HomeMy WebLinkAboutPermit Electrical 2004-3-1
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. 225 FIFfH STREET.. SPR.Ii'fGFlELD, OR 97477 .. PH:(S41)716-3753 .. FAX: (541) 3689 ",
ELELl ideAL PERMIT APPLICA TION ! ,The, following project as su~mitted h,a.s the following
. ,',,""' Q I J OL\ ,zonlOg, and does not reqUire specific land use
City Job Number COM ZOO L.f -00 ~ Iv Date 0, \ . , approval, " " " ,L
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. 103 W~ Q. ~U2....-\-- , ",' ,"",', ,'.,', ',',,' "".,AuIhorized Signature ",.~vJ
LEGAL DESCRIPTION ) 70;1 '274/ 00/00 A,':~;;~',~c#,'~riti~I~~;s~i~J:(i()r:#Wd;f~l~;h:i>.i;,,~~y:~11i~~A":if.:
~('\t'')-\i<.t,\~ ~b1tL ~8U1cj \k..Ju-~-1cVj Hosr;'hJ Service Included
JOB DESCRIPTION 1000 sq, n. or less
Each additional 500 sq, ft, or
portion thereof
Owners Name S'i> PJJ - E:vtb-
103 tJ G(
'City sYrU '-TEPiN1('Iu.t!IO" "'..- - -nl-'N requ,t~~Q8u~-eg!ltiOn'. $ 50,00
1-\1 II I'I.\JIC;~V ...... ,'j""
, ,w rules adopted by the Oreot3l~~urlmyLlghtl~g " $ 5~.00
OWNER JNSTALL~~#~ation Center. Those rules ~'!.~tIf.m:wlResldentlal $ 2.),00 .
The installati.on is beurH:1WR~$'L~i...:{lOO.f.(H~ough OJ:\lPFW52fe)ugy/Commercial \ $ 45.00, L1~.C()
I~ not 111 tended for sa~5dff6~ 4fb~tfT1ay obtain copie:ryr~Q!l1~I~8"ik Pes-mil Inspection Fee is $45.00 + Sun:hnrges
OWllers Signature: n~~~n;r ~~~ t~~n~r~~~~t~~i~~~ ~111r~i,~~~~~q%]:~:'[:{~1!;;'~;.~i~1~21;~{~;j~;}~;1{';,~ L{~. 00
,.....~-,fM;<:: 1_P,Of)-~~2-2341.%.Sra(e Surcbarge~ ~,.L5
NOTICE: 10% Administr.\livf Fee 4,50
Inspection RcqueSl: 726Jti~ PERMIT SHAll EXPIRE 'fffJ>J1J~ORK " , ~
,', , ACOUTMHMOERN'lCEEDOUONOER THIS PERMIT IS~ivclT:)'~uildm;;l:onm/EI~Lri~uIPcrmi(Arrlicotion t,(\l,d(1C 5Z ~
.. " -, .. R IS ABANDONED FQ
ANY 180 DAY PERJOD. Q. t<\ R ~ '
. . ~ " \'C.():; C\i1hV \
~~~
~.~ \j "S~ ~C4"'"\
Pecmits a~e non-tcan.~ferablelU\d e;rpire .if work ;s
not started withio 180 days of i~suance or if work is
SU5pended'for 180 days.
::: ::;. ::";' :.. ::,;. :.:' ...:. .. .:. :':":~: ~" ':: ". " .: :~ ;\:: :~.~ . ~.l.~:.~' ;:.. ~.~:.;; ;': :.' : .;;.. :::~'. : .r, 'F~' ~-;: ::.: :'.,; ~ ..::~.:::~;; ~:.;.;;(. ~.:
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2. :':Sq~~~~~~;~~r1b~%I?~B!'fF8:~;
,Electrical Contracwr ~y""~ A\u..rm Cor'P
Address 2 \7 ~~ I"~V"\ ~ .
City
A\bJ
Pb()ne ($L-\\) 'fz<g-~54"1
Expiration Dare
9cr-tLE'.A
10/" OS-
21. "57 C-I.-E.
