HomeMy WebLinkAboutPermit Electrical 2010-7-8
Electrical Permit Application
225 Fifth Street. Springfield, OR 97477+PH(541)726-3753' FAX(541)726-3689
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Permit no,;
Dale: 7 - &' - /0
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.
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Zoning approval verified? 0 Yes 0 No
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o Residential I 0 Government l.-Erc'ommercial
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Job site address: ;;;OS'~ I ~ .. '87U..d-
City:<S1) , . \ '.\1 T State: ~ I ZIP: q~ ,i~::j
Subdivision: I ~0'3 27 ( 0 I Lot no,: 02. I G (
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Name: TSl2- """ . I I c...
Address: Lj ::r.... ~. ~
City:S),:, ,i :^~1I TState: Cl~ I ZIP:"!t411'
Phone9{I~14iv<;<\"l-n I Fax:5'1J-=lH 'i:ltJ15
E-mail: Of' ",~.~r",\c,~-=A.J. . (1 \..l ".0, CD"'"
This installadbn is being made oJ'. 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).
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Signature:
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Business name: l:::.~ A .. \I',,,,,, """,,,tV":>
Address: 40bl l.0"l \ ~ ~
City: "7....." l"^,,, I State: CJ7- I ZIP: eft'll).2
Phone:5'II-~'t4: (I\. V I Fax:91l-%S, 'S'VI'\
E-mail: du:"",,( tMI\<>,o.iL;",o S,<..,""""c",""
CCB license no.: 11"1 ~I': I BCD license no.: do--S3ou-S
Signing supervisor's license no.: :J Lf l{ ') i "I
Print name of signing supervisor: ,.eec..\ .c..\ Q~
Signature of signing supervisor: J n 001/ U.Yfr
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440-2584-) (9/08/COM)
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 t,OOO amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) , $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
201 to 400 amps (2)
40 I to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feede~ not included
$ 63,00 $
$ 63.00 $(0:5'
$ 63.00 $
Each pump or irrigation circle (2)
Each sign or outline lighting (2) t
'-".:bnal-drcuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (1)
~
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of [A])
TOTAL fees and surcharges (A through C):
$58.00 $
$/. ()o
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$ 7,51;
$ '2, IS
$(3 ;1-1
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2053 LAURA ST
ASSESSOR'S PARCEL NO.: 1703271002121
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00905
ISSUED: 07/08/2010
APPLIED: 07/08/2010
EXPIRES: 01/08/2011
VALUE: $ 2,150.00
Springfield TYPE OF WORK: Sign
PROJECT DESCRIPTION: Monument sign for C;omtant Gardener
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Owner: TSRS LLC
Address: 2053 LA URA ST
SPRINGFIELD OR 97477
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TYPE OF USE: New
Commercial
I CONTRACTOR INFORMATION ~
Contractor Type
Electrical
Sign
License
161313
161313
BUILDING INFORMATION ~
# of Units: # of Stories:
Primary Occupancy Group: Height of Stritcture
Secondary Occupancy Group: Type of Heat:
Primary Construction Type Water Type:
Secondary Construction Type: Range Type: .0
. ffl:YOU'
# of Bedrooms: 0 gon !fJIIf{gy:\VII . ~i\i\Y
i\.1TEN1\ON: d re .ed "'n~ll'Il\lnrtl\
a op, "T reS
Notilication C - T10N
\ OAP. 952-0 'c .
n " y obtain. ," t lephone
OO~~lii~~~:e~enter. ~~i~~~~tilication
numbedorthe.or~ ~!!l'3l!.~)Rqd:
canter IS 1 aved Drive Rqd:
% of Lot Coverage:
Contractor
IMAGE KING INC
IMAGE KING INC
Front yard Sethack:
Side 1 Sethack:
Side 2 Sethack:
Rearyard Sethack:
Solar Setbacks:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instrnction:
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Notes:
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''''.'"' ..."",. ,.Raee J'of 3
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Expiration Date
09/0112010
09/0112010
Phone
541-484-1482
541-484-1482
n/a
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/Drains:
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NOI\ef-. \1 S\\~\.\. EiJ'\RC tRWI\i \5 NO\l;:
1\1\5 ?E~~E\) UNDER 1\-\\~~OI~cD fOR;:,:.,
1\\.11\10 \) OR IS f>.\)l\d'" .,'
CO\lJ\\IJ\ENCD~'{ PERIOD. ..'
. I\N'{ i 80
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I V ahi~tion Descriotion I
Description
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
2,150.00
Tvpe of Construction
Sign
Use Bid Amount
Total Value of Project
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Fee Description
***+ 100/0 Administrative Fee***
+ 12% State Surcharge
+ 5% Technology Fee
+ 5% Technology Fee
Sign - Outline Lighting Each
Sign 0-35 Square Feet
Sign Plan Review
Amount Pai~~::"''t~
Date Paid
",,,,,.,,,,,,.,
$8.00
$7.56
$3.15
$4.00
$63.00
$80.00
$42.00
7/8/10
7/8/10
7/8/10
7/8/10
7/8/10
7/8110
7/8/10
Total Amount Paid
$207.71
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Shzn Review
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07/08/2010
APP DJB
07/08/2010
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00905
ISSUED: 07/08/2010
APPLIED: 07/08/2010
EXPIRES: 01/08/2011
VALUE: $ 2,150.00
Value
Date Calculated
$2,150.00
$2,150.00
07/08/2010
Receipt Number
1201000000000000805
1201000000000000805
1201000000000000805
1201000000000000805
1201000000000000805
1201000000000000805
1201000000000000805
Mixed Use/ LM1-CC. Placement of
new sign cabinet with electrical.
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, ins{!ections requested after 7:00 a.m. will be made the following
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work day. )~~~;~J~f ;;M;~~~_~\tn:;-",
l...P-e(J.tiii'e1JJl~nections I
Sign Attachment: Method of mounting the sign to a structure or pole. Method of attacbment of bolts or welds.
Sign Electrical: After connection is made but prior to energizing.
Sign Final: After all required inspections are conducted and approved and the sign installation is completed.
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Page 2 of3
CITY OF SPRINGFIELD
Building/Combination Permit
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Issued
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Status
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PERMIT NO: COM2010-00905
ISSUED: 07/08/2010
APPLIED: 07/08/2010
EXPIRES: 01/08/2011
VALUE: $ 2,150.00
225 Fit'th Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 employee.s,,;ho are.In ~iimplhince 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' ofthe property, and the approved set of plans will remain on the site at all
times during construction.
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Owner or Contractors Signature
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Date
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225 Fifth Street
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Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000805
Date: 07/08/2010
10:59:53AM
Job/Journal Number
COM20 1 0-00905
COM20 I 0-00905
COM20 I 0-00905
COM20 I 0-00905
COM20 I 0-00905
COM2010-00905
COM20 1 0-00905
Payments:
Type of Payment
Check
cReceint I
Item Total:
Check Number Authorization
Re.ceived By Batch Number Number How Receivcd
Amount Due
42.00
80,00
4.00
8,00
63,00
7,56
3,15
$207,71
Description
Sign Plan Review
Sign 0-35 Square Feet
+ 5% Technology Fee
***+ 10% Administrative Fee***
Sign - Outline Lighting Each
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
IMAGE KING INC
Amount Paid
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$207,71
$207.71
14814
In Person
Payment Total:
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7/8/2010