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Home My WebLink AboutPermit Electrical 2005-10-18 ,i.\"~ ~o SPR~~ r;"",~:.,.. eO \\\Ci\....- 225 FIFfHSTREET . SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ,i-"\~~ EtECTRlCALPERMITAPPLICATION ' . ' "",,,"~<>.~\<.L.. ' .0~ City Job Number ~O......" -z;.OO r-o I LlS-O Date /0 -(^'it~l7) 0'" I> v' .___~ I. 3[LZ-OoCAT~1..0NOO-ifiN.f)'<ft~TA.{.r=,4L!ioN"",' }-~ 3. r COMl'LEiE'FiiUEDijif;B'j'OW:- L..::;.:. -, .<:FS.o~' 1,.0"- -.- -'- t ~ ~ ~ LEGAL DESCRIPTION i 70 303<( 0 seOI A. L~,e-';'iiiside~!~~ "'-~~~_~,,~~\~fa~li~ ~~~w~Hiii~~i~. ' _! hi,A jJ~ if 1f~~#--,/'6- Service Included ':-~\"o JOB DESCRIPTION 1000 sq. fl or less A( ( I. () Il' / " ---f- Eac~ additional 500 sq. ft. or ~ A> S\A '? ~~ ...,. UI"CJ.A. spomon thereof $ 19.00 _ Permits are non-transferable an expire if work is Each ~fflqjd'~~9n law requires you to ~ not started WI, 'thin 180 days of ~suance or if work ~ MJdbl!,}:!Jwbl1.;jg. ryi<a 9'1 the Oregon Ut:ilt$Y50 00 S d d r 180 d F~"~w rules "u fl, --- Mt Ie: . uspen e or -,--a~~.-,--_ _ ,_.,---, , ,NGUkanolLcenter. T~~:~r~v~:";:-i ';c') C:___. _ '__ 2. ,IC()NTRAcTOR INSTALQ.,TIONONLY I B. 1\I~t.JiYiCeSlOr:Fl!t~l~!~t~o~;~lt~r~tions or R~ocaii~n: .~ . ""), j (. 0090. yocrma (Note' tllet.', 63 Electrical Contractor r ton",.; ~ 1.MwtA -Havl 200 <i!!;ijisl'2flless center. Ut' .. ./ $ 63.00 --:---. . 0 12 . I "lql'J 201 MtpS)tO~~~~~~i~~_33~:~- ,. $ 75.00 Address ~ _ "fC) o.L "" 7, , 401 Amps to'()oo J\inps $125.00 '60 I Amps to 1000 Amps $163.00 Over 1000 AmpsNolls $375.00 Reconnect Only $ 50.00 $106.00 City Vf;~ Phone q ~ "0 . '1 '3 d.. I Supervisor License Number 1./-7 tjo 5 c. I Temporary Services or Feeders . -"---------- ~- - I Expiration Date J(j '. /. 0'7 Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Constr. Contr. Number IS 1-750 q - 10 - ;;200(0 Expiration Date Over 600 Amps or 1000 Volls see "B" above. D. ! Bj-an~hCirc~i;;-=:__ ~:~__~~-_..:..= =-- -- - _.- --- . t-nf~ Owners Name rtt../ /I1dA,~. ~/...LL.l,eJ-af ~. '7 if(p. tfld J New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit if $ 43.00 $ 3.00 la , Address .~~,<) {]/,p",.",io City 5"lM.<ijr:;,:IJ Phone . ----- ----., E. ~ Mis,cella!,-eous (Senice/feeder not included) -Each Install~tiOl'J Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INST ALLA nON Limited EnergylResidential $ 25.00 The installation is being made on property I own wMO;nC~~ Limited l~l"~l\IWAl~O~~ $ 45.00 is not intended for sale, lease or rent. 11115 P~M)'Tr.S.Hllk~8'~aaM,*,Jti.MQ-1 ~ $45.00 + Surcharges AU1110Rlt~OV~~ll..mn~MOR ---l Owners Signature:, COMME:Ny~(!mu!!Uf7IDl'liVE, 7 ) lII'.1 ~~B g~'Ur?l$NQ~.-- - - ,~-- . - - L ~ A 7% State Surcharge ) 10% Administrative Fee 7 )0 f3 7 7, - Inspection Request: 726-3769 TOTAL Shared Drive(T:)IBuilding Forms/Electrical Pennit Application 1.Q3.doc . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01450, ISSUED: 10/14/2005 APPLIED: 10/14/2005 EXPIRES: 04/14/2006 VALUE: . Status: Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3205 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1702303405001 Springfield TYPE OF Electrical Work Only PROJECT DESCRIPTION: Add sub panel and 4 circuits TYPE OF USE: Addition Commercial Total: Handicapped: Compact: ~ '\'t\'t. ~~~\ '!1~ ~(.l'" \~ IPUBLIC IMPROVEMENTS! ~\.