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Home My WebLink AboutPermit Electrical 2004-4-16 .,~ CITY OF si _.:INGFIELD, OREGON ;" ~ . ~ - ... . jecl as submitted has th , 1/ ' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (~r\lfl!~1Iges not require specific la~dO owmg app(oval. use ELECTRICAL PERMIT APPLICATION z . .1 ,. --0 LI DOing "t7r City Job Number CQWlZOOL( -OOLfZ '7 Date C;;I./ (.:> ~I Date "r-/~~ 0 <f.. \~.& lG~CA16(::7~IA1~o; (:;;-5 I. qOMP~~TE)FeE~~~~~f1~T..' . , c;1ul . LEGAL DESCRIPTION A. I~e>i' ~esideptial - ~i~gle or M.ulti-F!lmliy Jler dwelling nll,it. i _I /7 () 23 CJC) 0 02-(03 Service Included qB DESCRIPTION 1- 1000 sq. ft. or less (' , .~ n '-' c::: ) . }jach additional 500 sq. ft_ or I ~.i VGVJ~I Y'-RrrrJJT I.. Ji),?p(;)nnOrliOnthereOf Permits are non-transferable and expire ~ work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder Over 600 Amps or 1000 Volts see "B" above. I ' ';" ,""- -i'V:. -..''''~''''.''- ,- -,. ~" n_ "', . .- . '. .,1 D. ~:.B,rn~~I}~~I'~uifS;.'~:;I:~.;,.r::.,:~ ~..;..,;;'.~;',~,"'" ',:'.', ,,_r: . }.'...., '1 . "rcAQUlltl"yv-.t New A1teration-or(.Extenslon year. paJlPln Utili y c:;t<.IT\U\"~v, >T the re\jo ,1SiJ \:;lrCltlt adopted by \ ~ ~"" "l;It5lQ3\001) lij\iclW\'i,llifri~aV;:i:f!iif'orJWllh'U c_ :,~ 952-00 ~_ "aIlWictl.,&rF~ea,,rP.eonit throUgh OI1.tf utt~.90 , " CI'i2-001-VV , -, ., 'es 0111'" ' ,,~c _ '_ ~nnl . 'rr ~~a&(Ji.~~s~~~de;til,;'tt~( ~~~~~a'eh.'"s1:iJlatio~ 1 calling \.. e on u\iI, P\'f&!Wi,j)nljllli~~,~~ ~",,,,_~"?_?:'l44). $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INST ALLA nON Limited EnergylResidential $ 25.00 The Installation is be~I'l'l'!\P_eproperty I oLt~i* If 1I-1E 'tJfU~ EnergylCommercial $ 45.00 IS not mtended for sali~~~~1'\'Wl\1 S\-I"'L~ 1 \-lIS PE~li\"iMb~~ectric Permit Inspection Fee is $45.00 + Surcharges 1110R\1.EO UNOE '''OONEO ~~. . ~'~ ". ',. -, .. " . , .., "I 7 - Owners Signature' ",U MMENCEO OR IS (>.~"" :r. r.~r;,p.T.q-r.~}i)1f1!f.O.v;f.:. -;' H.: '.: ,. '.' ) ~~'{ '\80 O{>.'t PERIOD. 7% State Surcharge )7 \' 10% Administrative Fee / / , !~ (;;ONTRACFO'k INSTAi,iAiJ6N ONLY I 2. E......l.::.'.: '. ~t "~I'.,."'" .......(. . ,.," ". '.,' .'..A...... ~ ..::1.J Electrical Contractor Address Burrell Bros. Eiectric 40159 Booth Kelly Road Springfield, Oregon 97478 ~~-:L..~L..~ City Supervisor License Number '""'-~'-, q... Expiration Date \'=:> \'=:>~ Constr. Contr. Number '\?;::,V "~ \ '.-..D Expiration Date ~\n~. Signature of Supervising Electrician _o\nk\U>) \)\~l) Owners Name !-hw ~rf .:J:vc Address 273"3 12wc^-,-,,"Al c.:... Lr' City c-'^bc7tfe-- Phone inspection Request: 726-3769 $106.00 $ 19.00 $50.00 B. [&~r~i,c~~'~r~Fee.de~s :".t~st~II~liO!I, Aii~fatiol;s orj~~.':aii~~:>j 200 Amps or less I $ 63.00 & 2) ,- 20 I Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNoIts $375.00 Reconnect Only $ 50.00 c. r:'1'~mpoi:.rY.S;'rvjceS:i\r Feeller. '.; .....:'-:/.';'.: -.:'; '.'; 1 .T Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 TOTAL 7)-0 7) 87- Shared Drive(T:)lBuilding FormslElectrical Permit Application 1..()3.doc -rr.:;- ~- . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00429 ISSUED: 04/15/2004 APPLIED: 04/15/2004 EXPIRES: 10/15/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line SITE ADDRESS: 3661 Olympic ASSESSOR'S PARCEL NO.: 1702300002103 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Sub panel and 4 circuits for unit E Owner: HOWAN INC Address: 2783 RIVERW ALK LOOP EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BURRELL BROS ENTERPRISES INC License 136446 Expiration Date 08/20/2005 Phone 541-747-2724 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Oeeupaney Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Fioor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surfaee Area: SETBACKS I DEVELOPMENT INFORMATION I . ATTENTION:Oregon law reqwERFjQU.~D PARKING Overlay Q~l)W rules adopted by the Dreglf~t~I~lhty . # Street."1;~""(!R"il:n Center. Those rules aWa\\9Iehoprtped: 't,,~~T -.. - DAD-a,,? n Paved qri'(5.J.m~52-001-001 0 thro~9~ 'c:omp.iid:' "''''''''' v~, may obtain copll~s'Of the rules l % of Lo,,"overa!;~: t I h calling the center. (Note: the e ~~ o~e _. ._'-__'M tho nrAoon Utilitv Notification I PUBLIC IMPROVEMENTS'''-;~ 1_ilM_<\<\<'_2344). Sidewalk Type: Fronlyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Sctbacks: Street Improvements: Storm Sewer AvaOp@f:ICE: Speciai InstructioqHIS PERMIT SHALL EXPIRE IF THE WORK Notes: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ,,,,, IOU UI-II rtl1IUU. I Valuation Descriotion I DownspoutslDralns: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 -u....:--'. ~ . . CITY OF ~rKll~loFIELD Building/Combination Permit PERMIT NO: COM2004-00429 ISSUED: 04/15/2004 APPLIED: 04/15/2004 EXPIRES: 10/15/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fr.~~ tiW!J Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Cire Ea Add Perm ServlFdr 200 amps or iess Amount Paid Date Paid Receipt Number $7.50 $5.25 $12.00 $63.00 4115/04 4/15/04 4115104 4/15/04 1200400000000000487 1200400000000000487 1200400000000000487 1200400000000000487 Totai Amount Paid $87.75 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.R..mJlr"1 Insn..~tJluuJ 1 Rough Electric: Prior to Cover 2 Eiectrie 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 eorrect, 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 descrihed herein, and that NO OCCUPANCY will be made ofany structure without permission of the Community Services Division, Building Safety. I further certify that only contraetors and employees who are in compliance with ORS 701.005 will be used on this projeet. 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 eard is loeated 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 . ~ ~. JijjJy of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000000487 Date: 04/15/2004 11:00:09AM Job/Journal Number COM2004-00429 COM2004-00429 COM2004-00429 COM2004-00429 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 63.00 12.00 5.25 7.50 $87.75 Amount Paid Check BURRELL BROS djb 3471 In Person Payment Total: $87.75 $87.75 4/15/2004 Page I of I