electrical Contractor r~~ [~ 0, d , '() d '/...Z(o Y City W~~ Phone 7c('(-<:l7<l) Address Supervisor License Number 3 G (fG ~ 5: , () / (OpE> I Consb'. Conb'. Number 2rJ -2- "[tfc:.. Expiration Date The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. t:.s~:.~!~;So~r.s ~.i~~t~_lj~tio~, Altera.ti~~ '~or' ~elo~~tion~ .. II 'ft." vi ION' 0 200 Amps!WJlfP'~W rUles a~ (egon I~w $ 63.00 ' 201 Amps,'l'{j6'OWinps CentONed bIH~6jIf!r.OO YO!> ~ , 401 Amps'~6'O'& Rti.psOOt_oeo~ rho~", ""' l$'i~llltl UIi,"(u u. ~')" lOt.. ",e!""'A .1y 601 Amps t<QI,oOO Ampsy Obt-. ',r04g1:) O~e"A':" III'{'I'I: c'me Cl.1l"~' Over lOOO!~WB1f.YOltS Center OPie~ 0 AAl2-.!'^t Reconnect Only {Of/he 0 . (lvOte. ,.. - S .OO/eA i . "" Ceflt~ri ~e!~on UIiliij-~elefJh.nQ:' C. l-lfeu;Jior8r'y Servl~es of Jegler.JJ2_2~' PJrlJ(:'illir>~ . .. - -~44). ___e. Installation, Alteration or RelClcatlon 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 I Minimum Electric Permit Inspectlo," Fee Is $45.00 + Surcharges 4. l,:S~;';~~Ai;:OF.i1BOvE .!:, " ,f I.. - I' '. 1':-'<" '-_~. "., . . ~ ". "'t1O . d 7% State Surcharge '3, - --00:;-''\-:) ~ 10% Administrative Fee ~. 2.. 2- Inspection Request: 726-3769 ~\!t ~\)-/ TOTAL 5'3. '1;""2..-- ,~~ ry Shared Drive(T:)IBuilding FonnsIElectrical Pennit Application I.oJ,doc &.~ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01080 ISSUED: 11117/2004 APPLIED: 08/30/2004 EXPIRES: 05/17/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2289 OLYMPIC ST ASSESSOR'S PARCEL NO.: i703254201400 Springfield TYPE OF WORK: Retail TYPE OF USE: PROJECT DESCRIPTION: Replace three roof-top units with gas-pacs. Add gas service. Alteration Commcrcial Owner: LOUIE JACK H & I 71.015% Address: 27725 ROYAL AVE EUGENE OR 97402 I CONTRACTOR INFORMATION I Contractor Type Elcctrical Mechanical Contractor License CAMPBELL ELECTRIC 73995 USA HEATING & AIR CONDITIONING INC 154663 BUILDING INFORMATION I E:[piration Date OS/24/2008 03/10/2005 Phone 54 I -744-0705 541-942-1401 # of Units: Primary Occupancy Group: Sccondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 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 DEVELOPMENTINFORMATION I REQUIRED PARKING Total: Handicappcd: Compact: Frontyard Setback: on law requ\r~~aytDist: Side I Setback: ATTENTION: Oreg db the Ore~~tr'e\!ill1'tees Rqd: Side 2 Setback: follow rules adopte h:se rules dl\!;vsl!tDlllt'e Rqd: Rcaryard Setba<<<~tificatlon Center. T hrou h 0&'0, ~~otlCoverage: Solar Setbacks: in OAR 952-001-0010 t . g of the rules by _ .. _ ~..... ....ht::l.ln eOOles vu,:,v. .--. ~ ., - ......'.-.....",,,-, calling the center. \N(,~I'PUBLICJMP,ROVEMENTS I b for the Cregon ~.. , Street Improvemetlts':11 er. . _ 1 ;"".3 ;<.23...4). C~f1ter \~ 'o~v - Storm Sewer Available: Special Instruction: Sidewall< Type: Notes: \.:crm:E: Downsp,out~r;ft"ff THE WORK THIS PERM.IT G~~~R ~HIS PERMIT IS NOT AU1H~ERNIZCEEDD OR I'; ABANDONED FOR CO:-'IIVI ' ......~ "'^" nCClnn IV.... ....,.. I Valuation Descriotion , Description Type of Constructi~" $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Datc Calculated Page 1 of3 " . . . CITY OF SPRIN\d<I~LD Building/Combination Permit PERMIT NO: COM2004-0I080 ISSUED: 11/17/2004 APPLIED: 08/30/2004 EXPIRES: 05/17/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 54 I -726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- S10.00 10/28/04 2200400000000001343 + 10% Administrative Fee S4.50 10/28/04 2200400000000001343 + 7% State Surcharge S3.15 10/28/04 2200400000000001343 Appliance Not Listed S27.00 10/28/04 2200400000000001343 Minimum/Adjustment Mechanical S18.00 10/28/04 2200400000000001343 + 10% Administrative Fee $4.60 11/17/04 1200400000000001625 + 7% State Surcharge S3.22 11/17/04 1200400000000001625 Add, Alter, Extend Circ $43.00 11/17/04 1200400000000001625 Add, Alter, Extend Circ Ea Add $3.00 11/17/04 1200400000000001625 Total Amount Paid S1I6.47 I Plan Reviews I Structural Review 09/0112004 09/0112004 APP DLM Engineered design for roof top units submitted - OK dim 9/1/2004 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 Rp*t1 In.n~ Rough Gas: After line is Installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of 001: appliance Including required testing. Presure test done at this point. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Pa2e 2 of3 . . CITY OF SPRINGNIi,LU . Building/Combination Permit PERMIT NO: COM2004-01080 ISSUED: 11117/2004 APPLIED: 08/30/2004 EXPIRES: 05/17/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection 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 perform"d 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 ofthe Communi!;1 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 ti~u~tioCIA 0)1'7/01-/ Owner or Contractors Signatur~ V Date Paee30f3 ./ . 225'f'ifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~ lIIIIIiity of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000001625 Datil: 11/17/2004 2:07:44PM Job/Journal Number COM2004-0 I 080 COM2004-0 1080 COM2004-0 I 080 COM2004-0 I 080 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment CreditCard Paid By GLEN CAMPELL Received By lkw Item Total: Check Number AuthorizatiOlI Batch Number Number How Received Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid 017275 000 I In Person :~ayment Total: $53.82 $53.82 1111712004 Page I of I