HomeMy WebLinkAboutPermit Electrical 2005-5-18
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(S41)7Zl>-3753 . FAX: (54ill26-;t689
ELECTRICAL PERMIT APPLlCArrON CRyj?;( 07)5 -DO'=' 7 s
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Servlce Included.s)~ ~.o Q'~..
.,~" 61~. ~
1000 sq. ft. or less -"r.. SIIl6.",lt.. <
Each additionel 500 ftlf1t~TIOI.!' Or . ""o:=~
portion thereof ,-;'.,\;, ~ 9~UI",io' ~U to
. fall_OW rules ~uc '. tli Oregon Utility
ElICh Manufact.d HQ1!1<l.9/illon Center.' ule re set forth
FM~lar Dwelhn~emff g!)2-001-001O I 1\' ftQ Q<:"-M1_
. eeu<r 0090. Yo . s ""
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200 Amps orless Centf" ,~ . ~Q~-3~344}
201 Amps to 400 Amps S 75.00 .
401 Amps 10 600 Amps 5125.00
601 Amps to 1000 Amps S 163.00
Over 1000 AmpsIVolts 5375.00
Rcconn,* ()nJy __ $ 50.00
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Imbtlbti.n;Alkr!l.!i1'\';"[,~I~tIO"IS ?E:Hf.,1! IS ,/1,(
200~~I;;'.ieSi) DAY Pt:R/~ f\BAYUtJ{\Ho'P~1 ,/i!:$ 0
201 Amps 10400 Amps liJD. $ 69.00"
401 Amps to 600 Amp' 5100.00
Over 600 Amps or 1000 Volts See "BOO above.
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05/18105 MON 08:21 FAX 5417283889
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City Job Number
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LEGAL DESCRIPTION
/7-()Z-~O
JOB DESCRIPTION
0/936
?#A..</2.ctA.
~&74r,o-u
Permits are non-transrerable and czpire If work ill
;- not .tarted wilhin 180 day> or Issuance or if work is
Suspended for 180 days.
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EleclriC3l Contraetol
~l3
Addreso
/00/ 1-14 II'; Sflleer
City ~r:Lb
Phone 7tJY-:::$708
Supervisor License Number
Expimlion Date
Constr. Conti'. Number
Expiration Dale
Signal\lre of Supervising Electrician
Owner.lName ,*,€/vt;Sr-IIZU tII-./dY &:t
Addnss /001 J4!-</h() .5/
City ~~21 Phone 7<1C/-3708
OWNER INST ALLA nON
The instalJation is being m.ade on ,...... _.~ I own wbicb
is not intended for sale. lease or ",.t.
own~.' ture:
L_,~. .........I
Inspection Request: 726-3769
CITY OF SPRINGFIELD
~002
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Dille
ov
New Alte.-atioD or Extensinn Per Panel
One Circuit
Each Additional Circuit or with
Service 0.- Feeder Permit
543.00
S 3.00
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Pump or iniga!ion $ 50.00
Sign/Outline Lighting 5 SO.OO
Limited EnergylResidtntial $ 25.00
Limited Energy/Commercial S 45.00
Minimum Eleetrle Pennit Inspection Fee io $45.00 + Surcharges
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7% S1.8te Surcharge
10"10 Admiilisll'8tive Fe.
.TOTAL
SIwod Dmoc(T:)lBullding FomuI_lricoJ pcnn/t ^ppllCllllon I.oJ.doc
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
. CITY OF ~t'Klr~l..1<U,LD
Building/Combination Permit
PERMIT NO: COM2005-00573
ISSUED: 05/16/2005
APPLIED: 05/16/2005
EXPIRES: 11/16/2005
VALUE:
SITE ADDRESS: 2820 Olympic St
ASSESSOR'S PARCEL NO.: 1702300001936
Springfield TYPE OF WORK: Electrical Work Ollly
TYPE OF USE: use initials
ATTENTION.
lo/lr)\" ...,_ . Orenon /",,, ._
NOliliCation-c ~uupfed by the O~'"'''' YOu to
In OAR 952-0 enter. ThOse rul regon Utility
oo_~~:. You ma~l~~~~;~ t~rough ~A~~q~e;~~rth
-"'''':III/e c . -,..."" Uf lh 1
JO.. ent,,. (N e rUles b
'CONTRACTORINPORMAmlQN_1 ate: the teleph y
. , !JOn Un one
,",ent~r is 1-800_i':Q:':~~~tiliCBtion
License ~J!n Date- Phone
PROJECT DESCRIPTION: Marcola Substation
Commercial
Owner:
Address:
SPRINGFIELD UTITLITY BOARD
1001 MAIN STREET
SPRINGFIELD OR 97477
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer A vaUable:
Special Instruction:
Notes:
Description
Tvpe of Construction
BUILDING INFORMATION I
# of Stories: Lot Size:
Height or Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water:Typ.e)~':~: Sq Ft Basement:
RangeiW~e:r'I:KiI'.IT SHALL EXPIRE l~qt..!fI1J,a,~"KCarport
Energy ~ath:,~ lLD UNDI:R T S Sq F\.Other:
S . 1iI\I'O"Udl I' nI HI PE:o"", ''''tfi!JT d
pnn L~II'II~,cI\N~~n nR Ie; A~!lWlml~f1u~~nD a:
, DEVELOPMENT INFORMATIONJI
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
Downspoutsffirains:
I Valuation Descriotion I
S Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
.
. CITY OF ~rKll~l..t<l~LU;
Building/Combination Permit
PERMIT NO: COM2005-00573
ISSUED: 05/16/2005
APPLIED: 05/16/2005
EXPIRES: 11/16/2005
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
Fp.p.~ tlWU
Fee DescrIption
+ 10% Administrative Fee
+ 7% State Surcharge
Temp Power 200 amps or less
Amount Paid
S5.00
S3.50
S50.00
Date Paid
5/16/05
5/16/05
5/16/05
Receipt Number
2200500000000000586
2200500000000000586
2200500000000000586
Total Amount Paid
S58.50
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.
L.Rp.nlJirp.rlln~
Temporary Electric: Approval required prior to Utility Company energizing pole.
By signature, I state and agree, that I bave carefully examined the completed application and do hereby certify tbat all
information bereon Is true and correct, and I further certify that any and all work performed shall be done In accordance with
the Ordinances of tbe City of Springfield and the Laws of tbe 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 furtber certify that only contractors and employees wbo 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 tbe approved set of plans will remain on the site at all
times during construction.
~ "Ildj J liJuJJDvJ
B ~ / (p --CJ"J
Owner or Contractors Signature
Date
Paee 2 of2
225 Fifth Street
~
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00573
COM2005-00573
COM2005-00573
Payments:
Type of Payment
CreditCard
5/16/2005
.
RECEIPT #:
~
WiL.
..kity of Springfield Official Receipt
.evelopment Services Department
Public Works Department
2200500000000000586
DescrIption
Temp Power 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
SANDRA WESTON/SUB
Date: 05/16/2005
Item Total:
Check Number Authorization
Received By Batch Number Number How ReceIved
njm 080486 In Persoll
Payment Total:
Page 1 of1
9:59:14AM
Amount Due
50.00
3.50
5.00
S58.50
Amount Paid
S58.50
S58.50