HomeMy WebLinkAboutPermit Electrical 2003-10-29
! as submitted has the tOliowing
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA)to~6>lJl)>\i6tti1l1<),ol require specific land use
ELECTRICAL PERMIT APPLICATION approval. f'l t'I
III frr/ Zoninr' ~
City =::~_:::~~~:::~:.:.~ I,~"~~_.,~ate ~r~:~." u~.le -C'--fC: ,lf2.;~: - _9 '1,)0'"_'
1. ~:~Ot::A.'-fI(J.~;;91' IlVS,&~i:.ATJO~: ' '\'i 3, IPOM.P..1:.E-5'FEil?'$aRlE!}~<Bl:;wW;' .fKaJc:J!l
, 1/71.-1 . 6"'11+e-t,J~ Lv'.:-P 'Vt~ Pwlt-/'
LEGAL DE~J RIPTION r ' 1 A. :2~~~ft~~id~;;'ti~'~~~~r~Kf~~ti;;'~'~;'iriif~~~;,~)~~!I~~:~~i?';:\';
, ,...~,.~~._,-t..........,;" ~. ~.~J . ...-...:;..................1,____.......1......".-"--,...,,,.""'",,__"-'.;..._..........;
. nO' 2i'Z,O_'. . b'2<fod # 5tg?ervice Included
JOB DESCRlPTION 1000 sq. ft, or less $106,00
Each additional 500 sq, ft, or
51 r.,-,..I '--I C:rit17/V' &- portion thereof $ 19,00
,
"
Permits arc non-transferable and expire if work is
not started within 180 days of Issuance or if work Is
Suspended for 180 days,
t'C6i\jjRAcroiiiNSTM:~iJd}i;::'oNiyj
2. .<",..", .." ......".....,<"" ,",n .,.,j,..~..~~. ..,..0<-"',".> ,..... ....;..._ "
Electrical Contractor IS? fI S I').. f /h-..", 0
Address (~( 0 ~ fA Ie- IlL 1z fA rz.J.
Phone 91 /- tfO~rr4b
~~~
L.{ '3 L<<~~
1r4~"'# ~&
'(~.'<;'\
~C ~v ~v
,,~~'1~<:)
.~u~ ~\
Expiration Date . . ,..... CO .
V ~.~~<:) ~
Signature~fS ~~~~~<<::
p ~~C;)~~'>~
,/ I ~ ')~1/'>,
Owners :am: M riMI ~chtA/Pv1-c
Address -'pc{ 6Mct1//01 tp
City~rl1.15 /'e1d Phone 7z.-c. -b'z,Z.1
City
t/A 0'1-('
I
Supervisor License Number
Expiration Date
Constr, Contr, Number
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Requesr: 726-3769
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50,00
:'0?'71':~, '>;,,: ,'-~litr"70_'r~'t . '-.",>;.....,-",.. ,-,,:""~;':'-"-0'-~"-, .~" ,,-,:.;;~"., .,.,;:!~~';;"~:~~
B. :::~_~t"~~~s ~.,!r.' !:~~p.~.r.s;:fIri.~t~!I.~-~~'Oii~)~l~~r.~~i~~~To,~~~el.o~~ ~?~X;i)J.j
....101._.. '.. .' ..-, . -' ,.. .,' - --. - ." . .
200 Amps or less $ 63,00
201 Amps to 400 Amps $ 75,00
401 Amps to 600 Amps $125,00
601 Amps to 1000 Amps $163,00
Over 1000 AmpslVolts $375.00
Reconnect Only $ 50,00
.,0 -<'I
c. f~Ji1~.~/~ryr~er;i,~~~;~~,.,t~~~t~iW~.,~,,~~~::',;{;f~~:'~}:~.~::i<:}1;~~1
~0 O~ 0,0 '];r::5 ~
Installation, Alteration o5-:R~atlo~') ~0 0
....flJ 0<; q;~ <; ~~~
200 Amps or less ~ 0~00, t>' 00 oC'-~~,OO
201 AmPst0400A#s~~ ~ '!:-v~~ ~0",~69,OO
401 Amps to 600J'%r.? i' o.::;~".o, - _0---i'-O' &100,00
O ~;B~~~~lJi.';un~, ~ '~ili,~~~J~~r~W{>p~~.'~~~nJ""'i'"'''' ."..,,,;, ",""".1
. '\ ranc ' I C its, ,'(! :_ ;~~~~E.~:,(\::,,,",,,{;l,.t-:'::J~'~' 'r,:" ,,'.-.~? -'-';)<~'_ :--,:...." ')1
b'~;r-".." ---~'Y~"~- ~-- ~+~~"J.,- -,.. -~'.<<,__,__~""'~\1, .',
'N ~'~ -,.,0 (j~ t"\, ~'-~~l
j ew ter"!lo!!;or ""xtenslg,l1 !'.." "1!ne
'" ,0 n~- 'l1"1 0 ' .
One' l<.Wt q; ~~.~ 0 0 .c-" $ 43,00
Each ^Wi~n(l-~~;i~ ~~,v .
