HomeMy WebLinkAboutPermit Electrical 2010-2-1
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I DEPARTMENT USE ONLY
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I Date '2 - / - I 0
Electrical Permit Application
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225 Firth Street tSpringfield, OR 97477 .1'11(541)726-3753. FAX(541)726-3689
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This permit is isslled ull~cr OAF- 91S-309-0000. Permits 1ll'CnontnHlsferublc. Permits expire if work' is not started within 180
days ofissllllllce 01' if work is suspended for 180 days." ,
I LOCAL GOVERNMENT APPROVAL I FEE SCHEDULE I
I Z~H1il1g approval verified? DYes D No I Number o{inspecliolls PCI' item'() IQty, \ Cost I
I CATEGORY OF CONSTRUCTION en,
I I I ~ I Residential, per unit, service included: I
o Residential D Government t:::'J'Lommercial
I JOB SITE INFORMATION AND LOCATION I I 1,000 sq. f1.orless(4) $ I
I Job site address: 3315 Marcola Rd I \ ~hae~.1~~?ditionaI500 sq. ft. or P5lrtiGn $ 1
1 City: Sprinqfield I State: OR 1 ZIP: ';7'17.31 1 Limitedel1ergy(2) $ I
I Subdivision: J70z..3coO .ILotno,:OI i/7 I I Each mal1Ufllct,ured home or moctular I
I DESCRIPTION OF WORK I dwdling service or feeder (2) S
I Pole Lights I .1 Services,oot' fcedcl's: jusrol/o/ioll, altera/ion, relocalion I
I I 1 200 ,Imps oi.less (2) 1 $ 81.00 $ 81 I
I PROPERTY OWNER I 1 201 to 400 amps (2) $ 95,00 $ I
1 Name: Kingsford I 1401 to 600 "i1PS (2) $158,00 $ I
1 Address: 3315 Marcola Rd 1 160t;0 1,000 mnps (2) $205,00 S I
I I OR 1 I' lOver t,66'O 'llllpS or volts (2) $469,00 $ I
City: SnrinafieldSlate:. ZIP:.
I I 1 1 Reconnect only (2) $ 63.00 $ I
Phone: Fax:
1 E-mail: I I Tempollll v sCI\lcesy*ff'ftIS: IIM/allwwH, ,dlel(!/Um, IdoClllHm \
TIllS 1n$tnll,I;lOn IS being made on lesldent,,1 01 1'a1l1lJ':;sJi];[l', 0119blll~:~il\ 0\1\\\'1 $ 6300 $ I
o\Vne.d by 11ll,;' 01 <-lmembel ofl1~Y Immcd:~lc !(I~~E'fIlJ\;'UN. do )\$dtb\b~~ 111 set ion!, $ 8700 $ I
plopeily IS not Intended fOI sdle, exchange, Ie'll:.;: 1~\Kl'UYeSJ8; ",,,n,,,,~ -9S~-vU ,- I
479540(1) and 479 560(1) 1V ;Ca\.\Ol\cel\\ II. ~11DM I r':Y $12600 $
Slgnatwe NO~M:a 952.00'-10 1\l~~~Wi\~otl\n~iee Se<V"'S al feed", ,"C\lm1 .,bow I
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I CONTRACTOR INSTALLATI 'l'OU",a., V.tl"I'll!l\e~e\lI,,"'"'''' . IOlll"''''''"''!'''''''''';
I Busmessname, Olsson Industria ~l\AQ:;tjl~;~;''e~~~l~J14~~IS\V\thPI''ehaseofaSetVlCeolleedet tee I
,I Addless 1919 Laura Street "u",\)e{..~~t'l! i$ t-iMtl/b'i'an::i,';-"cuH 11 I $ 6001 $ 6 I
I City: Sprinqf ield I State: OR I ZIP: 974"77 I b. Fee tor branch circuits without purchase ora service or' feeder fee: I
I Pirone: 541 747 8460 I Fax: 5~1 Cf47 4846 I I First bmoch e;lcuit(2) I I $ 55001 $ I
1 E-mail: I I Each additional branch circuit';.- ;:. $ 6.~O $
I CCB license nD.: 63473 I BCD license no.: 2 0- 241 ell Miscellaneous fees: ,~er"ic" or/eerier /.10/ im:/llded I
\ Signillg supervisor's license no.: 33348 ] Each PUll!P or irrigation circle (2) $ 63,00 $ I
I PrintlHlI11C of signing supervisor: DOUiji Heer I Each sign or outline lighting (2) $ 63.00 S I
I Si,gn<lturc of signing supervisor: /f 1 /.. ot""'7~ I Signal cirelli I or lIlimilcd-encrgy poncl. S 63.00 $ I
--"" 1-../;.. 'VI /' nltenltion, or extension (2)
/ I ~nch additional iIlSpCC~~,(I) $ I
I _"",'Mp.plileA'NTUSE I
. (A) Eotet slIbtalal ofaJop'f~WOR" "
N01\eE. . M I i I II , P\~G'\t$~~~ie. MOi,
1\-1\5 I'ERM\ 2TtI~Gh~~~~;~R .,'-',
l\\)ll10R12E1 J ~~~~\~I'1'A]) - '
COMI'AE\-\vl\f ,~ nnd SlIlChlUges (A lluolIgh c),
I\\-\'{ ~ COO D,;;Y-? -
Total
cost
$134.00
$ 25,00
$ 32,00
$ 63.00
$58.00
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'40.258'.J (9~CO,*
