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Home My WebLink AboutPermit Electrical 2004-1-13 ( as submitted has the following 01 require specific land use approva ' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541n.26-~689 , Zonmg ELECTRICAL PERMIT APPLICATION City Job Number COWl ZO OLJ - 000 r;1 Date . 1//3/ /) 1- , 1. "'iocATioNOimsTALLATloii,':j';;c;, 3. coi\iPiETEFEESCHEDULEBELOlll ".. '. 53 :3"'~'t)'1(54~Ji~~"~"""" ,:,,~ '" - "'" ^ c,__ ,'d .:^< ;'.., LEGAL DESCRIPTION (SOIJI?Y 6 7frt/L'/<}J) A. ii'~~~i,€~~j~driti~i~~~,~~W~r:~i~th~i~~YJ>R(~;~;lII;gi:'~~it.":<~': i 70 ',s Z-b 'i 1- 00604 Service Included ~, I ^ JOB DESCRIPTION :1'iVST/llL ~A- lfijle/J-lE/) 1000 sq. ft. or less ~~ /J. ., / ,..tJ. ' .... .;, / - Each additional 500 sq. ft. or v/~Mt1r rCJ~ l-OI/'8.V //}J/1U?//7L. portion thereof f Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. '-:-?",_'~~ ,,;~;-~;' '. ::''':-,;-:7'~ ~.'/,:~~} .:>~"~,.r. """;-:~:~::T:;~~~' '-'<' :'::;;~'~';-:;,' -'-:'-- ':'~: $'/>:., ': ~:~, ";~~~:':::,\:":. .,"~\<' 2 ;, CQNTRACTOR:INSTALEAnONO!jLY , . ~,'. '):.\~ ~~~:';:L)='.~;- ;;1~:i ~:,E:::::;~&].: :..,~;,..:': :-,: ;:o:.L:_:,_~~;~ i: i~.~<:', ,~:\:~ ' .;~,'.,:.i)C. _., ..'~ ;__L<__ ,:.;~. Electrical Contractor L. R. Brabham, Inc. Address 68 West "Q" Street City Springfield Phone 747-6638 Supervisor License Number 4 9 4 4 S Expiration Date 1 0/0 1 /04 Constr. Contr, Number 8699 Expiration Date 1 2/ 1 8/04 Signature of Supervising Electrician / // ,?{~~ ~g---c.L/ ,~ ,/ ~ Owners Name So AJ /lIV J &'/J/ f / /tJ5 Address Po !3&^ t; 5 ~ CityS);;Q/1/J6F/EiLJ Phone 7L!-/, /95:3 OWNER INSTALLATION 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 Ct.. ';}., U.. "\ ,'O' . ,.,_ ._'''; ~ ~", ".. c1\~ ';u(honzed Signature _ $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder .:"':~' :'..:";' :7f>":"'::)",~~':',: .tt.,:, ~:~"~'-,:~'~~":?:;':~::c:::':',::-::': ~;'~::;'-::' -;,:'~'" ~;:;. . Y''i~7'' ":;:0:;~,:.,.:'~.::; ;-~::::;Y:~',' _~;0:;_7oJ,::;:~-"';-- '. .:'~ . ,. ~,~.. ;: -.', R 'l,$eryJc'es ',~i J:?ee~~d~.bistliila iion;'AJt,erlitio#s',orReloca tion ;,^. . ".,..';' , .., _ --'.. - .;~' :"1.< ~_ ,;;.<'_';;. ':~'~~::'_~'_~<,,~;'=.:'~ ';,~ : .-,'-;.i:'" ,:' ; . ~ __ ~ t #, 1 ~" _ > _ "l_l~' $50.00 200 Amps or less $ 63,00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps , fO\l'iO $125.00 601 Amps to 1000 AmPfen~;~~::,,;~~~\\\\'1, $163,00 Over 1000 J\!11DS~"'i$,...... O(!3<;:,,"'", ~~\ \t;rlt" $375,00 .r.~~llv , '" \v. ",,"'0 "'f\l] !,~(~~~~i>'l;~~~;~ w\a~~f- ::~~~\~;OOO , ~\)\\~ . >'.~~Q':t\O".~(' .~. '\1'\ \ r" ',," . .<' ~"' '. ",\\(i~'\ ,~O;\',' ;:~ "'~'V\,l .,.,',~..,~' :.;',1;.." . ""c'.,.',ir','" 'f!>J,f>,'I,,'.Cr,., ", Sta'.' mfer~ im:ijr 3l.'ll)'" ,,\ 0 " 'n ~ ,"'~::'J"tij ~ 'J. ~ ~ "TJ , !1l. :";l v t':C\~ ." "'" ~~",\ Vv f?'3f~~' . ')~g'LO.V ~}Cvl:resU';<:3'W"'~" '~r~It.- ~ $ 50,00 '~~,~~., 'm' A~ld'4'b.~Q~\I('h' $ 69,00 _L.t(\~'\aT H.''t \ \r'4Ul ~m~'106'00 Amps $100.00 Over 600 D. New Alteration or Extension Per Panel One Circuit 1 Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 /1 at ..,,3, E. ':Mi~celiarie()~s'(Seriicelieedef not bi~iud~d}::"Ea~h Installation' :::'-:c:r>:..;. ";".:::..:.'".;.:;':::;..,, :<",;.:- :,\ _" ::,0.'