HomeMy WebLinkAboutPermit Electrical 2010-6-9
Electrical Permit Application
"ciTyJoE '5;PlUNGFIELil-:llIiEGON>;
,;,.~_,&t_t~~. ~r--.' '" i! .;w.: ~'.. ,'_ ~'A:>'"jJh~ " ~ ~ r ,_.~r~.","!f~~cl.i.fi~,~- ...., -=- ~t~~' ~,
225 Fifth Street. Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
. DE.PARTMENT USE ONLY
CO..v\ eDro -0 Ds:d:>
Pennit no.:
Date: (,- 7 -ID
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
E-mail: .~__._Temporaryservicesorfeeders:installation.alteration.relocation
Th" II' . b ' d 'd' I 0 200 amps or less (2) $ $
IS msta atlOn IS emg mae on rest entIa or larm property 63.00
owned b~ me o~ a member of my immediate family, This .,.,...' ~fIIlIlKi0lres you to $ 87.00 $
property IS not mtended for sale, exchange, lease, or reIlom~~'.':\ _.u... the_uregon u,i,i.,
479.540(1) and 479.560(1). follow ru.... ~'H ._~ ._-+h $126.00 $
Signature: ~otIIIcatlon~rOJl.\liI9Sl!'oo'..ervices or feeders section above
. CONTRACTOR INSTAllATION . ::':;'-_;.IrIsV~clIClpllIllQf,tNt~OO,pYxtens;onperpanel
Business name: ~ 1\JM-1'u1~ oeIuno . ,UUI_~chase of a service or feeder fee:
Address: 1(0 d-l~ sft:},L & \\. '" rt .....~~i@44). . $ 6.00 $
City: l ,^ ~ ~ ( I State: ....rr..\ I ZlP: ~cOBl b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: ';;{,u- ~ l[u'd-o I Fax: - - First branch circuit (2) $ 55.00 $
E-mail: Cu~..-v-c.lc.htiJl........-{....ll-{... ,....\.I . G:.,,,,,,- Each additional branch circuit $ 6.00 $
CCB license no.: I BCD license no.: 7lf!6S. '(,- Miscellaneous fees: service or fteder ~ot included
Signing supervisor's license no.: 7 <{ '6 '7. Yr- Each pump or irrigation circle (2) $ 63.00
Print name of signing supervisor: (I ~()'l---. -v-E:.J.u- EaclJ.sign.Q[ outline lighting (2) ($ 63.00
Signature of signing supervisor: ~ "'-V)' k V . - -CIrcuit or a limited-energy panel, $ 63.00 $
...... / _alferation, or extension (2)
v-~\t ~~~~~~~Afttk!l'""!~;j~?~,,,,
NOTICE: v.-\ (Minimum Permit Fee $58.00) $ b 3:
l~~S PERMIT SHALL fXp '{aJ:~~;~~yio/~~urCharge (12 x [AD
COM7JRIZED UNDER TNt I 5% of[AD
ANY 18~~AEyD OR IS ABA surcharges (A through C):
PERIOD. .,' ,
'.LOCAVGOVERIiIMEIiITAPPB,OVAL"+'.,;, ':}
Zoning approval verified? DYes D No
",' '. ,'CATEGORYOFCONSTRUCfION';", '
o Residential I 0 Government l...a-commercial
~~k~~1;'r~,o.!t;:SITEHINFORMMIONfiAlilo;to.CAT:IOIiI;,~!i'i; .,.
Job site address: I 97.0 0 C-VVA~ ( <- .
City: S ? (..;...~ I State: iYL- T ZIP: '7 7<{7 ';
Reference: /7 0 :s z 5L{ 2. I Taxlo\.: 01 bO (
" DESCRIPTION: OF WORK ""t:,:.', .f(;'.
96-N UC-t+rtf'lC-'
PROPERTY OWNER-
Name IA/IIVeo ~o?\ S LLC
Address: ') D <1 c) X s 7 S b
City: ]5015 e- I Stat~.:J:01 ZIP: 8'~70.r
Phone: - - I F~: - -
~Q;)VJt 'Jx.\Q<0 ~'!Y
\.Q.\J) ~.
~
~
440-2584-J (9!08/COM)
;~,_c >',';i:;'i::;q~~i;i~~1tr~h'?F:-:'?'~F5EE:.~SC_H EJ>"LJ [}E~\7i~J;'i.~'if.;tf;:~:,iTiW~~("~~:~{i;l~~~i~~
Number' of inspeeiio'ris per it;m'O Qty. Cost. Total
. . ,'; ..",' ',__ _.""""',.,'-.'-,"'1": . ., .e~. cost
Residential, per unit, service 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) $ 81.00 $
201 to 400 amps (2) $ 95,00 $
401 to 600 amps (2) $158,00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
$
$h~
7S-f,
$
$ S/)
$ 7j?!.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1920 Olympic St
ASSESSOR'S PARCEL NO.: 1703254201601
..
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00516
ISSUED: 04/27/2010
APPLIED: 04/27/2010
EXPIRES: . 12/09/2010
VALUE: $ 9,186.00
,,;\',:')!(~...,~ .~,
Springfi~ld TYPE OF WORK: Sign
TYPE OF USE: New
PROJECT DESCRIPTION: Wall Sign(s) - 2 replacement wall'signs for WinCo .
