HomeMy WebLinkAboutPermit Electrical 2010-4-23
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INITIALS
DATE
SOURCE
3.
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number Q. \0 .:JD \
ATTENTlOrmQmm9b\lWIQM1"k~r&ftftation
fUllow VUlelCll!t~1 the Oregon HtV $ 55.00
GIlotlllcatlon ,l'1t'if.' liliJle8 are II8t foriSil
Cl'I OAR 952 -d6'I1/ItWI6~AR 952.0010 $ 76.00
C09O. You nlI1Yobtu1AlOOjfI1I~O rules b17 $11 0.00
M1llngth~..""B" above. .
~"{Qrn~':'R~..;.."~tSi,?:;tjjj':'1ii'~.:.;,,jl::':~:e.~":~i0~;.'t.... :;'3.'.
uVnlUl'&lU~amO(l, .~. ',,~'1t,...... ~qe44"''',d".,"0JE.;t'-''')iL1ki~'~' ."'~JI!'~gib;-"';;,.,,,,~
. "..':
.Pump orjrrigation. $ 55.00
II- .;;:1:.,,' ','::
Sign/Outli?e Lighting $ 55.00
Limited EnergylResidential $ 28.00
, ",. TO....;
The installation is being made on property I pwn which . 'Limited EnergyiCommercial $ 50.00
is not intended for sale, lease or rent. \J1,a/) Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
,,\GO ~t''''~''5''''.''''"'''ib1A;_,''''0;;0~'",.$Th..:.~'03fii;::.c'''$,ri,"~4tll'l.~+fY;'f""'4'\"'<""'" 'j '"""'\,.&, )
Owners Signature: ~ ~ JJ' \",' 4. ';-srm'l'O'l'AE'OF7tBOVE1il'l'!z.:.':!';';"':j'.'':':" I \ V'
',\..) "'" -""'~":,:t'---'--'k;if;;;;;;:;,~-}'-'~'-''W'~-'-~;';;;;;:4ei;J~~.)>,:;;;t,~~",,, ...' .,c..! .
('\ \. \ 12% stite Surcharge
b-&' NOYlC~~ .I~% AdministT<itive1Fee,A!i'/i)'" '.
THIS PERMrrs\fJ{tt~'FTHEWORK :.
AUTHOR'ZE~THIS PERMIT is NO~,~, . ~
COMMENCED OR IS~1lA1ImQIl!~f.liliFqImslElectrical Permit Application I-08.doc
ANY 180 DAY PERIOD; . ..
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LEGAL DESCRIPTION:
L~D3~~'?fl. Olo4.t'V
JOB DESCRIPTION:
~~r~\f:'::,e~:~~~~
not started within 180 days of issuance or if work is
Suspended for 180 days.
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2.
Electrical Contractor
/7hRUTfJ,u Pk
g~
Address &t!J.
c;-o '! Lj
Phone 9G -0 ()~ 7
,
City ~b..-" tJt:'
Supervisor License Number I ~ 17 < ~
Expiration Date jC) .- / - De
.~ Constr. Contr. Number / I tb 3;) 9
~ Expiration Date /(~~ /_ Df?
dj' Signature of supe~iSing Electrician
OWNER INSTALLATION
. .~~
Inspecti~~e?b~~ '16-3769
b(.~
Date
A. ~~~~~!~_~~r~:il~T~il~j~~M:!!It~E~milY:~~~,~,f~~~fljrig"'unit
Sen-ice Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$21.00
$55.00
B.
200 Amps or less
20 I Amps to 400 Amps
. 40 I Amps to 600 Amps .
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
\
8\.rP
$~
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
c.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or F~eder Permit
$ 48.00
E.
lope)
. ,
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-0050I
ISSUED: 04/23/2010
APPLIED: 04/23/2010
EXPIRES: 10/23/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 102 SA ST
ASSESSOR'S PARCEL NO.: 1703353206400
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Public
PROJECT DESCRIPTION: Lighting for City Sign
Owner:
Address:
CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD OR 97477
Phone Number: 541-726-3753
I CONTRACTOR INFORMA nON .
Contractor Type
Electrical
Contractor License
THORNTON ELECTRIC INC 116329
BUILDING INFORMATION I
Expiration Date
08/21/2010
Phone
541-686-4151
# 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:
Rillige Type:
E'!ierg{Pafh':
Sprinkled' Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION .
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Description
Type of Construction
I V aluat~on Description I
$ Per Sq\Ft'.:.:"' ::';' Square Footage
or multiplier ,,' or Bid Amount
Value
Date Calculated
. "i"."
Pa2e 1 of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00501
ISSUED: 04/23/2010
APPLIED: 04/2312010
EXPIRES: 10/23/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Une
Total Value of Project
Fees Paid _
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter; Extend Circ Ea Add
,Perm Serv/Fdr 200 amps or less
Amount Paid
$ 1 0.44:,' ,.
$4.35"
$6.00
$81.00
/,
Date Paid
Receipt Numher
4/23/10
4/23/10
4/23/10
4123/10
2201000000000000398
2201000000000000398
2201000000000000398
2201000000000000398
Total Amount Paid
$101.79
Plan Reviews ~
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.
l Reouired Insoections ~
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is coniplete. "
',.Ij. .'.
