HomeMy WebLinkAboutPermit Electrical 2010-3-2
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH,(541)726.3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION
City Job Number C:ln. \ ~ ~
LEGAL DESCRIPTION:
\,n33 teA \ ()~
JOB DESCRIPTION: 1000 sq. ft. or less
C ~ '^. _ Each additional 500 sq ft or
~ ~ "'t' portIOn thereof
. a ~;;) e~~~ \ Each Manufact'd Home or
not started within 180 days of issuance or if work ~~odular Dwellmg Service or
Suspended for 180 days. Feeder
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~rv In~on Request: 726-3769 ~ IV' ~O
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Electrical ContraOflfGDid FI ~rrr:i!f. SERVICE
P.O. BOX 2237
Address E'::S~~E, OR 97492
City
Phone 541-141-1681
Supervisor License Number
13925
E.-.;piration Dale
10-1-10
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Offte'1!"cOriti' Number C 4 ~ {H\fijf0~l
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1HISrl?~!Ml(\ al"tlOEE\ 'nUS PERMO rOR
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Owners Name ~~(0
Address 2...'SOC\. ~
City ~f--~\.
Phone
OWNER INSTALLATION
The installation is being made on property lawn which
is not intended for sale, lease or rent.
Owners Signature:
Date
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A, t''N'ewiRisi4ei1\jaL~'Si,~ gl~'o";l\1ultFF anli1y:p~r:d)YeJliiig unit.;;',,:
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Service Included
$117.00
$ 21.00
$55.00
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$ ~i 6\~
$ 83.00
$138.00
$180.00
!).. ~O A.l!A ;ci:>
$ 55.00
200 Amps or less
20 1 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
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C %Te'mp"'o'rar'y;Services'or'Feooers'~0"4\,\:",.,i'i",r--.~",~WJ:<.:,f.t'{ll ~!,:r~'::~:~~'~. ~:.~..
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Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 1 Amps to 600 Amps
Over 600
D.
$ 55.00
$ 76.00
$1 10.00
"1 fl!m\l3tf~~!lont8ll1"lIli\,*IltM\l!ll.to .
foIlOVf'l'\i1eStadopted by the Oregon Util\$ 48.00
Not~lIlIr6cemsrclRUlflll'rrwl~ ar.. ..et 10 lc>.~ EA.
In OAA1le~.aQ1~U9hO~-= ~ CZD
oo:;\~~~Is~~~W~;-P!1C!~''<a)&~in/i~;i~ilation
nuriiD8flortheOregonUtjrdY~0tiIil!iUl. '-" <.'.
Pum,GeFJ\elall\,~-800-332.2344). $ 55.00
Sign/Outline Lighting $ 55.00
Limited EnergyfResidential $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is S50.00 + Surcharges
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I.;( ~ State Surcharge
10% Administrative Fee
5% Technology Fee
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Shared Drive(T:)/Building Forms/Electrical Permit Application 7-0i.doc
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00123
ISSUED: 03/02/2010
APPLIED: 0112912010
EXPIRES: 09/02/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2509 MAIN ST
ASSESSOR'S PARCEL NO.: 1703364102300
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
PROJECT DESCRIPTION: New Electrical Service and Sander Motor Control Center
Industrial
Owner: ROSBORO LUMBER CO
Address: PO BOX 20
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor License
OREGON ELECTRIC SERVICE 181997
BUILDING INFORMA nON ~
Expiration Date
05/09/2010
Phone
541-343-1681
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type Water Type:
Secondary Construction Type: R'3'~ge'TYije:
.' 'Energjepath:
HAll EXPiRE IF THE WOOmed:Building
AUTHORIZED UNDER
COMMENCED OR IS ABAND
Front yard ~lb'bcl~O DAY PERIOD.
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Bedro"tfbTICf::
Lot Size:
Sq Ftl st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
. Oregon law requIres you to
opted by the Ot~IBtll~ ARKING
. Notification Center. Those rUJel!~set forth
Overlay DlSt: In^ OAR 952-001-0010 through 0, '52-oq1~
# Street Trees RqillO. You may obtain copies YiJl6B~
Paved Drive Rqd:calling the center. (Note: lh~fc5i1e
% of Lot Coverag~mber for the Oregon Utility Notification
, Center is 1-800-332-2344).
I PUBLIC IMPROVEMENTS....
PMENT INF
Street Improvements:
Storm Sewer Available:
SpeciaI'Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I V aJua~ion D~s.cription I
Description
Type of Construction
$ Per 'Sq' Ft .
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 3
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00123
ISSUED: 03/0212010
APPLIED: 01/2912010
EXPIRES: 09/0212010
. VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
54] -726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~l
Fee Description
+ ]2% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 1000 amps/volts
Perm Serv/Fdr 200 amps or less
Plan Review Electrical (25%)
Amount Paid
Date Paid
Receipt Number
$132.36
$55.]5
$84.00
$938.00
$81.00
$275.75
3/2/10
3/2/10
3/2/]0
3/2/10
3/2/10
3/2/]0
320]000000000000070
320]000000000000070
320]000000000000070
320]000000000000070
320]000000000000070
320]000000000000070
Total Amount Paid
$] ,566.26
I Plan Reviews I
Initial Review 01/29/2010 01/29/2010 APP LLH
Electrical Plan Review 02/]7/2010 02/1712010 10 BAR Started plan review.
Electrical Plan Review 02/]8/2010 02/] 8/20 I 0 10 BAR
Electrical Plan Review 01/29/2010 03/01/20 I 0 APP BAR
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To Request an inspection call the 24 hour re~rirdingat 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.
l..-P-eollired.Jnsnections ~
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
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" Paee 2 of3
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00123
ISSUED: 03/02/2010
APPLIED: 01/29/2010
EXPIRES: 09/02/2010
VALUE:
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 of the Community Services Division, Bnilding 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 theproperty, and the approved set of plans will remain on the site at all
times during construction. " ".-1
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Owner or Contractors Signature
.~ ~
Paee 3 of 3
Date
if-j
City of Springfield Official Receipt
. Development Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
Date: 03/02/2010
9:43:03AM
3201000000000000070
Job/Journal Number
COM20 I 0-00 i23
COM20 I 0-00 i23
COM20 I 0-00 123
COM2010-00123
COM2010-00123
COM20 1 0-00 123
Payments:
Type of Payment
CreditCard
cReceint 1
Description
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or iess
Perm Serv/Fdr 1000 amps/voits
Add, Alter, Extend Circ Ea Add
Plan Review Electrical (25%)
+ 12% State Surcharge
Amount Due
55.i5
81.00
938.00
84.00
275.75
132.36
$] ,566.26
Paid By
OR ELECTRIC SERVICE
Item Total:
Check Number Authorization
Rec~ived By Batch Number Number How Received
Amount Paid
002902 By Mail
Payment Total:
$1,566.26
$] ,566.26
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