HomeMy WebLinkAboutPermit Electrical 2010-8-5
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225 Fiflh Slreet.Springfidd, OR 97477.PH(S41)7Z6-3753+FAX(54I)726-J689
DEPARTMENT USE ONLY
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Permit no.: .
Date: 8- S . I 0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Pennits- expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? Dyes DNo Number of inspections per item ( ) Qty. Cost Total
ea. cost
CA TEGORY OF CONSTRUCTION
o Residential I D Government I ~mmercial Residential, pu unit, service indud,ed:
1,000 sq. ft. or less (4)
JOB SITE INFORMATION AND LOCATION $134.00 $
Job site address: .q.:54~ 4/1reWAv :3T Each additional 500 sq. ft. or portion $ 25.00 $
lhereof
City:.5/'I!JAlt,rIU b \.Slate: 0 IZ I ZIP: tJJt/77 Limited.energy (2) $ 32.00 $
Reference: pO 31 r J J I Taxlot.: 01 zuo Each manufactured home or modular $ 63.00 $
DESCRIPTION OF WORK dwelling service or feeder (2)
t/1''f4'A-/)E 8/1 (!OIIT'O(.. ro ))/I1P ~ flE:PfI/Cf..,,,"'e;c;',' Services or feeders: installation, alteration, relocation
ADT JOB :283- O!i/(Pl' <( / , 200 amps or less (2) $ 81.00 $
PROPERTY OWNER 20 I to 400 amps (2) $ 95.00 $
Name: (!#f}SE'7?/fNK 40 I 10 600 amps (2) $158.00 $
Address: I ~ 778"1' 60110 1,000 amps (2) $205.00 $
City: ,/. ,,4_+ ""- ./ I Slate:CA I ZIP: "ZbS! Over 1,000 amps or volts (2) $469.00 $
Phone: - . I Fax: - - Reconnect only (2) $ 63.00 $
E-mail: Temporary services or feeders: instal/ation, alteration, relocolion
This installation is being made on residential or funn property 200 amps or less (2) . "nil $ 63.00 $
owned by me or a member of my immediate fumily. This r>.T E l\XDbI:4Gli&l\i4 ~~Y..h'':''&eqon Uti! ty $ 87.00 $
properly is not intended for sale, exchange, lease, or rent. OAR A
479.540(1) and 479.560(1). foil W ~IUR~ ;-~~e rules are se! t< I,~: $126.00 $
Signature: Noti ic =r ~ l\lJ01\>ll>tIlJllllllOOi\if:'.J.e s""'~b"I feeders section above
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CONTRACTOR INSTALLATION "no fMOlaall)'i~ ~r ~'lffiYqs\ermar&l per panel
Business name: AOT Security C \Ii !l "= '}'u" ~ iffiui!ltiiillJ1 ~l:~~Hl"d'serviee or feeder fee:
Address: 2815 SW 153rd Dr nl m '~'~!!rd\ll:h1elWllr3;j,,-"-"~~ " $ 6.00 $
City': Beaverton I Slate: OR I ZIP: 97006 b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: 503-469-7206 I Fax: 503-469-7114 First. branch circuit (2) $ 55.00 $
E-mail: spate@adt.com &ch additional bfanch circuit $ 6.00 $
CCB license no.: 59944 ~CD license no.: 26-209 CLE Miscellaneous fees: service 0;' feeder not included
Signing supervisor's license no.: 389LEA Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: Ken Kraus ,/J I Each sign or outline lighting (2) $ 63.00 $
Signature of signing supervisor~ ---I-:;. " /1 J-- /;r} Signal circuit or a Iimited-encrgy pane}, / $ 63.00 $
altcmtion, or extension (2)
I J I Each additional inspection: (1) $58.00 $
APPLICANT USE
(A) Enter sublotalofahove fees $ 63.00 7
~~ E (Minimum.'Perinit'F& $58.00)
11 J;;.fl!aJ NOTle : g~= $ 7. 56
. THIS PERM1T SH . . [A])
~THOR1ZEO UNd!!R>lFl-\G~ ~~).. $ 3.15
. COMMENCED OR \9"I,lI.'BMlf}~\)\Iilt'stI-'Jlarges (A through C): $ 73.71
,
440-2584.J (9108/COM)
~ fJ ~\;l ANY 180 DAY PERIOD.
