HomeMy WebLinkAboutPermit Electrical 2005-6-30
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r CITY OF ~r"RINGFIELD, ORE.GON /
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (54m~6-J ,I\h~ ~'''-..... J
ELECTRl~'ERMITAPPUCATION .J~* 6'6SCG:";;3,b//s\gn~_!
City Job Numb r 5'- ()()Lj9' Y Date () _ ;) r /O.L
, - I '
I. ,LOOA,-'F10N.ifm!N{ff,jfJjHA7!ION. ">J 3,I_COMPLEI'EFEESCHEDULEBELOW ----.--,
3333 ~(i."",P Cq...~ ';2.l\Q.-J
LEGAL DESCRIPTION S pc,-u.. '#;;L '1
IfJI!;ZZOO 0 l (X)O
JOB DESCRIPTION ~ ~
lb-r~t..i)o~. ,,~
Permits are Don-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
I'~~''''''- 1J 1, ~ -~w1i
2.<t~lfP~~R'INS:P~~~tqNL~
Electrical Contractor ~. C, Crwt ~
Address fo ~ -Q 'J...c:;' ~
City ~_~ Phone b"tfl- 9~6-v:>.~
/
Supervisor License Number 3 ~ f: I) ~
16(/(()?
Q..~-l,~("
10/1/06
Expiration Date
Constr. Contr. Number
Expiration Date
.
,ature of Supervising Etectrician
o~ers Na-4f!J'-/ r/J/li-ti-J
Add'/?)"fbV'"l!t))( / Odl1//
City 'm:zrm~ Pho4sD3)
<YO} '-J -35/i
OVVNERINSTALLATION
The installation is being made on ~,~~..;/ I own which
is not intended for sale, lease or rent.
A, t 'New Residential" SI"gle "rMulti-Family pe~ dwelling uni!,_J
Service Included
1000 sq. ft. or tess $106.00
Each additi'iJJ@5003IlJ:fDIr"gon law requires you to
portion lh"1:'(,o,fi rules adopted blt thp nr.egoo~~
Each Mantfi'ct'a(Hbhili'aler. Those rules are set forth
Modulan DwelliiigSeMcelliV1 0 through OAR~~%.Q01.
Feeder0090. You may obtain w...~~ .:.Hhe rule~ bi
B I'NS'-'~i"....,,;o.;~,}!!Ft,e "'iJ'el""r"''', fl-lliklII/Nti~~lt!.'!B~~~~'" ,
. ~-$,~~~WJf~~J~'lbku.re~88!_ _ CaUop9!=8;tIO!l:
200 Amps or less Center is 1-800-332-234f~3.00
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps $125.00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsIVolts $375.00
Reconnect Only $ 50.00
C. tiI'e'*t~;1~~~~iC~'9~JF;f~i!~i'j<P1RE IF "l'Hh W:iJl-i~
~'I i'1-HnRIZFD UNDER 1HIS PERMII I~ NU I
Installation, Alteration or Relocation~DONED FOR
r.OMlv1tNGtU un '0 "un'
200 AmI);' W~s~O DAY PERIOD $ 50.00
20 I Amps~to 400 i\rlips $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D. -l\t~n~-m!!cufts~Y~tJ;:~Urt;:,.,,::,,:-~: .>;~,:::;J,[,y{', };'1:~~':_' '"',; 1
.........
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E. il~!1i;~il~~~~~lt\!~!:d~J~phli~ilJ!~"~911'1
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
,
~
Minimum Electric Permit Inspectiou Fee is 545.00 + Surcharges
4.1i.~imTOTAL'OF".w('>VE . '.! 'fs.,Q
1\ ~ 7% State Surcharge 3. I L
. tt'\~ \~UOIO% Administrative Fee Cf. (' 0
..~ ~\'f.j TOTAL " ,.C;::;...6..C;
~W '# \. Shared Drive(T,YBu.ldlng FonnalElectncal Penmt Applicatwn 1-03 doc
~
Owners Signature:
Inspection Request: 726-3769
225 Fifth Street
! Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00498
COM2005-00498
COM2005-00498
Payments:
Type of Payment
CreditCard
c
c
6/30/2005
.
RECEIPT #:
.~
WiL-" ,
~ity of Springfield Official Receipt
.evelopment Services Department
Public Works Department
3200500000000000406
Date: 06/30/2005
Description
Low Voltage - Commercial Indus
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
EC COMPANY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 030264 By Mail
Payment Total:
Page I of I
2:54:31PM
Amount Due
45.00
3.15
4.50
$52.65
Amount Paid
$52.65
$52.65
,
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3333 Game Farm Rd
ASSESSOR'S PARCEL NO.: 1703220001000
. Ull' OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2005-00498
ISSUED: 06/30/2005
APPLIED: 04/28/2005
EXPIRES: 1213012005
VALUE:
Springfield TYPE OF WORK: Commercial Miscellaneous
PROJECT DESCRIPTION: Construction Trailer Site
Owner: PEACEHEAL TH
Address: PO BOX 1479
EUGENE OR 97440
Contractor Type
Electrical
Contractor
ECCOMPANY
# 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:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
TYPE OF USE: New
Commercial
I CONTRACTOR INFORMATION I
License
49737
BUILDING INFORMATION I
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
01115/2008
Phone
503-224-3511
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
Overlay D1st:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Square Footage
or Bid Amount
Date Calculated
Paee 1 of3
Value
,
..
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 1000 amps/volts
Perm ServlFdr 601 to 999 amps
Plan Review Electrical (25%)
Temp Power 200 amps or less
Temp Power 201 - 400 amps
Temp Power 401 - 600 amps
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Total Amount Paid
Initial Review
.
. CITY OF ~rKll'1uJ1lJ!,L1J
Building/Combination Permit-
PERMIT NO: COM2005-00498
ISSUED: 06/30/2005
APPLIED: 04/28/2005
EXPIRES: 1213012005
VALUE:
Total Value of Project
F""o, PIilLI
Amount Paid
Date Paid
Receipt Number
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
3200500000000000406
3200500000000000406
3200500000000000406
$803.10
$562.17
$750.00
$1,141.00
$2,007.75
$1,400.00
$4,140.00
$600.00
$4.50
$3.15
$45.00
5/2/05
5/2/05
5/2/05
512105
512/05
512105
512/05
5/2/05
6/30/05
6/30/05
6/30/05
$11,456.67
I Plan Reviews I
04/28/2005
04/28/2005
APP LLH
Temporary Electrical Plan Review
approved by Clair. See attached
documents for information.
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.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Low Voltage: Prior to cover.
Pal/e 2 00
By signature, I state and agree, that I have carefuily examined the completed application and do hereby certify that ail
Information hereon Is true and correct, and I further certify that any and ail work performed shail 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 ail 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.
::;~C~SI~ ~tr(L~
..
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Paee 3 of3
.
LlJ f OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00498
ISSUED: 06/30/2005
APPLIED: 04/28/2005
EXPIRES: 12/3012005
VALUE:
(qj 00/ d (JDS
IV~
Date