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HomeMy WebLinkAboutPermit Electrical 2004-12-14 ;~i" .'. criY'of"(_.lNGfp3LD;!OREGbl.'J'" ':C)" , ,. 225 FlFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number ('OWl 7..004 - 01 J ~-S- 1. ~qSit!21VOEifYsTApC.ftJjf~i"t;~ 3. ~'C.O&:fJE:1}I~~E!~IjjR.iJ:cEif~~o~:t;;i~-"1~'ar.c9t\ J!!lt( (~n/~A:-1 L() z29 LEGAL DESCRIPTION I .1?D.3 z.7.b-D ~OZ5()C:Y , l10Yl::l:zooicA 61Z, 9?98V ~ _ ,,/ New Alteration or Extension Per Panel / ~ ~~ One Circuit ATTENTION: OreQon law ~~@Syouto " - Each Additiona~@i1owtrt?llootbdopted by tne Oregor'iVu"'J Owners Na;;~ r9A- ~W ^: flU ~ (~'a-~ S;:,i::or::e~~g~~~~~~~~~;9~;;;;~p~~;ii~.~ ;:rd .~u. ~~ D E.~::~::I:::~0~~!::;~!1;~~:1.!i~~:;~~~3 , SignJOulline Lig~tYng Center is 1-Rn~~). OWNER INSTALLATION Limited Energy/Residential $ 25.00 Limited Energy/Commercial / $ 45.00 JOB DESCRIPTION Sp+tJ . Permits are non-transferable and expire if work is , not started within 180 days of issuance or if work is Suspended for 180 days. FCONiRAcrORfn\iSTAi:MTIONO~~ 2. ti~~,-,).~.'iiilll;,,:..->,,:;:.., --, ~.._~.-.!.;.i,;.~~__~',(lVi'1.l::..~;t, :",-: Electrical Contractor <3-/_ [If'(' 7€>ct-.- Address ..sIt.( /'II6(r;,M;~ "i$(Q/J. City Fc..-Ct7NL. Phone 52/-,)851- v Supervisor License Number 35X-2LEA- Expiration Dale //')-/- 200,<;- Constr. Contr, Number /0&&/!? Expiration Date x--;f"- O.~ Signature of Supervising Electrician The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Date { "'_-"~"'-'''' ,'"~-t""- "<'" p- -. """",",,-,,-."-0' - .....-=.-.'-- . "''', '."i -.;;~- '-. Y\--:'" ..~T '~;;''''--'''' .':":";"::' A. k_~w~~~n~_~al--~~$~~!~i&Mti:fmi!fp~',~~i(lJ_ng'.~,~i:D:; Service Included 1000 sq, ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. ~~.S~~;'f~F~e'd~;~':;~Ynit~'ll:tl~~~-t~~t:iih~1~-~riJf~~iiti~~'::/~:'~I . .~ ~ '.~. ___"'.~', .t,'..?.-" '" '}'c~_''':~'"",'_'Ji;,..l',_,_'~'_''''~~-_-:' .,...., -,':.:\""-~ ""',-.,,~ MnT1r.1=' 200 AnIjiS'or qei;s" . $ 63.00 201 A~J;a4'&f..t1lJsSHALL EXPIRE IF HI75\b'olRK 401 Anl'tIiTJ-l600IAlihlsUNDER THI~ PERMfiiSlO'dOT 601 AnlPQW{&f'd~pR IS ABANDONEESfSRJo Over lob"dU~~~ PERIOD. $375.00 Reconnect Only $ 50.00 ~,~~-.',:-'''''--:''-''-i.;::,' >.",,,,,,",,, '.- .:...",.r..;-....r: """"",,.,-..-i('."-~~,:,-("". \".!fJ. '~,"" ;'tr.,,_:-"~"':,~~'~,._;~,; : ~\""'~," -_~:-,~ c. -irempor~ry_S,er,Ylc~-",or:.Fee~~!s:~*'~}:~_~iC~;::..r" ,ft:J.~;'Ltl~~-),!!:,'1 Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50,00 $ 69.00 $100.00 Over ~OO Am~r~'<>"y~lts se.:: "B" above._ ['IO.:::rert'~--"._,'<; ". "<""""":'<'~;,,>,j. jt't'.r;""',")f,,:.,""7'.;g' ",'.".40,' ~,f).;;'-<';-: D. h:Branch"ClrcUlts.~. ..:1/'" 'i.;>::t~}ti:''iii.i.:2r.;;}'.;':;l1',; :,"";.:_:.:1,' y:y(~;"i"~~'f:r:~',,\1;-'~;';A<'" 8'".,", ~,_~_,~:':",j,::' ~'L~~~'''-'''''rj~, ".t;,_-.