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Home My WebLink AboutPermit Electrical 2004-2-12 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-368'9'" ,'oJeCfassubmltf dh . '.., II.. uoes n teas rhp 1N/ ELECTRICAL PERMIT APPLICATION / I /' .,' ,,,, 0 reqwrespeClfic/an OWing City Job Number COM ZC:i~L\ -LX..) { 7~ Date oZ. - / ~ - 0 7' ::'onlng (L<!- Q l.Il;)", '. ,'I 3. COlllfPLETE FEE SCHEDULE BELOlil/ &~:/3 -~~. ~;iqhature q<);:J ...--. ~,_.................._- Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits ,__.~~~M~t~!l-H~p.((JY,,jEXleRs~ii36lf\~S,,ne)~!~; \'\"'; ,cd I.....". , .. ;'I",~f'r!:\".Hld.\ 'I U7 .; OQS: Fj~EWtajCp;:~,;a r.y)! ;., !.~ .~.~ ~~'l"):j ~ "f~r43.00 7 .) ,a~~a~.h.~rlrlit1Wt~k~ir~iHturtWithd'J r,"~'<c'~~~ ( _ ..;ot1. f"'a~t'"'~"; .... , .,', '.--if~~~~~~'e...-,\t...."'l 00 / R ~ ()A1Q'~5~~ge~drn~itTc~:)i1r ~4:~~":'1!e;-".)' - ~ v.oll mav obu,,,,, I h ,e J~u 'l\:'lIsce~an~?:nt,~~r~~e(ffit?li8tli1tti~O) -EllCh Installation ~a\l!ng t.e ,.l).~ '("'-'" Not~i:cat.1or; 1!"~~r~Rligitro~; ~ (:;,7t~~.r-\~'-..?3/1.4\ $ 50.00 ~":.,...l""t,~,...~'~ ,M\. . Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 25.00 The installation is being made on pro~t6i1 which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. THIS PERMIT SHAllti6Kii\lRftID!eclHEIWQRi<l:nspection Fee is $45.00 + Surcharges ~g~H~:~~EEDD ut~I~~ATB~~i~~~OVE 6 ( ANY 180 DAY PERIOD. 7% State Surcharge 10% Administrative Fee 1. LOCA1TON OF INSTALLAITON rA/~ CJ) 57. LEGAL DESCRIPTION 170'32b"3 ( 02(O':S JOB DESCRIPTION C I R-c u , -;..s -(' cf\- C A/J'A) I b l " 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. CONTRACTOR INSTALLATION ONLY 'c... ..Ct) &e..... "b J)Q C- ~~~cL Elect~1 Contractor ~ 7 D 7 L v:::'t:.-UA1Jr(L Address EC'(ry t ()., .p bBJ.-7i)'f Phone Supervisor License Number 38/ V S Expiration Date / D / 0 V Expiration Date I O~6 '7'7 !/!'D/o5 Constr. Contr. Number Sign; ofSnp",,~ing El"tricinn ( ~ . ........... Owners Name Q sL,.~ ?J.A~ Address 26 77 W"l(A~7l6e lld City rfAC-.-HVr- Phone Owners Signature: Inspection Request: 726-3769 A. New Residential- Single or Multi-Family per dwelling unit. 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. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. Temporary Services or Feeders 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 TOTAL iI z 7 blo j '7 I 37 f Shared Dlive(T:)/Building Fonns/Electlical Pennit Application 1-03.doc ".' ,;. ..~,.., Status Issued , CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00173 ISSUED: 02/12/2004 APPLIED: 02/12/2004 EXPIRES: 08/12/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 215 Q ST ASSESSOR'S PARCEL NO.: 1703263102103 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Add 7 circuits '1,;, Owner: Q STREET PLAZA PROPERTIES LLC Address: 2677 WILLAKENZIE RD, STE 3 EUGENE OR 97401 ISONTRACTOR INFORMATION. Contractor Type Electrical Contractor GLOBE BUILDING & ELECTRIC License 103677 Expiration Date 01/04/2006 Phone 541-683-7077 '_BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure ' Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: Street Improvements: Storm Sewer Available: Special Instruction: NOTICE: . ~g~~:~~~ ~~~~~tw~z~~~1~:R~: ANY 180 DAY PERIOD. I DEVELOPMENT INFO~N:Oregon law reqUires yo~. ~u follow rules adopted by tm!&r:ft009~A\l.itY.-~TG . Thosarules are set~" Overlay Dist: \lotificatlon Center. ":.fP,tNOAR 952-00' # Street Trees Rq~~ OAR 952-001-OP1? thr~~~rfR~drules l Paved Drive Rqd: 0090. You may obtam COe\?mpa~~lephone I\' the center (Note. me % of Lot Coverage: ca mg h Or~gon Utility Notification number for t e f"'~n+N;~ 1_p.nO-332-2344). I!yBLIC IMPROVEMENTS' SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Sidewalk Type: Downspouts/Drains: Notes: l.:y aluation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount . Value Date Calculated Total Value of Project Page 1 of2 "'-wt$~'Jl~~I,~,gf' ,_..--- ~r 1 t ;e . ...,,.. ~-~ ;.'~~~. .:;r:- ,f ~ -. _. , "'" _ __' u ~ ~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid $6.10 $4.27 $43.00 $18.00 Total Amount Paid $71.37 I Plan Reviews I Date Paid 2/12/04 2/12/04 2/12/04 2/12/04 CITY OF SPRI~(jJ11ELD' Building/Combination Permit PERMIT NO: COM2004-00173 ISSUED: 02/12/2004 APPLIED: 02/12/2004 EXPIRES: 08/12/2004 VALUE: Receipt Number 1200400000000000202 1200400000000000202 1200400000000000202 1200400000000000202 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. . lJeouired Insoections I 1 Rough Electric: 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 of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pa2e 2 of2 Date 225 FiftwStreet Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00173 COM2004-00 173 COM2004-00 173 COM2004-00 173 Payments: Type of Payment CreditCard ./":J Receipt #: 1200400000000000202 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Received By djb Check Number Batch Number Authorization Number Paid By MICHAEL FARRELL 000298 115262 City of Springfield Official '..leceipt Development Services Department' Public Works Department Date: 02/12/2004 2:54:01PM Amount Paid 4.27 6.10 43.00 18.00 $71.37 Item Total: How Received In Person Payment Total: Amount Paid $71.37 $71.37