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Home My WebLink AboutPermit Electrical 2007-8-21 Date ZON rn uC/ INITIALS pi-- DATE 1.--u /c;"' SOURCE- ~ t/dJ'UI 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO..-.. 'Z-o'" ,- 0 ( 'Z.-4 'Z.. 1. LOCATION OF INSTALLATION: . W1otlA~.~ ~(vd )7DOO / III LEGAL DESCRIPTION: ,-, 0 s ?SJ::S JOB D~~C~P,?ON: ?- 7t d~ C l r L.V\..' h 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. ;"_:" ~-_.- . -/ _ - :--', f-Y-:-'~~'\'-:;.:c;:;f:>'-."('T\<--:-;'.>~p-:::::>",_;",,~ " - < CONTRACTOR INSTALLATION ONLY , : }.': ' . - ,,' - ~,,- -'~ .__ Y:<~'" - -', .:: V.__ '-' - ---" < - - - J" Electrical Contractor , \ ~ C \ iLL \-.r:c.. I V\ t. Address '--l (p~S- \ ~o..."'~\ \e.... s.\-- City (. ",--c. e.V'le... .J Phone Co<8 1-511 C) Supervisor License Number ~ "R-7 ~ S. Expiration Date 10 ~ /-TJ7 Constr. Conu'. Number (D ~<\ :2.9 Expiration Date 3- \ L.\ - D "9.. Sig~~O . upervising Electrician .. / !./ ./ / ~._-- -- I Owners Name 5W/ a \i204 ~J:. t:-S J#Dl,zAvl~ 1S/vJ Address 11// s.Yr1\ Phone City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owner~~!!~~; THfS PERMIT SHAll EXPIRE IF THE WORK Ai:1TI1UNllEiJ UNlit" THIS PERMIT IS NOT COMMENCED OR IS ABANDONED fOR ANY 180 DAY PERIOD. Inspection Request: 726-3769 3. ' COMPLETEFEESCHEDULEBELOTV 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 <.'>'":,,,~".. .-'..: ",--,>.' >'::":j.-, B. Services()rFeeders~ Installation, Altel'ations or Relocation: 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps A~rem: Oregon law I'A'1I.driS~ 60 1 AmpfcMtd~~dopted bv the Ore~(l)93~ity Over 1 O<Notm~ationtCenter. Those rules a~~Mpnn Reconneim Mfl952-001 ~001 0 througn OA~ ~2rP01~ 0090. You may obtain copies of the ru1es bJ "/ . <".y'~:ttletelepJ1Ofl& c.~,~~poh~~~ . tUfty Notification Center is 1-800-332-2344). Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Ov~r600~ps 01';1000 Volts see "B" above. D. :.BrallchCircllits New Alteration or Extension Per Panel I LIe, One Circuit $ Q-:ee Each Additional Circuit or with / Service or Feeder Permit {;;:;> $ I{.OO '18 -z-'-I , ',d,'" .;_ '., ,,' .. :.''/' ,,:' ,,-~. '-'. -,' E. MiscellaheoJ,ls (Service/feed~r not included) -Each Installation Pump or llTigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SU?JTOTA,.LOE ABOVl{ 8% State Surcharge 10% Administrative Fee 5% Technology Fee 72. 7'2.- gr5b TOTAL Shared Dlive(T:)/Building Fonns/Electrical Pennit Application 8-06.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01242 ISSUED: 08/21/2007 APPLIED: 08/21/2007 EXPIRES: 02/21/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1111 MOHAWK BLVD ASSESSOR'S PARCEL NO.: 1703253317000 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 7 circuits Owner: 5MB PROPERTY HOLDING LLC Address: 1111 MOHAWK BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor JB ELECTRIC License 104929 BUILDING INFORMATION I Expiration Date 03/14/2008 Phone 541-687-5770 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: NOTICE: Sprinkled Building: . .,- -, I" ll"Vf\lr.' ~ n: ,-uc: wnRK THIS t-'thIVII" \oJ M - b!~I... -,. , . AUTHORIZED UNO: N1UiNNRMA TION COMMENCED OR IS ABANDONED . ANY 180 DAY PERIOD. Overlay Dlst: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: n/a REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: "I 1...:F;.e~1! 1;7::1~- '''''- ftl(]1I1""A yop.t :~cat~~~~:~r:Orth. In OAR 952-001-0010 through OAR 952..ootsldewalk Type: 0090. You may obtain copies of the rules ~ownspouts/Drains: caltlng the center. (Note: the telephone number for the Oregon Utility NotiftcaUon Center 18 1-800-332-2344). Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 2 , . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01242 ISSUED: 08/21/2007 APPLIED: 08/21/2007 EXPIRES: 02/21/2008 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 J Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $7.20 8/21/07 2200700000000001328 $3.60 8/21/07 2200700000000001328 $5.76 8/21/07 2200700000000001328 $48.00 8/21/07 2200700000000001328 $24.00 8/21/07 2200700000000001328 Total Amount Paid $88.56 I Plan Reviews, To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Rough Electric: Prior to Cover 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 Date Pa~e 2 of2 225 }'ifth' Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01242 COM2007-0 1242 COM2007-01242 COM2007-01242 COM2007-01242 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 2200700000000001328 Date: 08/21/2007 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DANA ALONSO Item Total: Check Number Authorization Received By Batch Number Number How Received djb 023825 In Person Payment Total: Page 1 of 1 2:44:57PM Amount Due 48.00 24.00 3.60 5.76 7.20 $88.56 Amount Paid $88.56 $88.56 8/21/2007