HomeMy WebLinkAboutPermit Electrical 2005-3-8
Expiration Date /0105 Installation, Alt'eration or Relocation
200 Amps or less
Constr. Coulr. Number 59 c; tf if 20 I Amps to 400 Amps
/ 40 I Amps to 600 Amps ,
Expiration Date ~ / a I:)
, ' , .~ ~ . ' N. ~re~60?,,1.'-I~P~:~~ 1,000 Vo.l~_},~7"~'"above"r~;;~"" ':
SIgnature ofSupervlsmg ElectncJan OTlCE.n, : Hranch CJn:U1ts,. ''',Jet,,', " .' '
,THIS .. ,h,,' .", ,.'"
Ii . ;) /\. ~ AUT/ERMIN8Y/i't~fr~~l'l' " EXI.n,;on P.r Pan"
~:,R:,/ kr":' ,~.. ('n.. ORIZE[b~~J<e.i[cl1it- I~E IF THE W /. '
V hm ~ A.N'''MENCE/j'fJIl'!f!_~,ftll~ diflMI>T rS'~tl,
Own... Nam. G ~ 0"'f'iJ~ DAf,~~IbOq,~~~~ fo.~: r, ... S 3.~ .
Address /7 Z ,', iI o.{LVoA.,4-t'( ;4-v E.:,,~IJ~cell~n,eous ~~er\'fce/fe~(I,er,!~ot included)':"'Ellch lnstallallon
CityLO-v S '-~-7' O~Phone Pump or in-igation $ 50,00
Sign/Outline Lighting $ 50.00
Limited Energy/R,=sidcntial $ 25.00
Limited Energy/Commercial >< $ 45,00
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Supervisor License Number .32 7/ t::LA \
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e. fTeinl'onJry Services oiFeeders . ;.. " "
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$ 50.00
.$ 69,00
$100.00
.$ 43,00
OWNER INSTALLATION
111e installation is being made on property lawn which
is not intended for sale, lease or rent. "
MlnimulII Electric Pf~nllU Inspection Fee is $45.00 + Surcharges
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,I~'~,65
Owners Signature:
" "J." '~:''1 -', I ': ......, '"" :1 . ".'- ;.". ,. ;,. ~.' 1"1;,'" I :~: . 'r;' ",'\ ': j"
4. ~SUBTOTAL OF ABOVE 'i;;",
"-:'1' (,. '. . ~ I . , ' . , ," :" ;~
7% State Surchilrge
10% Administrative Fcc
TOTAL
I"'~" \~~~65 .
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Shored Dri~ e(T:)/Building fonnslElcctrical pcmiil AppHc;lion I.oJ.doc
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00338
ISSUED: 03/25/2005
APPLIED: 03/25/2005
EXPIRES: 09/25/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 177 Q ST
ASSESSOR'S PARCEL NO.: 1703263102100
Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: Addition
PROJECT DESCRIPTION: Low voltage burg alarm and access control
Commercial
Owner: Q STREET PROPERTIES LLC
Address: %OCEAN CREST 192 NORMAN AVE APT 121 \0
COOS BAY OR 97420 ~o\) .~{\.~
, .t>t?> , \~ )0.\(\
0.\),1 ~\ \V'
I.C?OOffcT'~~~~TION I
~eQP 0 X')~ <,,s,e orr (,~ ~
Contracto~~~'~o~0 ~~:~^\)~'<0 !\~e R'<00~~ense
ADT ~~~~~c:t~~~~~~~~ ~ t>\~~:\,\vrz59944
to: ~~ ~o~ 1I:'lN ~ ION
\0'" . ~ 9;f:S
# of Units: ~O\6~~ ~~\) ~~~c.e<fl\~~~,?'2>1:
Primary Occupancy Group: ~ B~' ~ ~e ~ ~ejgfit~f Structure
Secondary Occupancy Group: ()(S ~\~ 0<' \0 (\~~e of Heat:
Primary Construction Type ~\)~'() C0 Water Type:
Secondary Construction Type: Range Type: '
# of Bedrooms: Energy Path:
Sprinkled Building:
Contractor Type
Electrical
Expiration Date
05/07/2005
Phone
541-736-4973
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION}
~\)~
Overlay Dist: ... \'Y \\\'t. S ~\)\
# Street T~~~\Rq(f~~\\ '\ ~
. Pave~DJi~e ~gd':12 ~\) ,\-\J
f\i,\tfi,. ~~'l'L~~Cb\'er.~~~
~\\>> c. \'\:.~ c.\) '0~\) \S \\~~
....0.\~ _ n\1 \- r..Q.. "
'\\\)\I\r~ii~~le~l.MrROVEMENTS I
. ~\)\"!'I" <(,\J ~,
\\~-..J. \ Sidewalk Type:
Downspouts/Drains:
REQUIREDP ARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
l.,yaluation Description I
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2005-00338
ISSUED: 03/25/2005
APPLIED: 03/25/2005
EXPIRES: 09/25/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
L Fees Paid'
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Low Voltage - Commercial Indus
Amount Paid
Date Paid
$4.50
$3.15
$45.00
3/25/05
3/25/05
3/25/05
Receipt Number
1200500000000000369
1200500000000000369
1200500000000000369
Total Amount Paid
$52.65
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_Reouired Insoections I
Low Voltage: Prior to cover.
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
Date
Pal!e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
)velopment Services Department
Public Works Department
'i Job/Journal Number
j COM2005-00338
COM2005-00338
COM2005-00338
Payments:
Type of Payment
Check
~...
"
3/25/2005
RECEIPT #:
1200500000000000369
Date: 03/25/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Low Voltage - Commercial Indus
Item Total:
Check Number Authorization
Paid By Received By Batch Number Number How Received
TYCO FIRE AND SECURITY djb 41091 In Person
Payment Total:
Page 1 of 1
9:52:36AM
Amount Due
3.15
4.50
45.00
$52.65
Amount Paid
$52.65
$52.65