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Home My WebLink AboutPermit Electrical 2005-11-15 Date t+.I. ,",lJ&.l6/1>5 .,'~ //-8 - (J c~.:..- ..1i1f~ spd"j 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number rL)fVl '2.DDS ... D/ bl ~ , ' 1. 'LOCATION OF INSTALLAIION /cf:4i A Ie, 'S {, LEGAL DESCRIPTION l7 O"b 3~ 00 OO~ JOB DESCRIPTION ~ec~/ ~ &-e S'_'ppR:5<';~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ,CONTRACTOR INSl'ALLATIOlV ONLY, 2. ' , . . " _ Electrical Contractor C~L ure f.ec~ ~c... Address 5/t/ ;\la/~M;-U\ 'irfvJ. City /..- v:;eV'lL Phone Sl-I t1tfBi- Supervisor License Number 33~JLEA, Expiration Date /b - (- ~oo'7 Constr. Contr. Number /S6~/R Expiration Date 8- ~- z.. 00-=1- Signature of Supervising Electrician ~ "'/L . 1./'7-"~ / ~~~ ,~ ~ - / J' . Owners Name ,r?~ fu~ Address P r5. l3t::>X ~O CitY2Jpr/~ Pho", 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 3. COMPLETE FEE SCHEDULE BELOlV' "'. . '. :.,. :. ',',>'\". ."..' 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 $106.00 $ 19.00 Each Um~~ Home or ~~~~\~J~[R~~T~HA[L E~t If TWeW~K "AUTHORIZED/UNDER THIS PERMIT IS NOT B. ,. S~rcb~R{~emOfffS1~~IlJ~~v( Relocation: 200 A~~Yo1ft:QsDAY PERIOD. 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 v . :'\ ,";-" .,' :' .,,'" C. ;T~in~orary SerYices()r,f~e4~rs Installation, Alteration or Relocation 20~M/r\'~' $ 50.00 20 Am~s to ~b"A Of>~gon law re~uires Y'$~~~O lORg~s ~~lgOba.$?sted by thtj ,ureyori l$t~B~o ~otlTlCatlon CenltJr. Those rtlle::; art! set forth <mej)99.Q b:81PU~J1L<e,ovOj ~q~~~~t,e;~'r~'t~~Piv,~'52-00 1- D. ()6~~ c~::,gli~m}S Qt)t3Jn. GC; pj ,~~ ~Gt; I~ @'J~~t 1:'.s2;.~" Ne*S\!a~t.Mi~i1 d.eE~t~n'i~nJP-er;Panel' ~)r '-or-,.~:, O nlc'mlJPr 'ior~:p Onr,('1r, : :';: " " ""$,'43 .0' 0 ne :ircUlt ~ -~.' '-' ." .- Each AdditfdfiiiiGii-6uif of with') -: - ,. -.). Service or Feeder Penn it $ 3.00 E. ,Miscella?e~~S (Service,/feedernot insluded)--Each InhaJlation' Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 X $ 45.00 4'5.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges , .- 4. , SUBTOTAL OF ABOVE 45.00 3.\tS If-.150 52. .~'5 ".' <, 7% State Surcharge 10% Administrative Fee TOTAL Shared Dnve(T:)/Building FomlS/ElectIical Pennit Application I-03,doc ,_~~!,~,r!9J;;;,I!t,~I'... ,."~",",_'" i " Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-01613 ISSUED: 11/15/2005 APPLIED: 11/15/2005 EXPIRES: 05/15/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax : ",.541-726-3769 Inspection Line . ;'.1 SITE ADDRESS: 1801 ASTER ST :. ASSESSOR'S PARCEL NO.: 1703360000300 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Security and Fire Suppression. N Of\Gi:OF USE: ~Xe\);IRE IF THE W~~merciaj THIS PERMIT SHALL t .to' AUTHORIZED UNDER THIS PERMIT IS NOT ' COMMENL;tU UK I~ f\OI'\I~uui~i!u ro;" ANY 180 DAY PERIOD. Owner: ROSBORO LAND ANNEX LLC Address: PO BOX 20 SPRINGFIELD OR 97477 i ' I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor SECURETECHINC License 156618 Expiration Date 08/08/2007 Phone 541-521-2837 ~ j~, I BUILDING INFORMATION I # of Units: : Primary Occupancy Group: .. Secondary OccupaiIcyGroup: , Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: , '\ w reSnUFt\Basem'eJlt: N'O gona ~"""vJ--' Range Type:TENTIO . re d b the ~:K~&~\1lg~farport , Energy Path':)w rules adopte Y I Sg EtrOthe,:o~ ,- 'c ter J,bose rU1f:,;3 a, v ,"," . Sprinkle,(MWildingil en ' nYa Occup.{lg~.J:.q"l\St:.. , '~....... ,",1:'''1 nn1 J)n1 n throuqn UK . I DEVELOPME~~~NFO~lII(i)Na'l copi~S ot me r~~~e~ calling the cemel. (Note.,t.heNtelet'~P.-JIJRED PARKING f the Oregon Utility 0 1 lea, Overlay Dist:lmber or . 1_800-332-2344J.Total: # Street Trees Rqd~enter IS Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: ) ~ ~ Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ,. ~'r I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: ~ Special Instruction: i Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated ~ ... i Pae:e 1 of2 . ~". _$~!!it~~J~I!!t'9J" -"'~'.'..,.^., II W;r; i" it ;. ti: "- j' ~ ..~~(] - I, ,r,r. . e': ~ ~ . . '~!""- 'I r:~ ~IJ. ''.~' . ,,~,;r::"~,t"'ll~~~ -<'".;-- CITY OF SPRINGFIELD . I -I Status Issued. Building/Combination Permit PERMIT NO: COM2005-01613 ISSUED: 11/15/2005 APPLIED: 11/15/2005 EXPIRES: 05/15/2006 VALUE: '. 225 Fifth Street, Springfield, OR " 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge " Low Voltage - Commercial Indus Amount Paid Date Paid $4.50 $3.15 $45.00 11/15/05 11/15/05 11/15/05 Receipt Number 3200500000000000640 3200500000000000640 3200500000000000640 , . 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. - 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. "Ii' .\ . Owner or Contractors Signature Date t.. , I,. . Pal!e 2 of 2 . 2.25. Finh Street 'Springfield, Oregon 97477 541-726-3759 Phone r''v of Springfield Official Receipt ,velopment Services Department Public Works Department Job/Journal Number COM2005-0 1613 COM2005-0 1613 COM2005-0 1613 Payments: Type of Payment CreditCard I II15/200S RECEIPT #: 3200500000000000640 Date: 11/15/2005 Description Low Voltage - Commercial Indus + 7% State Surcharge + 10% Administrative Fee Paid By TROY DERRICKSON Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 015842 In Person Payment Total: Page I of I 9:36:21AM Amount Due 45.00 3.15 4.50 $52.65 Amount Paid $52.65 $52.65