~~
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-OI063
ISSUED: 08/05/2010
APPLIED: 08/0512010
EXPIRES: 02/0512011
VALUE:
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SPRINGFIETYPE OF WORK: Electrical Work Only
SITE ADDRESS: 3545 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 1703153301200
PROJECT DESCRIPTION: Upgrade controls
TYPE OF USE: New
Commercial
Owner: WESTERN SERVICE CO
Address: PO BOX 7788
NEWPORT BEACH CA 92658
I'CONTRACTOR INFORMATION ~
Contractor Type
Low Voltage Electrical
Contractor License
ADT SECURITY SERVICES INC 59944
BUILDING INFORMATION ~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
# of Stories:
,.,
Height,of..!;'tru,cture
'\ "Type of.H'~at~ :. ou to
>>,.' ..", ~ Jaw reqUires Y . .
ATTENTI9.~~j;~ . the Oregon Utl\1ty
lallow rule~lIeli' ~e rules are set forth
Notification (;uf!\gy.1rl !/jiD~9.~ OAR 952-001-
in OAR 952.~1nOOeq liUg ~'of the rul€lf/liIY
iSa1n c I ~ni
uC:ll ;~~~Q~~[' . 1I n
num 'center is 1_800-332-2:.1 4 .
Overlay Dist: '
# Street Trees Rqd:,
Paved Drive Rqd:
% of Lot Coverage:
", " . ..~.
I PUBLIC IMPROVEMENTS ~
Expiration Date
05/07/2011
Phone
54 [-736-4973
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:
DownspoutslDrains:.. '"
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. " ';r -nW. \NOr>..
.,'! ~Oi\Ct: '"'~\.\. t'f.p\r>.E RWI\1 \S ~01):
X'.!0l' .;:""I,,'t'tll.lc.'PERWI\i S 1,",\S pE \ Or>. .c":"
valu:~,'1;o~'f)~ic~rtiO~\ EO O~~~O~.';'"
"." - 80 1\'1 PI'''
$ Per Sq Ft NS4u\re Footage
or multiplier or Bid Amount'
Paee I of 2
Value
Date Calculated
Status
Issued
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-01063
ISSUED: 08/05/2010
APPLIED: 08/05/2010
EXPIRES: 02/05/2011
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'n.!.?tal ,\( ~!ue of Project
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L;;Fee~'p.~id~
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Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Traffic Signal - Panel
Amount Paid
Date Paid
Receipt Numher
$7.56
$3.15
$63.00
8/5/10
8/5/10
8/5/10
1201000000000000879
1201000000000000879
1201000000000000879
Total Amount Paid
$73.71
I Plan Reviews' ~
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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.
Low Voltage: Prior to cover.
Reouired Insoecti!wi.i
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By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 he made of any structure without permission of the Community Services Division, Building Safety.
1 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. " "., .
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Owner or Contractors Signature
Date
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.. .' . Page 2 of 2
225 "Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department.
Public Works Department
RECEIPT #:
1201000000000000879
Date: 08/05/2010
2:48:40PM
Job/Journal Number
COM2010-01063
COM2010-01063
COM2010-01063
Description
Traffic Signal - Panel
+ 12% State Surcharge
+ 5% Technology Fee
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Amount Due
63.00
7.56
3.15
$73.71
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Item Total:
Payments:
Type of Payment
Check
cReceinll
Paid By
ADT
,.C,t. ' Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
3281703
I n Person
Payment Total:
$73.71
$73.71
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