Service'5"F~orY~~i!.<..'O ~ $ 0,00
" ~'-> $$' 0 Cf'
;-~;r~.-\.t:-"''''r"~t:::5''''''''-tlf1:i:~~'''-~-'}'-r--, ." -',~,---_;,_" '.' ~ry-.-:""'1':c;-'-m',-::'---;r'::"""''t'1
E. ~ }1i~rel(%~~~4~f(~~~;.~~eJf~~~!;_~\~~Jn.~~(jJ4'>~~gif.~~~;i~s.t~'!la-f~Ii:.~
. Pump or irrigation $ 50,00
Sign/Outline Lighting / $ 50,00 '" ~O
Limited Energy/Residential $ 25,00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
"~:",:,<w~~,;,.---: "-::",-r'~';~-:l~:.~';>.~", "r~'~-'~:\-"i!-':':co _,.~,,, !"- ":-;7'~"'7',
4, 'SUBTOTAE OF'ABOVE,~'jt,,'Ji... ,;! '''i,i,'f:~''~ ':'1
~:~_ >.- .:, ~ :".:"~_.__':ll. ", - -~, ~~" "-":, ~~~~.....~:..~ '-:":;~~' ..:::' ..J
5"'0
'5,QO
!).ou
7% State Surcharge
j 0% Administrative Fee
<$
~
$
)'3,SO
TOTAL
Shared Drive(T:)/Building FonnsiElecuical Pcnnit Applicmion 1~03.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-0l090
ISSUED: 10/28/2003
APPLIED: 10/28/2003
EXPIRES: 04/28/2004
VALVE: $ 900.00
J
.
Status
Issued
'.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspeclion Line
SITE ADDRESS: 5111 MAIN ST
ASSESSOR'S PARCEL NO.: 1702333206102
Springfield TYPE OF WORK: Sign
TYPE OF USE:
Alteration
Commercial
PROJECT DESCRIPTION: Freestanding sign
Owner: GIBBS ROSS E & MONICA A
Address: 35893 BAIN LN CRESWELL OR 97426
, CONTRACTOR INFORMATION I
Contractor Type
Sign
Contractor
METRO WESTERN SIGN & AWNING
License
128586
Expiration Date
04/15/2005
Phone
541-746-3312
BUILDING INFORMATION I
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: Lot Size:
Height of Structure Sq Ft 1 st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
a..~ Energy Path: Sq~Ilt2ther:
"" .< nil""r.vious Surface Area:
~,'-> ,,' S-"v "-
,. '\.' _,'" ,., . ,-..; ..n
~<11lh&OPMENTINFORMATION I #'" ~O" r.,0....:J,;C)Vo"
~~<-~~,.' .,....?J 0....0 ~~Oj'" ~9YIREDPARKlNG
.s.~ ~"..",,<<) 'it' 0 00, ~ - 0" 0', 0"
Front yard Setback: <v~ ~ S:>"~ Overlay Dist: ~" >S'....~ 0 >S' ~tal~
Side 1 Setback: ~ ~'\~ # # Street Trees Rqd: 00.,00'Q':" Fo0 >>if Fo a- ,Q}'Th!nC[;capped:
Side 2 Setback: .< S~ ..;",<:::)~ "-- ~ Paved Drive Rqd: ,0" R,0 .<...",0 ~O ~,0 '$'0 ,,€'o!!IPact:
~. -~.... '~:F~""s:><::>' .a~' 00 ....' C)~ c..0 0' ~~ &'"
RearyardSetb~:)~':'-f.S> \:) ~ %ofLotCovera~.Fo'b' ~0 s;," ,~~o~.:::J~:J,;'1;
Solar Setback.4!\ ,,--'X # ('<$>_, ~<<:; <v~ ~0 00 "r;J '$),'b' ....~ 0" n.,""
......"":,"..> ,C'\ ~N....r' /' ." ""C). 0 _", _~ ('t
.... .....~" :.~V 0..<:::' . I PUBLIC IMPR6.V.EM"'NT.g;!' <$'~' c..0' :,O'.....~'
,- ~':" ,,, ., ..'" . ) 0 '" ,G-
el ~ 0"" ~ --I: >S' .;s' ."
Street Improvement~:~ ' '\: 0' '. ~ ~de\Ylllk Type:
,- " ~C) ~(;' .... ",<'
Storm Sewer Available: 'C)'5 c..'b' ~'Q0 DownspoutslDralns:
Special Instruction: ".s
U-2
VN
SETBACKS
Notes:
I Valuation Descrintion I
Estimate
Type of Construction
Estimate
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
900.00
Value
Date Calculated
Description
Total Value of Project
Page 1 of2
$900.00
$900.00
10/28/2003
.
. CITY VI' ~rKlr\lul'1j<,LU
Building/Combination Permit
PERMIT NO: COM2003-01090
ISSUED: 10/2812003
APPLIED: 10/28/2003
EXPIRES: 04/28/2004
VALUE: $ 900.00
'.
Status
Issued
225 Firth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54] -726-3769 Inspection Line
IF..... tlWU
Fee Description
Sign Plan Review
Amount Paid
Date Paid
Receipt Number
$40.00
10/28/03
1200200000000002378
Total Amount Paid
$40.00
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 R..~ection'l
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 each address Is readable from the
strect, 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.
Cj~cu.k- /()l;)gfO~
Owner or Contractors Signature
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal J\'umber
COM2003-0 1056
COM2003-0 I 056
COM2003-0 I 056
COM2003-01056
Payments:
Type or Payment
CreditCard
llitr~'~=~f!,~',"" ~
=r-.r. I
. ,
,."'t"ffi"-,_ . ,; ;.....?;,'~~ -.-... .~J
Receipt #: 1200200000000002379
Description
Sign - Outline Lighting Each
Sign 61-100 Square Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
ES & A SIGN & AWING
Received By
jmp
Check Number
Batch Number Authorization Number
000205 028490
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 10/28/2003 1l:41:49AM
Amount Paid'
Item Total:
50.00
140,00
3.50
19.00
$212,50 '
How Received
Amount Paid
In Person
Payment Total:
$212,50
$212.50 '
.
.