\.. ~'t\\~ '\It.~~~ l(\)t' , ..,~"\\V Gv..~~~~%~~ \" co.'?"" .,'~~ . \I(-.\~ I(-.~\>.\" rams ~\)'\~~t.~\~ ~ c,CJ ~ \'OQ, ~~ Owner: FOY MARTIN SHEET METAL Address: % ARDENT SALES CORP 3205 OLYMPIC ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor PROCESS AUTOMATION INC License 151750 ." I BUILDING INFORMATION' ,Iea.v" ,,0\\ V" \0<\'\\ # of Units: 0\\ \~"# of'StOries:se\ r::F:'\' Primary Occupancy Group: ~". olegeo '0'1 HclghtCo'i';; <:l"'?: \)'1 ",,\0" ,,~ ~" \ - ~'" ,~c, Secondary Occupancy ..-<"-~ \ ~oO" ,\'(\O"fYpe'of.Heat: <".., , ~\\~ ~es e~ c:\\\~ .\\\,..... 0("\.... P'rimary Construction Typ" ~ (\l . (je\\~ . \ () \\Waterifype: e?'(\' II Secondary Construction \o\\~'c~\IOII r.,()\-()() \":I~~~ :rrpif:'o\\\'c~\'O II" <;~-v :o'~ ,^,c,. !'o.\ # of Bedrooms: ~O ,,~<:l" a.'! 0 (Iiinergy(r-a~: c.'i' \(\ Or ,!O\l ((\ ce(\\e. Sprliti{led.'2.~C. nla ..."QQ. ~ \'{\e ... ()~I:;.o:J ,.,(\#.j:.>.... , ca.:;~( \{OENELOPMENT INFORMATION I (\\l\" l.'c Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: Street Storm Sewer Available: Special InstructIon: Notes: I Valuation Descriotion I Description $ perSq Ft or multipUer Square Foolllge or Bid Amount Type of Construction I of 2 Expiration Date 09/19/2006 Phone 541-935-9321 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Value Date Calculated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01450 ISSUED: 10/14/2005 APPLIED: 10/14/2005 EXPIRES: 04/14/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspecdon Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm ServlFdr 200 amps or less Amount Paid Date Paid $7.50 55.25 512.00 $63.00 10/14/05 10/14/05 10/14/05 10/14/05 Receipt Number 1200500000000001533 1200500000000001533 1200500000000001533 1200500000000001533 Total Amount $87.75 I Plan Reviews I To Request an inspection caD 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. wiD be made the following work day. ~ Tn.n'iliW&W Rough Electric: Prior to Cover Electric Service: Approval required prior to utIlIty company energizing service. Final Electric: When aU 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 cerdfy 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 wiD be made of any structure without permission of the Community Services DivIsion, Building Safety. I further certify that only contracton 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 dme, 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 wID remain on the site at all dmes during constructiolL Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-:~759 Phone . apJ:~~;~ WiE. Rty of Springfield Official Receipt .veIopment Services Department Public Works Department Jib/Journal Number COM2005-01450 COM2005-0 1450 COM2005-0 1450 . .COM2005-0 1450 Payments: Type of Payment Check .\ ., L '! j 10/14/2005 RECEIPT #: 1200500000000001533 Date: 10/14/2005 DescrIption Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By Received By PROCESS AUTOMATION INC djb I of I Item Total: Check Number Authorization Batch Number Number How Received 2236 In Person Payment Total: 2:28:23PM Amou nt Due 63.00 12.00 5.25 7.50 $87.75 Amount PaId $87.75 $87.75