HomeMy WebLinkAboutPermit Electrical 2007-6-25
SPRINGFIELD
ZON eU
INITIALS N(\I'-
DATE (p -'.)..<0 ,>-01
SOURCE ('()~
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION 0,
City Job Number COvVt z...co 7-00 9 S I
JOB DESCRIPTION: 1000 sq. ft. or less $106.00
La _ Eac~1l~lPoo\lIdPg~8rf'cBV requires you ta
~ ILLvU W.tu.,SIt.A/ IJAII'7I$UII-It>"bhlnWh1IetMfd pted by the Oregon llrillty $ 19.00
fallow ru as a 0 '.
Permits are n.on~transferable ~nd expire i~work i~ Nc tlR~e~ffiI.oriIi~QlSe rules are 5:.,t .1~rth
not started wIthm 180 days oftssuance or If work IS in ~W 5~W~1]@~tAAI9(lgh OAR 9::.>2_-~~1$50.00
Suspended for 180 days. OOl&; OU ma obtain copies ollll\; I ulv,", 'JY
2. B. ctS
numBer
Electrical Contractor es.,.,4 6/ftJN ,fNb AcuUWI:t-200 AmiGteft1~sis 1-800-3322344).
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
1.
?1oet UA'lAJ $r.
LEGAL DESCRIPTION:
/70L33l{(
03/00
Address
I:J..IO O/h!.. PMUI- 1'1>
City Iat~€
Phone ~5~
Supervisor License Number '7 (J '76 ) C;-
iO/vi
t
Constr. Contr. Number lIb? '11 0
Expiration Date
Expiration Date
~I(P'"
Sign~~.,~~-""
4:~~~.-
"
Owners Name W C(Lc-vt bcr Cc:> H l;
Address 2 g { ( {.;; . 'So t-
City {--LA tL t 1L A, uthone
r 707 _ l{4 S- -760 (
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners SignaturJj , A-
Inspection Request: 726-3769
b-Z~--o7
Date
3.
A.
Service Included
$ 63.00
$ 75.00
$125,00
$163.00
$375.00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 ol'l 000 ,Volts see "B" above.
$ 50.00
$ 69.00
$100.00
D.
. /: / I . I J ," ,-,_.. 'I 1,.) II Ii '- i C\/-..: -. _
New AlteratIOn or'Exteq~IO:nl'. er; ,Pap.e.I.. '-,', ,-' Ill'.t' -I ~..'E' ".'"
,,'. '. '.J I' IViJ r ,-' - I , VI ('I [) It
One Circuit t. ...,. .J,.. Lti j!'$Ql3,QO, . IUnf\
t..</, .' J I,U l"t"!-.:ri'j--.
Each Additional1<,EJ~cuitor ~ith} I S A 8A hi [, 10 :', I ,/! I 10 NOT
Service or Feeder Permit: I, ,-, '.' :b' 3JJOiEn r:{lD
1 i L) ........' r
E.
Pump or irrigation $ 50.00
Sign/Outline Lighting I $ 50.00 ~ -
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
5l)-
'1--
5-
2~SZ>
ftJ/,J{)
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Drive(T:)IBuilding FormslElectrical Permit Application 8-06.doc
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00939
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/25/2007
12/25/2007
$ 0.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.....\1..
SITE ADDRESS: 5709 MAIN ST Springfield TYPE OF ~~i~~~lectrical Work Only
ASSESSOR'S PARCEL NO.: 1702334103100 y \~ \~ \CO
\:.~\!\V't'<~8~:\Jt~Repair Commercial
PROJECT DESCRIPTION: Relocate wall sign - electrical ,~?Iy ~~\.\. \,(ofo y.,~~\:.~
/\,f-0 'c? , ~\'\ S _ ,(\~~ '" t-,.~\)
\~~"c ~\:.~'~' \) 'V'''- \S 'f....J
\\),,'\". \)~J.-S c.\) \)~ ~\)\),
~\\-':, ~\j'v ~\:.~
~"r". \~\~\~ '" \\ ~
\J-,,-J \'0'"
I CONTRAC1\OR INFORMATION I
Owner:
Address:
MCKENZIE CROSSING L TD
2811 E ST
EUREKA CA 95501
Phone Number: 707-445-9601
Contractor Type
Electrical
Contractor
E S & A SIGN CORP
License
163470
Expiration Date
03/16/2009
Phone
541-485-5546
BUILDING INFORMATION I
# 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 I
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: \0
# Street Trees.&q,djO~\\\\\.~
Paved Drt~~,!~b{\ ~ \0''\0
% g~~~vlrirg~ ~e ;t:\)\)\'
.O'<.eg 0 'O~ ~ ,0Wc:. o.~~ ~S ~ec:. 'O~
N. _\~ _C.e ._ () ,. (\) _
~'\"'~\ J f,TBL1G'<.I ,\.'~oV~~ENJ~ X\O~~~{\
~ '~ ' C ~ v ~\\\C
\0\\0, ?J,\\O{\ \)\)\< 'V\\i\{\ ..\o\e', . '~\ ~O Sidewalk Type:
:\.\\\C S'2: ~ 0\.1 ~ '0\~H' t),t),). ,
~o O~~ ~ 0 '{{\'O- e{\\e'<' Q;O{\ ~7.- ~'?J Downspouts/Drains:
\{\ ('\ --{O ""e C O,<e C\\)''2>
C\~'v', (\ \\, \.'{\e ,~'v
\)'v ~\\W" \0'<" . 'c:. \
c'O- ~e\ 0\e\ '\
{\'V(\I (je
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00939
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/25/2007
12/25/2007
$ 0.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Sign - Outline Lighting Each
Amount Paid
Date Paid
Receipt Number
$5.00
$2.50
$4.00
$50.00
6/25/07
6/25/07
6/25/07
6/25/07
1200700000000000820
1200700000000000820
1200700000000000820
1200700000000000820
Total Amount Paid
$61.50
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 ReQuired Insoections I
Sign Electrical: After connection is made but prior to energizing
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, 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 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
Pal!e 2 of 2
225.F~fth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00939
COM2007-00939
COM2007-00939
COM2007-00939
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Sign - Outline Lighting Each
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
ES & A SIGN AND AWNING
CO
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200700000000000820
Date: 06/25/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 42527 In Person
Payment Total:
Page 1 of 1
1:18:00PM
Amount Due
50.00
2,50
4.00
5.00
$61.50
Amount Paid
$61.50
$61.50
6/25/2007