J 0 J, JoL\
Supervj$or'Lic~n$e NUlnber
Constr, Conlr, Number
expiration Dale
S'R'~' Ek,",cim
Address
V t:T -,.to 7) P
st
$106.00
$ 19.00
Each Ml\nufacl'd Home or
Modular Dwelling. Ses:viceor
Feeder
$50.00
B. S~S~~~~;fi:"F~~~,~,i~~~!~e~i~~'i[;~~i,i~~~~:~~~~fi?~i~~?:~~;:.~:;.
200 Amps or less
201 Amps to 400 Amps
40J Amps to 600 Amps
601 Amps to 1000 Amps,
Over 1000 AmpsNo1t$
Reconnect Only
$ 63.00
$ 75.00
$125,00
'$163;00
$375,00
S 50.00
c, ;i~~~~&f~~:Y;~~1~]~~4rf~1~9:~f~ls~t2~fSf~I~WJ;~~~;,jI'i~;;i}j~::i~~':~m?~;ih
Installation. Alterari(ln lIr R,elocation
200 Amps or less $ 50,00
201 Amps to 400 Amps S 69.00
401 Amps 10600 J\D,lpS $100.00
D. t~~t;~tfu~;~i~1~i~~1lfr~.iJ~~t~ii~~*1H~~:F~;::~~;1,~;::'G~:'m~~tj:)~j~~:
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Servi,ce or Feeder Permit
$ 43.00
$ 3,00
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E. __,~4{~~~~~~~);~~~'~~#:~t~~~R-'r:?:~;i,~{~~~,~>:]~~~S~~!h:~:~~i!,~iJM:'
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00270
ISSUED: 03/12/2004
APPLIED: 03/11/2004
EXPIRES: 09/12/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
5-11.726-3676 Fax
541-726-37f91llspection Line
~j[TE Ae:' :J.C;S: 103 W Q ST
;\SSES~:~~'~; PARCEL NO.: 1703274100100
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE:
New
Commercial
PR,OJECT DESCRIPTION: Security system
Owner: SPFLD-EUG EMERGENCY VET HOSP PC
Address: J ::3 W Q ST SPRINGFIELD OR 97477
I_CONTRACTOR INFORMATION I
Contrac1Cr :~'ype
Electrical
Contractor
MARTlNVEST INC
License
40591
Expiration Date
09/28/2007
Phone
541-928-4544
I_BUILDING INFORMATION'
# of Units:
Prilllar~' Dccupancy Group:
~~l'Condan Cc','upancy Group:
rrilllar~' C()n~~rllction Type
SeCOndH\' Construction Type:
# ofBed:'~:!:rn~:
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:
SETBACKS
NOTII'C.
I DEVELOPMENT~t'~1.I4LL EXPIRE IFTNj
A ORIZED UNDER THIS PERMI ~ PARKING
Overlay Di~OMMENCED OR IS ABANDONE~[l~.1 or
# Street TrAN'RclOO DAY PERIOD Lfl.~capped:
Paved Drive Rqd: . Compact:
Front~'ard Sct!Jack:
~;ide 1 SI,'!:,ilC:,:
~::de 2 S~,:;ack:
~'earyarr: ~:ct""ck:
~~:dar ~I':;..~~ks:
% of Lot Coverage:
St reet I rn provelllents:
I PUBLIC IMPROVEMENTS.
ATTENTION'O .
foil , . regon law reqUIres you to Sidewalk Type:
ow ru es adopted b th 0
;Jotification Center Th Y e regon Utility Downspouts/Drains:
,) OAR 952-001-00.1 0 t~se rules are set tortl'
0090. You ma obtai r~~gh OAR 952-00'
calling the ~nter. ~CO~~'.~~ of the rules t
n"""'t:Q-.L" ~ . e telenhnno
- -;v, "'~ . u. .,j'-.: :':~::;~y f-JuUT/c tion
,,~, "Valuatibn~Desc,: I 'on
S!orm Sewer Available:
~:pel'ial !!. lr~lcti()n:
f'lotes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pa2e 1 of2
_ :-'dl'~F\lIIMC n z:U:)
'j.
~'
CITY OF SPRINGFIELD
:3tatlls
L!';lIcd
Building/Combination Permit
PERMIT NO: COM2004-00270
ISSUED: 03/12/2004
APPLIED: 03/11/2004
EXPIRES: 09/12/2004
VALUE:
225 Fifth Sln'cl, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
~,tl-726-J769!lIspcction Line
L Fees Paid I
!~'cc Dcscription
+ lO'Y" " ;,;mi":slrative Fee
+ 7'Y,) S::, tc S:' "charge
Low Voi:-'ge - Commercial Indus
Amount Paid
Date Paid
Receipt Number
$4.50
$3.15
$45.00
3/12/04
3/12/04
3/12/04
1200400000000000304
1200400000000000304
1200400000000000304
ToH Amount Paid
$52.65
I Plan Reviews I
'1' 0 Rr: .. :'st ' .. inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be ;.,ad:, the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I_Reouired Insoections I
] Low Voltage: Prior to cover.
?~' sigl';'! nt', ";1 'lIe and agree, that I have carefully examined the completed application and do hereby certify that all
i.lform;: :,11 hc:,n is true and correct, and I further certify that any and all work performed shall be done in accordance with
I 'IC Or,:;" ': !ICl" (J[' t hc City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
f'al NO :)CCL PANCY will be made of any structure without permission of the Community Services Division, Building Safety.
! furlher eerlir~' thaI only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
] further agrec to ellsure that all required inspections are requested at the proper time, that each address is readable from the
s: reef, t hat the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at all
timcs d;,ring Cf"lstTuction.
C wiler n -;:-'cr' ""clors Signature
Date
Pa\?:e 2 of2
225 Fifth Street
>lgfiel !, :;r':::.;~'~ ';'7 '77
, .. _ ....,., 1:....... .- 0.- "
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~e
,,(I,
.
COM2004-00270
COM2004-00270
COM2004-00270
Payments:
Type of Payment
Check
I{eel'i.! 1'7: 12IJu-HJOUUUOUOUUlbu4
"Illller
i ll'~\.' ri,) I j( 111
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Paid By
MARTINVEST
Check Number
Batch Number Authorization Number
Received By
djb
39519
City of Springfielci Official Receipt
Deyelopment Services Department
Public Works Departmen!
Date: 03/12/2U04 7:57:43AM
Amount Paid
Item Total:
3.15
4.50
45.00
$52.65
How Received
In Person
Payment Total:
Amount Paid
$52.65
$52.65