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Home My WebLink AboutPermit Electrical 2004-3-23 ,-'~ .'-;< -." ,-,""C," , "0 - ' ' 'FlE''r.,;:r\'''O'RE '.~ .",.-, ,"'-.-, },t"~".~. ~ -~-' ~.... ,,- ...., . ,<1 . .J.;f.L.J"'" - -, 1 ~ .......,,\. ,.....::,~ ' ::l:~Wg';~"'!'I-7.~?:: :::'-57..~.: . ,: -;..;.,~ ~:: ~~ -_,:!:~~;;~\i.~~~;l:~:~~~ ,:'::-, ~~~:~.;. .::;;~',:'_ .: ..~~ ._! ::.; :\.=::.}~~'~ ~~{"'i'.,:':".n:'t.:'~'" ~~ 225 FIFl'H STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~_~m~~~~a 'iliff~~:~~~i!~ ELECTRICAL PERMIT APPliCATION approval. t ,~^"UMl';,., ~1" , ' CityJObNumbereoo,d()7)L} -L'JO~51.~\ bate 3-19-04 Zoning 'PIc Date '3 -.23. o'f 1. ~~lfI~~1 3, ~~~ti.~m,~~~ 2701 Olympic Street -Sprinqfield 200 Amps or less $ 50.00 ~OTICE:20IAmsto4ooAmPS ' $69.00 I rllS PER~4b1j ~bF6ool~f THE WORK $100.00 , AUTHORIZ~J!~JbtfmT~~ f&fo\}blJ~~0in above.' , X~~~E~~'~~_~J{~ ,- '_... -~, . . New Alteration or EXtension Per Panel One Circuit Each AdditiomII Circuit or with Service or Feeder Pennit LEGAL DESCRIPTION 1-103 ~$' 4-1 JOB DESCRIPTION (X-no 0 T~~t~ll 1Ph~~p ~prvicp toPurno Station 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.'~~~~~~' , ATTENTION:greaon 1~~re(ltum~1 YEt t"t ' ElectrieallContractor "M....I;l.I;lQn_.. !L\J;3.X:L.a. .' ,..~.c nc . .....,V.......II;;i~t,;;,. .1----.-J...---....::1.......'OoJu..~'I ~otification Center. Those rules are set fori Address)AFP~0~-IBox.('10413w" '~h f"IlJ. c a"~ ~::> 0090. You may obtain copies of the ruiesl C. ""m.," 'f' ", 'l"'nterPb'''.'e' i74'" 8460 Ity Sprln5{ ,:re' u ,one. I 'd ' one numoer tor Ihe Oregon Utility Notification - , '. 1 p"n.~~?.2344). , , Supervisor License Number 33345 Expiration Date 10-1~04 Constr. Contr. Number 634n Expuation Date ' 1-26-05 Signature OfS~ing Electrician Ji?L A.. -2---- Owners Name City of Springfield Address 225 ..5th Street City Springfipln Phone 726-3753 , OWNER INSTALLATION The installation is being made on~,v~".J lewn which is not intended for sale, lease or rent Owners Signature: , Inspection Request: 726-3769 A. 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. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps , Over 1000 AmpsIVolts Recoimect Only 3' $ 63.00 189.00 $ 75.00 $125.00 $163.00 $375.00 ' $ 50.00 c.~~~~~~ InstaUation, Alteration or Relocation $ 43.00 Q $ 3.00 27 .~~~"":~_.l\!""~~..,.,"........1i E. "0 _ _~,,~~~ m . .~~~~~,s.9) .- a~c~~~jrQJ' . Pump or irrigation Sign/Outline Lighting Limited EnergylResidentia1 Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimuin Electric Permit Inspection Fee is $45.00 + Surcharges 4..~~. 216.00 '15.12 21.60 252.72 7% State Surcharge 10% Administrative Fee TOTAL Shan:d Drive(T:)IBuilding FonnslEl",trical Pamil Application 1-03,doc . . ::S~37 / ) <S.t-il. ~l/-'1063D1 'Z. 71.) I 0/ '-11l1p1rc ..:;_ .. . . CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2004-00312 ISSUED: 03/2212004 APPLIED: 03/22/2004 EXPIRES: 09/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ^"'T'Tr-,................~. ~ - _... .""', ".'-q....':;I"'IIIUVV 1t::4U1res you to SITE ADDRESS;v rulouUm,9h'B1!.';s ~~A nrp U ., Springfield ASSESSOR'SjRARCEL'NO.: f 1'703254100700.90n tllily '0. .I__..voo ~v,,,or, '"U;:;t:l rUles are set for' n OAR 9"2-001-0010 !hrn,,~h nllQ c-,., 0- PROJEC'!)@ESGRI[JPTION:...instaIl3rdPhaseService,toPumpStation "'v, ,'v IlIUY OuLlIn Copies of the rules i r!:lll.,.," .1....., _...........,~.. u.... .. - --... \' ......... u..... l'ClC'fJ'1UfJ8 Owner: n(!:'it\rJOFJSPRINGF[EIWJtilitv Notifi,.,"tin'J Address: 225 FIFTH.STREET.,' SP,~.N<.c;~~~",? OR 97477 TYPE OF WORK: Electrical Work Only TYPE OF USE: use initials Public Phone Number: 541-726-3753 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OLSSON INDUSTRIAL ELECTRIC License 63473 Expiration Date 01126/2005 Phone 541-747-8460 BUILDING INFORMA nON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport NOTI~~ergy Path: Sq Ft Other: ~~~S~~R~I! SHALL EXPIRE IF THE WORj{'tpervious Surface Area: I Dliy,EL(ip.MENiINFORM-A.i~!O~J~:>RNU I ANY 180 DAY PERIOD. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: REQUIRED PARKING , Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsmrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00312 ISSUED: 03/22/2004 APPLIED: 03/22/2004 EXPIRES: 09/22/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Ff'f'~~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid Receipt Number $21.60 $15.12 $27.00 $189.00 3/22/04 3/22/04 3/22/04 3/22/04 3200400000000000009 3200400000000000009 3200400000000000009 3200400000000000009 Total Amount Paid $252.72 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 Rf'ouired I n~nections I I Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service. 3 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 of any structure without permission ofthe Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be uscd 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 ....,~..",'."",.,..,D..,,.:... ~' "'tii ...._.~~ . Job/Journal Number COM2004-00312 COM2004-00312 COM2004-00312 COM2004-00312 Payments: Type or Payment Check Receipt #: 3200400000000000009 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By OLSSON INDUSTRIAL ELECT Check Number Batch Number Authorization Number Received By njm 36985 City of Springfield Official Receipt- Development Services Department _ Public Works Department Date: 03/22/2004 9:28:44AM if Amount Paid Item Total: 189,00 27,00 15,12 21.60 $Z52.72 How Received In Person Payment Total: Amount Paid $252.72 $252.72- . .