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Home My WebLink AboutPermit Electrical 2004-8-12 , -";,h<C, .'. ,.",'C. :. "01:',' GFlE'T,;n--;;'''r\~:TI.''''<'''' '"''"''' ,..... J?" '.~"'~~:."".:~- .,...... " "' r- .'T ~::-"" rl.L,.....~ '.r'f'~1"''''''':''j'r. ".-_\!.. ...;,:...L: 'i\~~<:~~"'j~ :.-,..'/ ::~ ~i:~'..:.1 .: I it. i.:,~.~~ ~. -: ~,,: ~~~::.:.?:.~; ,t b";"'~:~'~-". I --:: '-:;~::~:~ \'...: ~:~. ~:G:~ " i\'~'~'~t"~t-" _~:::::1 ~ 0 '- ffi,.--f),l~~~,~th!<~~~-41'~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-~" oq, \~~~)' . i,"':", ':iff! ELECTRICAL PERMIT APPliCATION " o~' <s>" ~~tl~, ',if&\f " . .. ~ ~ Q'Qf"..o City Job Number CDN~,:2..00&-Ooq,?,9.> Date 08. t 'L ~ 0 &.- \,0. '\ ~. "b";s.",, 0"., ,,~;? -?.....?" 1. ~~Bi~7W.~~ 3. ~lili~~L' - mJ,)J:. r:G:~~~~~~ON ~ 2885 Olympic Street JOB DESCRIPTION l A. ..e II (j 2.. ~ 0 00 0 Z 0::> IService Included Retrofit Lighting Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Snspeniied for 180 days. 2. ',~~~'i~~~.' Electrical Contractor Olsson Industrial Elec. Address P.O. Box 70413 City Eugene Phone 97401 Supervisor Ucense Number 33345 Expiration Date 10/01/04 ~~'+- Constr. Contr. Number 63473 '. I ~ .,,,,'\ .' ~'\~;~~ Expiration Date ,01/26/05 !1'<~ !,.~ . <<<:::$ , ~" ~v ~" Signature;Z;fSU . ing ~~~~~~~ //<..' /' ~ SY;-~~<V<(;.J?;<Q~ .-//SiY--~ /~.o.~~ - ~y ~'<.-' ~..z~ ~ tj ~it-' Owners~"Y;-~~~ ~RrA(!' Address 1~''()vo( 1I1AA....,'L C:;f.~f- City$pr/ ~~~JJ Pho~e '7 2GrSO{ ~ . II OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: , Inspection Request: 726-3769 1000 sq. ft. orless Each additional 500 sq. ft. or portion thereof, Each Manufact'd Home or Modular Dwelling Service or Feeder 550.00 B.~~~1Th~~~_ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps . Over 1000 AmpsIVolts RecOimect Only $ 63.00 $ 75.00 $125.00 $163.00 5375.00 5 50.00 c.~m~~~~~~. InstaUation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or I ,,,,,,,,,,"..,..,,,,,,,~~.. .D. . na 'ten e:1Jilui New Alterati,l),~ ~~~~~~ OneC?<' 'Q'\ 0<'''' -s-O ~'S'0 0~'<:' )j},o $43.00 43.00 Eac~~~~~~~S"~ ~...- ~~~~~li~lO!~le~~~~4.0 $ 3.00 120.00 ~~. F . ,".... ..~ ~~'lt1a~;i~:'~ ,rS' Ci C!i ~ 0 0" !ll ,~~ ,,'h-;a~l1Q 0 '" $ 50.00 ~o}:5'::' .Q,G-.^",," ~ ...."" "Sl~utIltte llif,"rp,1: 5 50.00 ~ ~,~ 0~"~ L'ifui~~esidential 525.00 Limite8'Energy/Commercial 5 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4'~~~~3.00 5 50.00 $ 69.00 5100.00 7% State Surcharge 10% Administrative Fee 11.41 16.3Q 190.71 TOTAL Shared Drivc(T:)lBuilding FonnslElectrical Pennit Application 1-ll3.doc ! -lit&~~~:!"'