HomeMy WebLinkAboutPermit Electrical 2004-1-26
.t as submitted has the following
ot require specific land use
225 FIFTH STREET . SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX:"(5~11~26-3689 A 1\
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~LECTRIC~ PERMIT APPLICATION.~. ( ....,' ~ __ _ :..., _ -i.cl-D t./-- ..
CIty Job Number COVU zooL{-.c.'O l , ~ DateoLf, JIfyV 6.tllLbd Signature ____.____~J-.
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3.;;'CaNIPLETEFEESCHED[JLEBELOlll:i;,:, -".2::.:";,c; . i.. .: ".;;
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., 7/2-~p:
Phon6g6-~ Vii" Pump or irrigation $ 50.00
" _. Sign/Outline Lighting $ 50.00
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OWNER INSTALLATION. Limited Energy/Residential. tc $ 25.00
of ,,\,Q\f\I rl::l,",1 ireS y~u _
The installation is being made on property I oWA')Vliu:trnloN:O~,'9~gY&~XWBff~\it)! $ 4).00
is not intended for sale, lease or rent. tollow rU\a~~ffi6~~~g;Bm"!Jli1lW~t8iaJiiFee is $45.00 + Surcharges
Owners Signature: '~o~~~~~~_~;~~~~m~91$~~~c
, obtqH'I copt&SJ;;l " ," .... . L/ Cj'
0090. You may - . 11\01 ~~. +h~ telephone ~ Cf]
\\:no the ceVlCYI9Sta.re<~'rt::~:-4toeN t"icatiop ...:>
ca I ~ n e:t.l"Illn UtIlity 0 II. . 9 0
':"'lumber tor tha.~A;"Ram~~~~~3I~. Lf
,-......,.,+-->....,. -I _p-nn . 7'>
TOTAL '5 7
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LEGAL DESCRIPTION
/70326'3/
C:>Z{o3.
JOB DESCRIPTIQN
jV(],vJ C{ (L C-u I s- 13
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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, c;Q!.VTRi!c,TOJ1.:INST.A,LEATIQNONLY.'
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Electri~~i?&- P>L-D<6 l:fr> ,,/to
A$rlo7 2- ke.LL~~
&pq~ Phok&>~9u'77
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Supervisor License Number 3 &1 tj" ..:;;'
Expiration Date / /) / () S-
/ OJ 6 ~-:::;-
//~/~06
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Constr. Contr. Number
Expiration Date
;l,
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w?~
Owners Name
Address
City
Inspection Request: 726-3769
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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.;;,Serviceso~r'Fee~_err~Installation~ Alterations .orRelocation: ..
,;;.':;;~;__... '. ""-'';:.;.'~,.", ,'" .'.. '.' ';', . '..~..... n '......;.; ~ ,'.,:-"" .._:".~ ~. ".:;~, ....; ,. ; .:.r" "~'" ,;:. . : .:..~." .~,.:.. ',..~ .
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/V olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c.
b'JJJhC&;~N~~~P.~ ~ka~YiolHE W~~~
lW~~1Eff\jNDER 1H\S PtR~\1\S $ 50.00
~~ ~~t~ O~I\~ ABANDUNCU raR$ 69~00
1~'{ 1 Jd~M ~~O. $100.00
aye:.~~Q.. A31ps()r,~990Y()lts~ee "13'~ab()v.~. '~ ,
"c~':": . ";:::'-"> " ',. . "''', <, ,,:',,::<,<, " v.... <:(:: , ~,:;,:- , (),..-., " 'r '.' . ,:~::"
D. .;Br~a.~c~ gircuits .' "",~ '-'~"_._ ""
New Alteration or Extension Per Panel
One Circuit /
Each Additional Circuit or with
Service or Feeder Permit . 01
$ 43.00
L/~
6
$ 3.00
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Shared Dlive(T:)/Building Fonns/Electrical Pennit Application I-03.doc
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-00113
ISSUED: 0112812004
APPLIED: 01128/2004
EXPIRES: 07/28/2004
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
PROJECT DESCRIPTION: Add tcircuits
:3 b($
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
Owner: Q STREET PLAZA PROPERTIES LLC
Address: 2677 WILLAKENZIE RD, STE 3 EUGENE OR 97401
Contractor Type
Electrical
I .,fONTRACTOR INFORMATION I
Contractor
GLOBE BUILDING & ELECTRIC
License
103677
Expiration Date
01/04/2006
Phone
541-683-7077
I_BUILDING INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
,.~.,
Notes:
Description
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
I DEVELOPMENT INFO~ION I
. <k~~~~:f \~i \~ ~Q1
~01\C~~~\\ ~\\~\..~ ~~ ' M9~
i\\\~:~\\\lt.\l \l~~r~ ,~: .
~O~~t.~~~ ~'t.~.Lot Coverage:
~ \\\~ \~() , '.= \,nu to
I PUBLIC IMPROVEMENTS I nOn \a'IJ reOQUr~9"'~n ut\\\W ,
- nt-tore'!:' the at tort
l\"rtEN1~oew~k~:b'/ u\eS are S .()O
" u\esl:lUU ,J~ose r Af\ 952
iO\~~V11 ~\Bt\V@~it111~U9h 0 the ru\8S \
~o~~~ 95~tPP~i?~ta\h~d01>\e~h~1te\e~no~e
n '{ou ('f\a,/ 0 r tNote:. ~'o\\t\cat\OO
0090. ceote . Ut\\\t)I "
ca\\\09 ~~ ~he ore~o~ ~~2...2.344).
"'Ol::" 1- ., " s~ '-
I IOu,,", ",~f.''' 'c
"yaluation Description rf.' '
. REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Total Value of Project
Paee 1 of 2
Status
Issued
'"
'.,
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid
$4.90
$3.43
$43.00
$6.00
Total Amount Paid
$57.33
I Plan Reviews I
Date Paid
1/28/04
1/28/04
1/28/04
1/28/04
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-00113
ISSUED: 01128/2004
APPLIED: . 01128/2004
EXPIRES: 07/28/2004
VALUE:
Receipt Number
1200400000000000121
1200400000000000121
1200400000000000121
1200400000000000121
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_ReQuired Insoections I
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
By signature, l 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 bemade 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 ORS701.005 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. '
o:~
Owner or Contractors Signature
\:.
Pal!e i of 2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00113
COM2004-00 113
COM2004-00 113
COM2004-00 113
Payments:
Type of Payment
Check
Receipt #: 1200400000000000121
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
BETTER BODIES INC
9881
Cit'j of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 01128/2004 8:46:58AI\.f
Amount Paid
43.00
6.00
3.43
4.90
$57.33
Item Total:
How Received
In Person
Payment Total:
Amount Paid
$57.33
$57.33