HomeMy WebLinkAboutPermit Electrical 2010-6-8
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EleCtrical Permit Application
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DEPARTMENT USE 'bl'lL Y
COW\~'O.007]~
Permit no.:
225 Fifth Street. Springfield, OR 97477.PH(541)726-3753+FAX(541)726-3689
. LOCAL GOVERNMENT APPROVAL .. FEE SCHEDULE
Zoning approval verified? DYes DNo NUQlbcr of inspections per. iteQl:(): Qty, Cost Total
" CATEGORY OF CONSTRUCTION . ea. cost
Residential, per unit, service included:
o Residential 1 ~r Government I 0 Commercial
1,000 sq. ft. or less (4)
'JOB. SITE INFORMATION AND LOCATION $134.00 $
Job site address:' 780 7 P,i^~, FJJ. ~ Each additional 500 sq. ft.. or portion $ 25.00 $
thereof
City: So,",. l--<"k'; ~ 1 d State: OR . ~' ZIP: Limited energy (2) $ 32,00 $
Reference: -.) I Taxlol.: Each manufactured home or modular
...,'.: :,DESCRIPTIONOF; WORK dwelling service or feeder (2) $ 63,00 $
.
l: ""T' p' P..< \("J"~ Eui Services or feeders: installation, alteration, relocation
~ 1\t' '1 ,,",C'" Q--n I \:II ..... -':~......
.~ "<5'\ <..~"J -\,"" .\h., Jp ~ ~1" L.. I.J"", '^ 200 amps or less (2) $ 81,00 $
. PROI"EFtTY.OWNERV J 201 to 400 amps (2) $ 95.00 $
Name: l<lnQ C'ov....t... 401 to 600 amps (2) $158.00 $
Address: 3a '\ () f\oA"\! b ~ 1t<l hi w'" 601 to 1,000 amps (2) $205.00 $
City: 'E.' l, Q 1I .....t. State: () fl" ZIP:<ti' Qo-3 Over 1,000 amps or volts (2) $469.00 $
Phone{5'\.\~ -l,&2..-b ~ "1'1 I Fax:(s4-1 ) - G15Z, ~O I Reconnect only (2) $ 63,00 $
E-mail: 1::>",,, ~ \3 \ <> '^J ..... Temporary sen-ices or feeders: insta!!ation, alteration, relocation
,"i,i_'~oo' ~~~, 00"''',"'''. ,.. "00"" .. ~ "'00 ,
owned b~ me or a member of my immediate family. This III (Ill bv tha-;J.- .,oJ, 011 il 700
property IS not mtended for sale, exchange, lease, or rent. OAR In ~ $ 8 . $
479.540(1) and 479.560(1). ~! ose",I~;ef26'00 $
Signature: ~ ;J . dieTS section above
'. . CONTRACTOR INSTALLATION - ~ rn~: 1fII!.wiJl<riki IiIIIes> ane!
Business name: C\. p T" ~'" C rt ~ I;: 1 ,,~t r" L '.~ ee .., crvice or feeder ree:
Address: \S 't 6 c..~ ~ S'1l5L Each br~cli ClrCLl1t~"2344)~' l- $ 6.00 $
City: .5 ~ \ c ...... State: ()~ ZIP: ~'l3()<. b. Fee for branch circuits without purchase of a service or feeder fee:
Phone:{s<:.3 ).S66...$i. \\0 I Fax{s<J3).Se9-2..tjCLS First branch 'circuit (2) . I $ 55.00 $S'?:
E-mail: ich" ....,:~'n B ('l t'., r: t ~ "1e,,t'r; ( ["'''' Each additional branch circuit . $ 6.00 $
CCB license no.: q 166~ I BCDlicen~eno.:'3Y-~z.OC Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: \8~~'..s Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: \(~ h n...tl W \ ~ \1-"... Each sign or outline lighting (2) $ 63.00 $
Signature of signing supervisor: 1< ~ w'1J ,- Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
APPLICANT USE
~~~J NOTICE: (A) Entcrsub~ot~!.?,t~~?,ve rees $S3~
THIS PERMITSH~58'00) Q,
!\9~# W AUTHORllED UNO rn AJ) $ b?b-
COMMENCED ORI~ I ~'f[Il( -
.n.:
A Y 180 DAY PER TAL fe"';~'ii3' s'ul"c\:arges (A through C): $'0;<,0
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00733
ISSUED: 06/08/2010
APPLIED: 06/08/2010
EXPIRES: 12/08/2010
VALUE:
Status
Issued
';;
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
J
,
SITE ADDRESS: 1807 PIONEER PARKWAY EAST Springfield TYPE OF WORK: Electrical Work Only
ASSESSOR'S PARCEL NO.: 1703262302402
!':'-<c. ....c.,. , TYPE OF USE: New
""0'1"", "'.,.." .
