HomeMy WebLinkAboutPermit Electrical 2010-5-6
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.' Electrical Permit Application
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225 Fifth Street+Spriogfield, OR 97477+PH(54I)726-l753+FAX(541)726-3689
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Permit no.:
Date: s-f,- 10
Tbis permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180
days of issuance or if work is snspended for 180 days.
",'.. (OCAI.': GOVERNMENT' APPROVAL
Zoning approval verified? 0 Yes 0 No
" CATEGORY OF:' CONSTRUCTION
o Residential I 0 Government I Commercial
JOB SITE INFORMATION, AND lOCATION ' "
Jobsiteaddress:3,3""'\S 1- ~ ~
City: c...r:.vl..M.l! .t~.dA I State: O~ I Z[P:Q7<tT,
Reference:c...I.."t.,v""'--'.. ~'vI,1 TaxlotJ~r\ OA.
. ",", , DESCRIPTION OF WORK '
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'. . PROPERTY OWNER' "
Name:-.;;. ,I.. _ .OO - ~ ~.
Address:~"_- ~. ~I.~ ~v+
City:\M.a..v,a,':~ I State: ~ I ZIP:"&rLA:"2.-
Phone: 7LJ'7:. .~- I rv..,1 Fax: . .
E.mail:~ ., . NH.'.... ~- ,. ..
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale. exchange, lease, or rent. OAR
479.540(1) and 479.560(1). '
Signature:
':/ - CONTRACTOR INSTALLATION ,', ' '
Businessname:y,.....,,,. C'MI. ,'r <,,;~,^- '-..D.
Address:~\1 _ ~ . U ~ ~~->
City:" . ~ I State::r:A I ZIP:~~"'\4-
Phone:ZL)';t.. '-:u1<>z~~2.-1 Fax: ~-~,_- .. .
E.mail:'5Lr>iL' -,..d:;!,. 19 Ve.....<..rD. ~
CCBlicenseno.: ,Q1;O'" I BCDlicenseno.:':l.7-:l\!CL5
Signing supervisor's license no.: , ; th1 -5;<;
Print name of signing supervisor: €oJ'!~, r" I. ',1.
Signature of signing supervisor: ~ h_ --:r ,%/
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N OTI CE:..'....,,,.,"',.'<1:,,%W., <.
THIS PERMIT SHALL EXPIRE IF THE WORK ~ ~ T
AUTHORIZED UNDER THIS PERMIT IS NOTVn
COMMENCED OR IS ABANDONED FOR r\t(.\:\V
ANY 180 DAY PERIOD. " '," :";VJ ~t
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" ""FEE SCHEDULE' '
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Number:ofinspections'-p'er-iteni fr . Qty.
Cosl,
ea;:
,
, Total
cost
Residential, per unit, sen'ice included:
1,000 sq. ft or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
401 to 600 amps (2)
601 to 1,000 amps (2)
..
$ 81.00
$ 95.00
$158.00
$205.00
$469.00
$ 63.00
$
$
$
$
$
$
Over [,000 amps or volts (2)
Reconnect only (2)
Temporary services or feeders: jnsta/la~
200 amps or less (2)..- ~'Il t9 !hIe
201 t0400amJlAHW. O~~~d~'l_~'; ~e!.
401 to aUVet. ...~". \'$t.i
Over6~ , ~j.~
e/ocation
~ ._$
8$
ve
Brane ~
a Fee fo
~a f
Ice or feeder fee:
Each hranc l\\et $ 6,00 I $
b. Fee for branch CirCUIts without purchase of a service or feeder fee:
First branch circuit (2) .
Each additional branch circuit
$ .55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
/
$ 63.00
$ 63.00
$ 63.00
$
$-53
$
$
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy paneL
alteration, or extension (2)
Each additional inspection: (I)
:',~ "y'::;< .6;PpLICANT USE ., ~
$58.00
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(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(8) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of [A])
TOTAL fees and surcharges (A throngb C):
$ L""?...
$7$0
$ '3f~-
$73~
CITY OF SPRINGFIELD
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Building/Combination Permit
PERMIT NO: COM2010-00573
ISSUED: 05/06/2010
APPLIED: 05/06/2010
EXPIRES: 11/06/2010
VALUE:
:,n;o.:::'i ,'\~,.,"~
Status
Iss u ed
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3375 GATEWAY ST
ASSESSOR'S PARCEL NO.: 1703222000901
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
Commercial
PROJECT DESCRIPTION: Sign electrical only
Owner: JACKSONS FOOD STORES INC
Address: 3450 COMMERCIAL CRT
MERIDIAN ID 83642
I CONTRACTOR INFORMATION ,
Contractor Type
Electrical
Contractor
YESCO LLC
.:;li" ,\ ", ,. License
',"":-," .'T':,', 188015'
BuiiDINGiNFORMA TION ~
Expiration Date
09/14/2011
Phone
801-464-4600
# 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:
Range Type:
Energy Path:
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 ~
Front yard Setback:
Side I'Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOTICE: . Sidewalk Type:
THIS PERMIT SHALC:EXPIRE'lF THE WORK
AUTHORIZED UNDEFFtHIS'PERMIT is NOT-'DmATIE~WB~t&r:egon law requires you.to
C." - :.~.. follow rules adopted by the Oregon Utility
OMMENCED OR l~rABANDONED FOR ",,,,.,, Notification Center. Thoserulesaresetfort
ANY 180 DAY PERIOD..,. ,: -,.,.,~\,. In OAR 952-001-0010 through OAR 952.Q01
. lesb
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
I PUBLIC IMPROVEMENTS ~
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Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Dale Calculated'
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Pa~e I of 2
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00573
ISSUED: 05/06/2010
APPLIED: 05/06/2010
EXPIRES: 11106/2010
VALUE:
Status
Issued
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Total Value of Project
Fees Paid .
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sign - Outline Lighting Each
Amount Paid
Date Paid
Receipt Number
$7,56
$3.15
$63,00
5/6/10
5/6/10
5/6/10
2201000000000000469
2201000000000000469
2201000000000000469
Total Amount Paid
$73,71
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, insp,ection's requested after 7:00 a.m. will be made the following
work day. ' .
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Reouired InsDec~
Sign Electrical: After connection is made but prior to energizing.
By signature, I state and agree, tbat I bave 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 St~te.of Oregon pertaining to the work described herein, and
tbat NO OCCUPANCY will be made of any structure without permission ofthe Community Services Division, Building 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 tbat all required inspections are requested at the proper time, that each add"ess is readable from tbe
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 Contraetors Signatnre
Date
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Page 2 of 2
225 Fifth Street
, .
Sprmgfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000469
Date: 05/06/2010
10:02:09AM
Job/Journal Number
COM20 I 0-00573
COM2010-00573
COM20 1 0-00573
Payments:
Type of Payment
Check
cReceintl
Description
Sign - Outline Lighting Each
+ 12% State Surcharge
+ 50/, Technology Fee
Paid By
YOUNG ELECTRIC SIGN CO
.., 'V' ;, .~. Check Number
Re:ceived' B; .:' . Batch Number
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Page 1 of I
Item Total:
Authorization
Number How Received
Amount Due
63.00
7.56
3,15
$73.71
Amount Paid
3949
$73.71
$73.71
In Person
Payment Total:
5/6/2010