HomeMy WebLinkAboutPermit Electrical 2006-9-12
SPR ELO
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INITIALS N M..
DATE q-\~-<9(,p
SOURCE ffi"'~I~
(225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CC)e.AI\ t:.oo C; - D II e \..{ Date
e5t-~tb'L~t> 1ocJNIIJ&ttoo Amps or less $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps _ ""',":$'lQ.s~d01
. '" ,', Ie' , \ ",.,."" ) , l'.;\i'~\f
601 Amps to 1000 Amps ,,' S163~00J
O 1 000 A N 1 ' . ~ - '.. $3'l'7stO:'OO \ '.;-,
ver . mps .0 ts ,- _, ,l',~ c.' 'I OJ. A
Reconnect Only" , : " ,,::,.~ ~ ' - ,-" \ . $ '50-,""'0000 I
_ ...oJ l. ~\...... \1 .
.'0'\ .~'~,_., .:,. J~'\C' \.n\U~'=l' '<~\ the ruleS u~
C. \\~B tel'(3p'non,e
OOS '.' P. center. \ '.. Notihcatlon
I II t' \IA'~ltn (Ilt" D I -~fl 11\1\1\'1
nsta a JO.n}'ft er~ JOnl.oJ .~~ .o,gaHon 11344).
. I ber 10r I. \ 0-33'2.-e:.
200 Amps'Oli1ss center is 1-80 $ 50.00
201 Amps to 400 Amps $ 69.00
40 I Amps to 600 Amps $1 00.00
Over 600
1.
l\~O Mo~
LEGAL DESCRIPTION:
J 703 2<:S':J 3
/6c{OD
JOB DESCRIPTION:
lN~ ~ (,l.-i>U(..
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. ~ C:?NTR1c:rOR1.
Electrical Contractor
Address
1 ~t 0 OA't- IAn."*' ~
City
~
Phone 4&t=-~
?;oS-Slit
\0 I do i
Constr. Contr. Number I ~ -; If, 0
;llt~I01
Supervisor License Number
Expiration Date
Expiration Date
;rJ=\7'i'~';~: ~ ~ r
Owners Name --PAtAJ\~ ~ri fiyp~
Address to1 t; O#~,-
City ~e-
Phone ~ 3-- "2.1t
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
N{~
Inspection Request: 726-3769
3.
A,
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
B.
Alterations or Relocation:
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E,
Pump or irrigation $ 50.00
SignlOut1ine~1t.i;gl~tirigY: . . . \'-"'-'l,S\..5fl.OP:-\l= \JfSt)\~
__" o'-D~a\l Ct.lLILL Lf'l I .C If I _'
Limited EnergJ/tR:esiClZlUti'a! "11'~n ,.IIIS $JzfuOmT IS NOI
\1-runQ\lC[) UNOc:n II" I LI II>
Limited, Energy,LOommereiaY '" .. n [, 1\\ i$ ~ii1Q..Q) FO R
. _ rHr.'; rl\\rC[) OR Iv rIiJ"'u I
Minimum Electric (eeruiit\litsp'cction 'Ee~_is,$45.00 + Surcharges
.. \hJU.
4,
/X>-
4-
;-
z.StJ
~(.SD
8% State Surcharge,
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application 8-06.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-01184
ISSUED: 09/12/2006
APPLIED: 09/1212006
EXPIRES: 03/1212007
VALUE:
225 Fifth Street, Springfield, OR
54] -726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
SITE ADDRESS: ] ]90 Mohawk Blvd
ASSESSOR'S PARCEL NO,: 1703253316400
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
Commercial
PROJECT DESCRIPTION: Install electric wall clock
Owner:
Address:
PACIFIC CASCADE FCU INC
]075 OAK ST
EUGENE OR 9740]
Contractor Type
Electrical
I CONTRACTOR INFORMATION l'eC\uireS'lOu,t,o
gOD 10." gon \J\\\It'J
,,-\ON', ore. ''''''1\,e Ore . ..tor~
Contractor J\11EN \ do~tcense \&~Ptra':"t~oRN_ate Phone
E S & A SIGN CORP tn\\O\N ru\es},...",<!~3-;fVO)se,~~h oJ\ro31I)~f2~lZ, 54]-485-5546
BUlLDIiN~"iNF'oi~:M~Tre}N j t\~~?i~S 0\ \\I~ ~~;~e .
In vr~' ~OU rf\ay UIJ' .n(No\e', \\le \~ :jicatiOn
# of Stb'i-l'es: \\le center. \ ""' \Jti\i\'1D'oPSlze:
. s\\\I\O Orego" rc;!L\. A:\
Height of.; tru<:Jrfcr t\le. OO_33'2.-"'I.!.Yt'lst Floor:
Type of l1'eli'f:b center \s '\ -8 Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft GaragelCarport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side] 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:
. .... 'n.n: \NOR"
PUBLIC IMRRqlMEMENrxS( \1f\I...\.. t.~~\Si"\~E~~\' \S ~U \
"U\';) \,... P' I\W\'to. 1\-\\ ,cn fOR
\ \I Oo\l't.D I..\lw Sidew~IJ{J"(~pe:)
)-\Dl\-\ \I OR \S f\tJ \
COl\hM't.i\\GE.D coDo,wnspoutslDrains:
W\ ("' I':>,\'/ \J L"\U ..
i\~'{ -\ ~0 iJ '
Notes:
I Valuation Description I
Deseription
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2006-01184
ISSUED: 09/12/2006
APPLIED: 09/12/2006
EXPIRES: 03/12/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Sign - Outline Lighting Each
Amount Paid
Date Paid
Receipt Number
$5.00
$2.50
$4.00
$50.00
9/12/06
9/12/06
9/12/06
9/12106
1200600000000001406
1200600000000001406
1200600000000001406
1200600000000001406
Total Amount Paid
$61.50
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.
I ReQuired Insoections I
Sign Electrical: After connection is made but prior to energizing,
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 eaeh 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
Paee 2 of2
225 Fifth Street
Springfie1d, Oregon 97477
541-726~3759 Phone
Job/Journal Number
COM2006-0 1184
COM2006-0 1184
COM2006-0 1184
COM2006-0 1184
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
Description
Sign - Outline Lighting Each
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
CHERI FLETCHER POWELL
C' . of Springfield Official Receipt
l dopment Services Department
Public Works Department
1200600000000001406
Date: 09/1212006
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 012880 In Person
Payment Total:
Page 1 of 1
2:48:52PM
Amount Due
50,00
2.50
4.00
5.00
$61,50
Amount Paid
$61.50
$61,50
9/1 2/2006