Commercial
Owner: WINCO FOODS LLC
Address: PO BOX 5756 '
BOISE ID 83705
I CONTRACTOR INFORMATION ~
}., ,.V
Expiration Date
OS/20/2012
OS/20/2012
Contractor Type
Electrical
Sign
Contractor, .,'. ." License
IMAGE NATIONAL INC 66465
IMAGE NATIONAL INer"" . 66465
BUILDING INFORMATION ~
# of Stories:
Height of Structure
Type of Heat:
,. Water Type:
Range Type:
Energy Path:
Sprin~~lrg: n/a
~~'T,"N l
~~cet~~\l\~~~~~~~t\
.u..~oE.,'l..dJ ~~~'O"";:\O~'
..- OpS'- "'.-. e'l :J't"'ft.f.qd:
~. 'IoU \l\e ~ O;e9~ ~~v;rage:
~\\t\9 \ot \l\e \& \. ., .
I PUBLIC IMPROVEMENTS ~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction: ,
;'.';;~.'~
1;:
Notes:
'. "".,
~ ;"1,J::: .'
.: I. '
Phone
208-345-4020
208-287-1963
Lot Size:
, Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
,......:.-;!... .;
Downspouts/Qi~iii~\ '" "
,:,:l'.,':i!.'''''''' "v,,,
",-,-:'I';Y'" "\)\~~v 0\
. j>\V,'t. \t ~~ \~ ~
\\O~\tt.. ~~ s"~\.iif,,\S ~~~'t.t)T\lV,
-<\\\S ?~~"t.t) \j~t) % ~'O~~ . ".,
\ '-<"O?;\,'- "O'f.. \ "
f',\J \ I' r.'f!;C't.v 't.'f..\0t).
, C~~~ 'Oil \)~ ~
,I,"
Pa2e I of 3
, ,~~'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'. :.~~:s~,
,
;~T;J }r:.' , .
,~\f'< l.' i<
I Valuation Descriotion ~
Description
Tvpe of Construction
Use Bid Amount
Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
4,593.00
. 4,593.00
Sil!n
Sil!n
Toial Value of Project
..~
'''l '
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Sign 101-150 Square Feet
Sign 201-300 Square Feet
Sign Plan Review
+ 12% State Surcharge
+ 5% Technology Fee
Sign - Outline Lighting Each
Amount Paid
Date Paid
. $41.00
$20.50
$160.00
$250.00
$84.00..
$7.56'(- ,1','{,;:,
$3.15""',,~ .""..", .
$63.0.0,",,, .
4/27/10
4127/10
4/27/10
4/27/10
4/27/10
6/9/10
6/9/10
6/9/10
Total Amount Paid
$629.21
I Plan Reviews ~
Sil!n Review
04/27/2010
APP DJB
04/27/2010
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00S16
ISSUED: 04/27/2010
APPLIED: 04/27/2010
EXPIRES: 12/09/2010
VALUE: $ 9,186.00
Value
Date Calculated
$4,593.00
$4,593.00
$9,186.00
04/27/2010
04/27/2010
Receipt Number
2201000000000000412
. 2201000000000000412
2201000000000000412
2201000000000000412
2201000000000000412
1201000000000000632
1201000000000000632
]201000000000000632
To Request an inspection caIl the 24 hour recording at, 726-3769. AIl inspections requested before 7:00
a.m. will he made the same working day, inspections requested after 7:00 a.m. will be made the foIlowing
work day. :_' ",:' ,
l..Re{]uire1Jnsnections I
Sign Attachment: Method of mounting the sign to a structure or pole. Method of attachment of bolts or welds.
Sign Final: After all required inspections are conducted and approved and the sign installation is completed.
Sign Electrical: After connection is made but prior to energizing.
'. ~'~.';"" . .:1 ., ~
,'....,;:~/.; '.
'11
Paee 2 01'3
.",
Status
Issued
CITY OF SPRINGFIELD
. Building/Combination Permit
PERMIT NO: COM20IO-00516
ISSUED: 04/27/2010
APPLIED: 04/27/2010
EXPIRES: 12/09/2010
VALUE: $ 9,186.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
By signature, I state aud agree, that I have carefully examined the completed applicatiou and do hereby certify that all
information hereon is true and correct, and I furt~el:,certify t,hat 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 strncture without permission of the Community Services Division, Bnilding Safety.
I further certify that only contractors and employ~~s 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
. ";' '~:'{ , !: f.i ; ) ; l' , .;
s';:,'!.:,-'"
\ ,; :'r~ " . d j
,;.
I': ,,';.'.1.!:
r <"r . "
'.~:\ ,y,! "
; ~ ~ i
.,
j
.. Page 3 of 3
225 Fifth Street
Sprihgfield, Oregon 97477
541-726-3759 Phone
it_I
,..._...,_.~..._.,m
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000~000~0000632
Date: 06/09/2010
9:56:33AM
Job/Journal Number
COM20 1 0-00516
COM20 10-00516
COM20 I 0-00516
Description
Sign - Outline Lighting Each
+ 12% State Surcharge
+ 5% Technology Fee
"..;.,.,;.t .,: J'
Amount Due
63.00
7.56
3.15
$73.71
Payments:
Type of Payment
CreditCard
Paid By
COREY WELCH
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 035768 In Person
Payment Total:
Amount Paid
$73.71
$73.71
. O'
,
.,,'~. "i') ,;.,
" "
cReceintl
Page 1 of 1
6/9/2010