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Home My WebLink AboutPermit Electrical 2010-8-6 '~, Electrical Permit Application I ccum'fCOO~~@~ 225 Fifth Stnd+SpriDgfidd. OR 97477+PH(54I)726-.J753+FAX(S4t)726-J689 DEPARTMENT USE ONLY I~ Permit no.: ~D\ \0 ~\O Tbis pennit is issued under OAR 918-309-0000. Pennits are nontransferable. Pennits expire if work is not started witbin 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? 0 Yes 0 No Number of inspections per item ( ) Qty. CATEGORY OF CONSTRUCTION . I I~ Residential, per unit, service included: o Residential 0 Government ommercial JOB SITE INFORMATION AND LO ATlON 1,000 sq. ft. or less (4) . .Irfrl(. n I _ A rl ) S ( "~ch additional 500 sq. ft. or portion Job sIte address: ~ ,..,. "-"Jl S'r.4\-' '/ "( ~reof City: SoY\~ J-J.I'1 ,Q Slate: 0"-- ZIP: ( ') ~,"l Limited energy (2) Referenhe: v I Taxlot.: Each manufactured home or modular DESCRIPTION OF WORK dwelling service or feeder (2) W IT ~\t-o MHlI' ~.u-~ ~ ~CO II VI ( 16 W-€Y ~-L Me. c-- ~ PROPERTY OWNER -Ii 0 .If), .~ Name: Address: City: I Slate: ZIP: Phone: - - I Fax: - - E-mail: This installation is being made on 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). Signature: CONTRACTOR INSTALLATION Business name: (% VIe. re,.t)'VL "f'f" r,nn ,,' Address: ~')(l 'S _ D~~ ~ City: '-f LU.f>vvL I Slate: {\( ZIP: r., L.- Phone: om, /"W1"h.j I Fax: m, -b W"Ul.... E-mail: CCB license no.: L.j. <\ BCD license no.: X'j If! (,.... Signing supervisor's license no.: '-f {),'1 Print name of signing supervisor: 'VU J ,0_ ~ ;jL 1/ Signature of signing supervisor: :y w.h (11 Date: Cost Tntal ea. cost $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ 200 amps or less (2) Services or feeders: installation, alteration, relocation 201 to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) !t!1 Over 1,000 amps or volts (2) Reconnect only (2) $ 81.00 $ 95.00 $158.00 $205.00 $469.00 $ 63.00 $ $ $~""" $ $ $ Temporary services or feeders: instal/a/ion, alteration. relocation 200 amps or less (2) 201 to 400 amps (2) 401 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 of a service or feeder fee: First branch circuit (2) Each additional branch circuit Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) SignaJ circuit or a limite<knergy panel. 3lteration. or extension (2) Each additional inspection: (1) APPLICANT USE (A) Enter subtotal of above fees (Minimum Permit Fee $58,00) (B) Enter 12% surcharge (.12 x [AD (C) Technology Fcc (5"/0 of [AD TOTAL fees and sureharges (A tbrnugh C): $ 55.00 $ $ 6.00 $ $ 63.00 $ $ 63.00 $ $ 63.00 $ $58.00 $ $61dY $ lyCjG, $ '",.., $ Iq\, f) '. \, CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-01016 ISSUED: 07/29/2010 APPLIED: 07/29/2010 EXPIRES: 02/11/2011 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 470 S 2ND ST ASSESSOR'S PARCEL NO.: 1703353300500 Springfield TYPE OF WORK: Tank(s) i l~; ,l.';~ TYPE OF USE: Demolition Industrial PROJECT DESCRIPTION: Demolition of storage tanks Owner: HEXION SPECIALTY CHEMICALS INC Address: 180 E BROAD ST COLUMBUS OH 43215 I CONTRACTOR INFORMA TION I Contractor Type General Electrical Contractor License ADVANCED MECHANICAL INC. 148196 CHRISTENSON ELECTRIC INC' 458 BUILDING INFORMATION ~ Expiration Date 06/29/20 II 05/01/201 I Phone 541-466-3939 54 I -688-612 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: Wilter Type: . RangeTyjie':' '.. . ,n, J'. Energy Path: ,. ;~prinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: -,' ,. ~. Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I d" l\ ~'.~, 1; Sidewalk Type: Downspouts/Drains: Notes: ,'j:;[i . "'~- ..,. "'-... !{:n: ~. I "pl' . . "'1 Ene '. j';~. Ii . '., ,., . " "."~ .. .," . ;~t:;,: , Pa!!e I of 3 I Valuation Descril!tion I $ Per Sq:Ft ,.,,, "'." Square Footage ,-:-..' .,. I'" or multiplier "'~", or'Bid Amount :. I ~ .; _' : . Status :,:. .,--.., " . i . ...!,'- Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line '-.,', Descriotion Tvpe of Construction !.,,,.., !,,," .:t't '-..Totaj Value of Project ~ Fee Description ***+ 10% Administrative Fee*** + 5% Technology Fee Demolition + 12% State Surcharge + 5% Technology Fee I!erm ServlFdr 401 to 600 amps Amount Paid $5.80 $2.90 $58.00 '. $18.96, i ' " $7.90"",. . $158:00 . ' ., Total Amount Paid $251.56 I Plan Reviews I :, i. .~: Date Paid '>}. 7/29/10 '7/29/10 , 7/29/10 8/6/10 8/6/10 8/6/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-01016 ISSUED: 07/29/2010 APPLIED: 07/29/2010 EXPIRES: 02/11/2011 VALUE: Value Date Calculated Receipt Number 1201000000000000846 1201000000000000846 1201000000000000846 2201000000000000934 2201000000000000934 2201000000000000934 . ,i":A\ ,.: jJ..' ',' To Request an inspection call the 24 hour r~~~rding'at 726c3769. 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. . l..P:eonireCUnsnections I Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Electric Service: Approval required prior to utility company energizing service. " :;1 :1';.J : 'B;~,+ .,.~.t".l;~~" " , , ./,} "J ~,' '., ."", / ; ',. ' t; 'j:j~i ;." f,~ Pal!e 2 of 3 q~, ,~{,_! : r l--!,!"-' , : , ::\: '1~~~~ ....'1---;..-,' ',,:~...~; i'~~ft .....,~,: tw.!~'~{~ .. d '..') , j Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-01016 ISSUED: 07/29/2010 APPLIED: 07/29/2010 EXPIRES: 02111/2011 VALUE: '. By signatnre, 1 state and agree, that I have carefnlly.examined the completed application and do hereby certify that all information hereon is trne and correct, and I further c~rtify 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. J 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, t.~:~_. \ ". -~;~1'7~: ,.::~:. :--"-;\" ! . Owner or Contractors Signature i,tfr.;t..;' '. -f. .....~-r. h', ..t/ l": -l~ .'It-.'\" , ,.' '. .~ ,. - i, ,~,.....- ..-.... -' .....~- '< . ..-,...., .!.q.l.l :,1: .,': . . t. ~ . I.; . I r I;, c :.' Page 3 of 3 Date ., 22S Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~P.~~._A_I.N..~.~.ELD.....~_..... .;. ........... tIlL, . '. , ..~ .~ . ..... '"' ,0__>',_.- .__" City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 22010009900000.90934 Date: 08/06/2010 11:49:15AM Job/Journal Number COM2010-01016 COM2010-01016 COM2010-01016 Description . , Penn Serv/Fdr 401 to 600 amps + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment Check Paid By CHRlSTENSON ELECTRlC Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 158.00 18.96 7.90 $184.86 Amount Paid LLH 1607 In Person Payment Total: $184.86 $184.86 .- 'r~ ..,...~ . " i'''\'Lr '.! ':.: . ,r I '.~. "'_~.. 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