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HomeMy WebLinkAboutPermit Electrical 2010-5-6 , .' Electrical Permit Application . ~ - -= ""@IT-Y~6FSPRINGFIEiLDi" ORE(j0N~ - - . - - , .: - - - ~ - - ~" 225 Fifth Street+Spriogfield, OR 97477+PH(54I)726-l753+FAX(541)726-3689 BP,A:,GF:LD -iJ, L~-- L21.. ~ ',;'f~., .", "._ . "".....0 "" , ^ iDEPARTMENT USE:ONL Y' o. , . ., _,. ~. , COwl rolO -0 o57~ 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 ' ~- .~.L.. \.[ o"'-e.,. b\ ~ ~~ CG<..b......d- ""\u lA, ~ ti.l!J'-I' ... t>,/\D'^- t."St>La<-Y '. . 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 ,%/ ~ , / " ...,,e._','..:'_.....,,). """, -.~ . 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 -"~"-~~-Y '" " ""FEE SCHEDULE' ' , - ~., - . - ~ . ,. '- 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 ',."0' . (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 ;i~~"t1' :, ,. 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 ,:",.. \. 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 ~ : '.~:.::;' '-.:;';hiJ1~'i;'<;l~lN-?;';'~~~~-""'"' Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Dale Calculated' '\ ' ,~; Pa~e I of 2 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,1" .;lh. <.. , " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00573 ISSUED: 05/06/2010 APPLIED: 05/06/2010 EXPIRES: 11106/2010 VALUE: Status Issued ,', ~~. '0(' ;" .,z-~::,'H 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. ' . '" '. ,_~ 'i' 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 .,--'.) ., . ~l ~~ n t ',';l:'c . \', "," 1_,' ,_ ;.i('ri':.; , 'I' ''''';'~' :;; Page 2 of 2 225 Fifth Street , . Sprmgfield, Oregon 97477 541-726-3759 Phone wr~RI;~Q~I!!l.O '. ,'i"', ,~" 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 . ", ,I " ,,;..l., ~~4T ;"~"?-0. . " "djb .:' i~, I:, \ ,_........,... .. , " , ~~.Y" > ': j" .: ,; ., ,..f).,." ".0 t ,.' :~ . , ;~ I, . ~~f;'" '~'"';'I',.~;~f " : t f :~'-..v\: ,. '1'~-' ,~} t 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