PROJECT DESCRIPTION: Lighting on PioneerP~rkway East from Q st to Hayden Bridge Way
~ "-'I, ,T..!" ,
Owner: KRC PIONEER PLAZA LLC
Address: . 3333 NEW HYDE PARK RD
NEW HYDE PARK NY 11042
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor License
MORROW MEADOWS CORP 91668
I BUlLDiNGIN'F()RMATlON i
. __ . r 08 law requires yon .to
r':BIIIOIii smE!.~Y the Oregon Utility
, ,.,!ow nJles. %~t 'tI1'mi!!~OIe8 are set10Ith
; : otiHcatlOn \lP6oi1Ml'i!llugh OAR 952-001-
in OAR 952- IMta~pies 01 the rules bf
0090. YoU IlrytKQte: the telephone
calling th IWfc>tilld1l Utility NotiftcatlOft
numberci~ri\ijfinl<~)' n/a
I DEVELOPMENT INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
" ~ "
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Public
Expiration Date
07/20/2011
Phone
503-399- 7609
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
. : Sidewalk Type:
',.... '-' :.:>;<t"'~7i};'i::W;~:..;.':;,"',-- .
~~rl~E~M#S~AlC~~IRE1F~HE YfORKspoutslDrains:
AUTHORIZED UNDER THIS PERMIT IS NOT.
COMMENCED OR IS ABANDONED FOR '.
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
$ Per Sq Ft .
or multiplier
Square Footage
or Bid Amount
.,,".~;...,,"'" "'.4',' ,...-" 'u, . ,.
,:{i'i"t ~?::':'
1,.'
~:,. 'r.i~! > .
Paee I of 2
Value
Date Calculated
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00733
ISSUED: 06/08/2010
APPLIED: 06/08/2010
EXPIRES: 12/08/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,
Total Value of Project
L Fees Paid J
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Minim'um/Adjustment Electrical
Amount Paid
Date Paid
Receipt Number
"'I:"t'
6/8/10
6/8/10
6/8/10
6/8/10
1201000000000000618
1201000000000000618
1201000000000000618
1201000000000000618
Total Amount Paid
$6.96
$2.90.," :
$55.00;?;
$3.00, .,~
$67.86 "
"':';':'1"""..,;',
. ,',
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. ' ,
Reouired Insnections I
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, I state and agree, that 1 have carefully ex~mined the completed application and do hereby certify that all
information hereon is true and correct, and I further.~~rtify t~,~t ~ny"an'd 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 structi;,,~ '~ithoi,t permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who :ire in compliance with ORS 701.005 will be nsed on this project.
I further agree to ensnre 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
Paee 2 01'2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.::;.;
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000618
Date: 06/08/2010
1O:39:03AM
Job/Journal Number
COM20 1 0-00733
COM20 1 0-00733
COM20 1 0-00733
COM20 10-00733
Payments:
Type of Payment
Check
Change
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MORROW MEADOWS
. MORROW MEADOWS
Check Number
R~c,ei~ed B~ rB~t~h Number
'd'b
,J.
(jjb
22497
Item Total:
Authorization
Number How Received
Amount Due
55.00
3.00
6.96
2.90
$67.86
Amount Paid
In Person
In Person
Payment Total:
$68.20
($0.34)
$67.86
Job/Journal Number
COM2010-00733
COM2010-00733
COM2010-00733
COM2010-00733
Payments:
Type of Payment
Check
Change
cReceil1tl
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MORROW MEADOWS
MORROW MEADOWS
~ifJ~j~7 '~~'i~7~~( :,:
"'''-r~' ?', Check Number
Re?~~~ed Bf':~., Batch Number
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Page I of I
22497
Item Total:
Authorization
Number
Amount Due
55.00
3.00
6.96
2.90
$67.86
How Received
Amount Paid
In Person
In Person
Payment Total:
$68.20
($0.34)
$67.86
6/8/20 I 0