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Home My WebLink AboutPermit Electrical 2006-5-5 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COttA 2.00' - 6oS"'Z. 7 Date S' - 5 -c b 1. LOCATIONQFINSTALIA110N c> <L I z.h IN (J e,., t 5. S7 3. COMPLETEIfE~SCHEDULEBELOW LEGAL DESCRIPTION e.-ow - 1M'=- S Ie- JOB DESCRIPTION ~~4t\ Strviu:r ~ t~r Mv,j'7 Permits are non-transferable and expire if work is S.s "'- not started within 180 days of issuance or if work is Suspended for 180 days. A. New Resid~~tial- Single or Multi..Familyper, dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 2. CONTRAct(XRil\l~TALLATfQNt(Jfli}If B. servic~"o~t~~d.~rS + InstaJlation;AIterati6ns or Relocation: Electrical Contractor }E. C. ~mY.Jt1,rry / It)J()C0200 Amps or less I $ 63.00 bJ .I) 'f 201 Amps to 400 Amps $ 75.00 Address ro/3~ ~;)..,5 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconn.ect Only $ 50.00 Expiration Date City tfJlxU'y" Oil Phone Sl{ 1- 9 ~-1.(:J.t( 9? s p.i Supervisor License Number :3 &.&'1$ lO/t/()7 , I ~~-ISC /0/-1,/0 ( "-1:.("".:<"-: :>:::~-"",:'~'./--,'~"f';':':, _ ",:".": 1,:,_,-.-,: C. Tel1lporiit~S:eJi'j{~~/or ~~e~~r~': J,'f;., ,--,~ r-" J., '" '" ", ! I Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. Signature of Supervising Electrician IV 0 ' D. Branch Circuits ./7 \ . /J Il I? /) C\ T:!/?;~'~: New ~lte~ation or Extension Per Panel ~( ~:;..$J1'!i1Ii OneClrcUlt $43.00 C:v I: I vii ir '; ,'Ba:~I...~d,ditional Circuit or with I 3 'L /. i f.,j E ^ I f' ~ (J U~'Me 6XI%'~er J:>ennit $ 3.00 /iN'o/ .. ~ l~uL-D C'[ ,~f: hilt:' IJ Ir T;Jr I'll : ", /, 1" "t[t). .nf~ C/t-f'l raL .s I de 'rFi.r (yli'SciJIa~p.us (srivv;ee/'cteoer not included) -Each Installation , /'1/1 'D ./( I!II/:O ' t ' 6 V", I') City sfJr-U..,..::rw7 tJ"'-. Phone $"05 - 7 Z - Pum~ or irrigation c. ,-f,' $ 50.00 Z S5 z.. Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Constr. Contr. Number $ 50.00 $ 69.00 $100.00 Expiration Date Owners Name D ~"., Address 3.s-~ OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owne" Signa",,~ III ~ l-)Cl31 ~ <6 L~~ 01-IS 8% State Surcharge 10% Administrative Fee bb 525 6'0 77~ 4. SUBTOTAL OF ABOVE Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application] -06,doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00527 ISSUED: 05/09/2006 APPLIED: 05/05/2006 EXPIRES: 11/09/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: OR126 WB at MP5.59 ASSESSOR'S PARCEL NO.: ROW-TRAFC-SIG Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Install service for advisory sign on OR126 WB at MP 5.59 Public Owner: ODOT Address: 355 CAPITOL ST NE SALEM OR 97301 Phone Number: 503-726-2552 Contractor Type Electrical Contractor E C COMPANY I CONTRACTOR INFORM A TION I '", License Expiration Date Phone h. c..;.,A?737. , 01/1512008 ";._ 503-224-3511 ~f;', . ,-', I, _,' -II I' ," '- .<::. - - '- \~' I BUILDING INFORMA Tl0N .~ C$r"l~:i~/; - i/;. (,. - '&1("," "00/ Y:)l; t, " '/1 I{", / c (J0'l \; qr, / u.., , 0 '-'(9 1/(9 ~I: (; , 0,0;:.-,'01. O. 6) S il!;! # of Stories: 'tJ/(9i' Oi(9 'l"wot'Size:, '-111 n (9t 1.0 )/ IS go 'C"</ ~/!.L "'8,., 'iIA Height of Structure /'ao. 'tJ e~' Ffc-1st Flopr: "00 '/ Type of Heat: V\J>~[f'ltt/3irds~~0~i:s 6 /, Water Type: sq'),F.$- ~ils~(.~~'~ )/ Range Type: Sq Ft'i!;arag~(<\1rport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I NOr/r.E:. . I~v%ray. Dlst: ,.qU~St~~ees Rqd: COtt1.cF€I,l;9r-iveS'R'q~:/ .4/Vy ~f&tbd~tJtfre:fJ(P/R[ 180 DAv h~R /S jj:~/S Pf:~ IHE WI"l I PUBLIC IMP~6\fE.NmNt~rNiD": /S N~~ rOR Sidewalk Type: Downspouts/Drains: REQUIRED PARKING 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 Pa2e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00527 ISSUED: 05/09/2006 APPLIED: 05/05/2006 EXPIRES: 11/09/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $6.60 5/9/06 1200600000000000620 $5.28 5/9/06 1200600000000000620 $3.00 5/9/06 1200600000000000620 $63.00 5/9/06 1200600000000000620 Total Amount Paid $77.88 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Insoections I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. 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 Pa2e 2 of 2 225 Fifth Street Springfield,oQregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00527 COM2006-00527 COM2006-00527 COM2006-00527 Payments: Type of Payment CreditCard cReceint I RECEIPT #: r" , of Springfield Official Receipt ... ,elopment Services Department Public Works Department 1200600000000000620 Date: 05/09/2006 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By EC COMPANY PERMITS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 009783 In Person Payment Total: Page 1 of I 11:40:32AM Amount Due 63.00 3.00 5.28 6.60 $77.88 Amount Paid $77.88 $77 .88 5/9/2006