~~ , , , , .. ,', ......, - . . CITY OF ~YKll~~NJj,LU ' Building/Combination Permit PERMIT NO: COM2004-00998 ISSUED: 08/12/2004 APPLIED: 08/12/2004 EXPIRES: 02/12/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2885 OLYMPIC ST ASSESSOR'S PARCEL NO,: 1702300002001 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Retrofit lighting, Owner: KRC ROLLS Address: 2885 OLYMPIC ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OLSSON INDUSTRIAL ELECTRIC License 63473 Expiration Date 01/2612005 Phone 541-747-8460 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: "':\..... ~Eilet/lY Path: '\'?:-~ .sp"iinkled Building: '~I .,,~~ ~ ~~:- , ,"y ~,\<,,.,DEVELOPMENT INFORMATION I :1\O~ '!l.I$:\~ -S,f,:J ~\,),. ~\0<O ~~~~,<REqUIRED PARKING ~ '\'" ~ ~ ~O <00 !:>\;) ... Front yard Setback: ":J'?:-'?'- ~~ ~'?'- Overlay Dist: ~ \0 0\0 ~0 b'lfolllll'l Side 1 Setback: .~. #' \::)~'V f.>'?'-~, # Street Trees Rqd: ~,'I> ~0 ~0<O'l>'ir-~~ ~ltfi~~~&ped: Side 2 Setback: ,~~~ ~<:::> \J~ ~I:S Paved Drive Rqd: ~0C'J,O 0'0-4, r::,0 \.:s '&- 0 ~ ~0 S$f~P'!!.ct. Rearyard Setback~~ {::> <<. ~~\) ';.;~<:::> "" <<.'<; % of Lot Coverage~.O R....0 '\~o ~O.;:;C80'" 0 0 ....~0 is-,(j0' Solar Setbacks: ,,,~ ,y..v:..*~~", <:::>~ . ,:t-'O ~<O 'I>~~,:0~",\;) ~ vO~:<i,.~~ ~o...~. . ",\Y'"" "'- I PUBLIC 1M PRQiiME..lT,S Ir <;::,"Y ~"t>. ~- ~'0' a)"- ~ I' '.',1 RJ ,,0 0\' 0 'J)~ '?'- 'v' 'v. /:>- ~'I>'l ,,"I ,,,Al.....--fl. Street Improvements: o~ S?- ~ ~,. Siilewslk ;':'Yl'e: ~ O'?' --1.0 ~0 .'S'''' ""," ',<:- f?j\;)" >:-C'J, ,Do~gspoutslDrains: \;)<:5 ~' 0\ 0<:- v ~'O CJ <:-.:s Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a Storm Sewer Available: Special Instruction: Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pal!elof2 . . CITY OF ~rKJ1'1ul'l~LD Building/Combination Permit PERMIT NO: COM2004-00998 ISSUED: 08/12/2004 APPLIED: 08/12/2004 EXPIRES: 02/12/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 54\-726-3753 Phone 54\-726-3676 Fax 541-726-3769 Inspection Line I Ff'f'S tiWU Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number S\6.30 SlI.4\ S43.00 S120.00 8/12/04 8/12/04 8/12/04 8/12/04 2200400000000001043 220040000000000\043 2200400000000001043 2200400000000001043 Total Amount Paid S\90.7\ 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. ~f''''ionsl Rough Electric: Prior to Cover 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, L ~ ?//L/t;~ Owner or Contractors Signature Date Pal!e 2 of2 225 Fifth Street Springfield, Oregon 97477 I 541-726-3759 Phone Job/Journal Numher COM2004-00998 COM2004-00998 COM2004-00998 COM2004-00998 Payments: Type of Payment Check 8/12/2004 . RECEIPT #: ."~'~.~I:UI!' ,. .... Ilk' , , . - ! , , . __, _ ~ l Itii1Y of Springfield Official Receipt _elopment Services Department public Works Department 2200400000000001043 Date: 08/12/2004 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By OLSSON INDUSTRIAL ELECTRIC Item Total: Check Number Authorization Received By Batcb Number Number How Received jmp 37980 In Person Payment Total: Page I of I 2:18:2IPM Amount Due 43.00 120.00 11.41 16.30 $190.71 Amount Paid $190.71 $190.71