By signature, 1 state and agree, that I have carefullr~x~mined the completed application and do hereby certify that all
information hereon is true and correct, and I furthe;' certify that any and all work performed shall be done in accordauce 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, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will he 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 cons-truction.
Owner or Contractors Signature
Date
, ,
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Paee 2 of 2
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aj:QF;~
1Itr.",
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 'Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
Date: 04/23/2010
12:16:28PM
2201000000000000398
Job/Journal Number
COM20 10-0050 I
COM20 I 0-0050 I
COM20 I 0-0050 I
COM20 I 0-0050 I
Payments:
Type of Payment
CreditCard
cReceintl
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
. '.
Paid By
ROCKY THORNTON
Item Total:
Check Number Authorization
Recei~ed By Batch Number Number How Received
IIh 413251 Phone
Payment Total:
$101.79
$101.79
Amount Paid
lih
lllJ
'P,age J of 1
4/23/20 I 0
04/23/10 FRI 12:32 FAX 5417263689
CITY OF SPRINGFIELD
i4J 001
*********************
*** TX REPORT ***
***************.*****
TRANSMISSION OK
TX/RX NO
CONNECTION TEL
CONNECTION ID
ST. TIME
USAGE T
PGS. SENT
RESULT
1845
95416864151
THORNTON ELECTRI
04/23 12:31
01'24
2
OK
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number Q.. ~\) . ~")\
1
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EJeetriealConfraaor 77/e;RUm A.J !?ik 200 Amps or less l $~ B\.cP
20 I Amps to 400 Amps $ 83.00
Address 1Z:t!J. S~ c;;p ~Jj401Ampst0600Amps $Jl8'00
601 Amps to 1000 Amps $1 0.00
City t;::i:e0-o AJr Phone ~~ ~(!) ()~ 7 Over 1000 AmpsIVolts $413.00
""'" 0 C R;:::~:~::~~~.i"1!"~r,I~III~~~jl*'~'!"'''J!J!lffill''~I;I~:~1:,;::%1!;r~i!.lin:"i,e~"1JI!liffi
Supervisor License Number r J-./ / 7 ~) . ~~Hl~~~b'!tr.l~~~1~!:~~:!iiiW~Jfmili.~~U::~~$~1TI~~dbr.~_~Ug.E!!fui;j~~~:~~
AmNTlOrm~1iHMII'B%reMt-tion
:d:w~::~~~r~I~~~::etfo% I $ 5.00
1II0AR952~6Q1S1t~M952.co1. I $ 6.00
009111. 'I'OUm11Ya\ltalllto_~fllMll3bJf. I $1 0.00
=t,~.~'fr ' '1;.;~f~tll"~I~~i![,,'I;:~,gillilli'lill'ill';'1i?"Jw,~rnilllf~~Jiiiii
dl~it!Ii~ ll' ,)' j~~~,~!.lmi!t(dh~:::'!i%ll' E~t ij:~..:G~,Jh!illllii~~~lli!lHlli:
New Alteration or Extension Per Pancl
One Circuit $ 8.00
Each Additional CiTCUit or with 'I 10 C) tJ
Serv:i,e~ Or Feeder Permit ----1J, $ ~ ~ .
'~m:ir.P"~~~~:l::t!iii"I;:mim..iltii~~~~mllre:;;r:l"~;i'~;;r.:??lffi~itl~i'!".'9~!lr[!'[1n.""~!rn(!m';'l';~.:!\ll\3-.."%i'Jl!~I;)
!m'::''''''''-'''''OZ;'i':;:1~~1\l!f'''''''''''''i''~ljJl.j\iii1''''.~';:21''l\!!!l"'
1. ~k~~ti~h~h~_i~t~:~~I~~~~~J~_~~!
tD'2 <:n-. !;,h A ~t;
LEGAL DESCRIPTION:
LQD3~~;Q D~l~
Perml are non-tra sfenIbl. and expire if war is
Dot started within] 80 days of issuance or jf work is
Suspended for 180 days.
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'i.GI~;':;~',"'-.:'''lT..'. l" i01l:llfi,",,,"""......;t. " J ,..,,,,:,.,,."",,1,111 I" ;\;';\.B~l";;"" ~!. ~ii'~''''''', ,II ~ ~. ."';'-.''.;.''.'
~;'" <' .'.i'." ';' 1,,, II . .,.!'I!lJ/j',.. ',;""" -".~ '. ' 'r', " ,'~, 1;11.
2. fd~~!l!tit,~Ju;;~~tl!t~~~mui~;~.~~:liJ;l\i~.!Iliili~:l?~j(fji;.;:~:;r~ll'" tlliIltJ
Expiration Date /0..- i - D g:
Consfr. Contr. Number 1/ h 3,;;)" 9
.
Expiration Dale ,.f.J- /_ DR
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Signature of Supervising Electrician
Owners N
1\ " ...
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ZON
INITIALS
, DATE
. SOURCE
Date
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$117.00
$ 21.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$55.00