^}f' '~-;-i:..' Vi Minimum Eleetrie Permit Inspeetion Fee is $45.00 + Surcharges 4. ~w;f;;fAL'6;lBovit'f'~,~!Fi:;C] l{ r U~~~'J.B1;""""'~k:<.i.-~~.,..::;..i~.::..:.:...;:.':-"";'.0";;;:'i....-sa: ~' 7% State Surcharge 7>( r I" 1-"'::> 10% Administrative Fee 7 TOTAL 5 Z. br Shared Drive(T:)JBuilding Fonns/Electrical Pennit Application I-OJ,doc . . CITY OJ ~rJ:Or\jt.-t<lJ!.L1J ' Building/Combination Permit PERMIT NO: COM2004-0I555 ISSUED: 12/17/2004 APPLIED: 12/17/2004 EXPIRES: 06/17/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54 I -726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1144 GA TEW A Y LP ASSESSOR'S PARCEL NO.: 1703220002300 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Low voltage alarm system - suite 220 Owner: GA TEW A Y MALL PARTNERS Address: 110 N WACKER DR BSC 3-04 ATTN PROP TAX ADMIN CHICAGO IL Contractor Type Electrical I CONTRACTOR INFORMATION I Contractor \C~: ~?tblcense1t 1N~~~iration Date SECURETECH IN&\O~ nc~,,^1i S\-l1\~~ ~LJ\\(5~<i.~8M\"( \? ~'l\J '08/08/2005 1'''BiilImING:-Il~FORMA(fIONiNtU rv" \;IItNvCU ~. CO~ ~SI- 1".1'\:12-100. N\J ?tlv Vi es. 1\ Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Phone 541-521-2837 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: UileS 'ioi1"\~tal: # Street Trees Rqd: On ial/lleq gon \ltmhdicapped: Paved ~.wefflnOl>t Oleg d b'/ \ne Ole Ie setd'illll),act: % of l1lt'ellv~f1!ll~:adOP\e ose !\lieS a 95Z-Oof. ;~~~~~:~~~~~~~t~;~\nl~~~~ ~~~e ~~~~~'i I PUBLIC IM~Iill:;~bta\nf~o\e: \ne \e\~~icatiOn UU::Iv! c~n\el. \ l.li!lit~tl>lo \ calling \~el \ne OI~i$ll~a2~8-$l\). (lUrnbel c~n\el is ,,~Q)nspoutslDrains: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Slorm Sewer Available: Special Instruction: Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-0I555 ISSUED: 12/17/2004 APPLIED: 12/1712004 EXPIRES: 06/17/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fp.p.~ P3ill I Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid Receipt Number $4.50 $3.15 $45.00 12117/04 12117/04 12/17104 1200400000000001757 1200400000000001757 1200400000000001757 Totai Amount Paid $52.65 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 RP.Ouirp.llln~np.ctinnsJ Low Voltage: Prior to cover. 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 Serviees 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 Pa~e 2 of2 ~ I 225 Fifth Street rl Sprhigfi;ld, Oregon 97477 541.:726-3759 Phone . ~' ~y of Springfield Official Receipt .elopment Services Department Public Works Department RECEIPT #: 1200400000000001757 Date: 12/17/2004 1l:27:19AM Job/Journal Number COM2004-0 1555 COM2004-01555 COM2004-01555 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Payments: Type of Paymenl Paid .By CreditCard SECURETECH INC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 017431 In Person Payment Total: Amount Due 3.15 4,50 45.00 $52.65 Amount Paid $52.65 $52.65 12/17/2004 Page I of I