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$ 87
$10,44
$ lf~1
$ ~4-J--
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00135
ISSUED: 02/01/2010
APPLIED: 02/0112010
EXPIRES: 08/01/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3315 MARCOLA RD
ASSESSOR'S PARCH NO.: 1702300001917
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJEc:T DESCRIPTION: Pole lights
Owner: KINGSFORD MANUFACTURING CO
Address: PO BOX 24305 A TTN TAX DEPT
OAKLAND CA 94623
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,_ _ I C,ONTRACTOR INFORMATION.
Contractor'Type -' -Contractor License
Electrical OLSSON INDUSTRIAL El"I:/J;:~'~ 63473
AmtmON: Olegoo ':~~tMNA)RMATlON I
toIlOW rules adopte!.wJ:Nrer.:rr"AY. _'1 f\
, -"'on Center. IIIOS ",lI.C,i.no1.
# of UllItS: 1'10\11\...... ,001..Q010thlOUghl<Jll1'''101 ~. by ,
Primary Occupancy fAe~ 952 BY obtain copiesntl!(Dt' eucture
Secondary Occupan<$09a.u~ m center. (Note: .t~t ~ tllI5n
Primary Constr;uction ~ ': the Olegon U\II~~ ~~ ype:
Secondary constructi~cenler \8 t-80Q-332-RI}t~!'Type:
# of Bedrooms: Energy Path:
Sprinkled Building: n/a
I DEVELOPMENTlNFORMATlON I
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Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
Ii Streei Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Com'mercial
Expiration Date
01/261201 I
Phone
541-747-8460
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS.ly,,~;'if~,,:f1i~,,;;,,;".f,;,.:,
~Oi\C~~ ' l~'~\'\"t \f1\4i~~~~yte: ,
1\-1\S PERMI'T S,","; I:.l\ 1\\15 \'E~9'~~!f:!prains:
01\-10\\121:.0 UNtl ~B~~OO~Et) ,.,..",;:'0r
~~~~:~~~~ ~~i~OD. _,','r'~": ' ,
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I V ~Iuation Descriotion I
Description
Tvpe of Coustruction
$ Per Sq Ft
or mnltiplier
Square Footage.
or Bid Amonnt
;lv'i
Page 1 of 2
:.J'.
Value
Date Calculated
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CITY OF ~rKll'lLrl'lJ',LD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2010-00135
ISSUED: 02/01/2010
APPLIED: 02/01/2010
EXPIRES: 08/01/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe~~ P~i~ I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
Total Amounf Paid
$10.44
$4.35
$6.00
$81.00"
$101.79
2/1/10
2/1/10
2/1/10
2/1/10
1201000000000000090
1201000000000000090
1201000000000000090
1201000000000000090
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 R,eollired Insnections .
Rough Electric: Prior to Cover
Electric Service: Approval require~ prior to utility company energizing service.
Final Eleetric: When all electrical work is complete.
By signature, I state and agree, that I have carefully ex~mineil the completed application and do hereby certify that all
information hereon is true and correct, and I furtherte'rtify that any and all work performed shall be done in aceordallce with
the Ordinances of the City of Springlield 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 of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are iu 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.
Owner or Contractors Signature
Date
Page 2 of2
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth.Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM20 I 0-00 135
COM20 I 0-00 135
COM20 I 0-00 135
COM2010-00135
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
1201000000000000090
Date: 02/01/2010
1 :23:57PM
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
81.00
6,00
10.44
4,35
$101.79
Item Total:
Check Number Authorization
Paid By Rec~ived By Batch Number Number How'Received
OLSSON INDUSTRIAL ELEC djb 006381 In Person
Payment Total:
Amount Paid
$101.79
$101.79
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Page I of I
2/1/2010