...:~: 0.:_:~~~~,;"::,_:.:,:.... _ ,-~,-;:_~ ::,<;~', ~,:_~_ - ..'_~_:'_~ .~",,:.: ,,'":.:.. ~ ':' ~ ~.._ _"'A. ~';'ru~l::or inigation $ 50,00 ~~~I~~rJ~'5Firitbp.I~E IF THe wooil5000 Au'irffl~1~~eooffi:~'YA?S PERMIT IS NOr 25.00 C01~~~wt~ff~r{q~AWtlONED ron $ 45.00 ~qJ8lJ:t9mifJfmoI9.Inspection Fee is $45.00 + Surcharges . '. -. 4.~UBiOT.AL()FA.BOVEp ., 00" ,,1',.-" ."'0;:-( ..::": ; ..'"' f/S, tJ () .3, 15 4,50 S/J.,fo5 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Permit Application 1-03,doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00081 ISSUED: 01120/2004 APPLIED: 01/20/2004 EXPIRES: 07/20/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 533 Q ST ASSESSOR'S PARCEL NO.: 1703264200604 Springfield TYPE OF WORK: Electrical Work Only NOTICE: XPIRE \f THE WORK . THIS PERMIT SUHNAD~~ ~HIS PERMIT IS NOT ^\.1TI-mRI7ED \''l'1tlrn c:nQ , " ~- OR I~ I-\ot\ 'fUV --', I ' . rJlMM\;Nu ' ValuatIOn D)f~~~ PERIOD. . , $ Per Sq Ft Square Footage or multiplier or Bid Amount TYPE OF USE: PROJECT DESCRIPTION: Install20a circuit for lottery Owner: SONNYS TAVERN Address: PO BOX 652 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor LR BRABHAM License 8699 BUILDING INFORMATION. SETBACKS # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: OU \~ ~teS 'I U~S\\\'I , .....f\'J: ....(\ .."'<, DEV, . - - f ~ ~''PION O~'. ~e6 Se t'J: O~ tu\eS ~~~:~es;~~t'~~~~~~~~~~~~ot\ 'O\\o~ tf..\Ot\ O~,O? .~ ~~ ~d\.\~" ~o\\,\e'/): g~~\~\0.~\o'()~. ~9J9~\~~ ",AA...... O~~ ~O~ ~ cet\~ of)oG< ~Ol,~-ge: '.(\ "" '; ~e ot6'r'n-- ., r'\O~v' .~C}~ \'(\e ",9-~ \J r.\\\\' · ",( . ,. ~u~'Oe' l~fjLIC IMPROVEMENTS I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: , VN Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction Total Value of Project Page 1 of2 New Commercial Expiration Date 12/18/2004 Phone 541-747-6638 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Value Date Calculated Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid' Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid $4.50 $3.15 $43.00 $2.00 Total Amount Paid $52.65 I Plan Reviews, Date Paid 1/20/04 1/20/04 1/20/04 1/20/04 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00081 ISSUED: 01/20/2004 APPLIED: 01/20/2004 EXPIRES: 07/20/2004 VALUE: Receipt Number 1200400000000000082 1200400000000000082 1200400000000000082 1200400000000000082 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 Reouired Insoections I 1 Rough Elec~ric: Prior to Cover 2 Final Electric: When all electrical work is complete. 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 street, that the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pal!e 2 of 2 Date, 225 Fifth Street ",' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00081 COM2004-00081 COM2004-00081 COM2004-00081 Payments: Type of Payment Check Receipt #: 1200400000000000082 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum! Adjustment Electrical Paid By LR BRABHAM Received By djb Check Number Batch Number Authorization Number eity of Springfield Official Receipt Development Services Department Public Works Department Date: 01120/2004 3:05:07PM Amount Paid Item Total: 3.15 4.50 43.00 2.00 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65