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Home My WebLink AboutPermit Electrical 2004-8-3 .00 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 - FAX: (541)7lt:3 9 % . , ~ ~ ELEt.;1..KlCAL PERMIT APPLICATION . ~. ~ l;>)~ % 06/06/03 FRI 10:34 FAX 5417 City Job Number~~ - 0,073 1.::;L<!gn9&:Qf~t4L.iATIOiV:;::;::::':{'/.:~}:: 900 Bel tine Road / Springfield / LEGALDESCRlPTION 170"3>J '530 OlOOC:> Shari's Restaurant JOB DESCRIPTION Add outlet for 6th lottery machine. 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..co~~~~~.~~,r~~q1:~~,"', CITY OF SPRINGFIELD ,>, ~-~~--~ .~ 0'-'9\ o~ <9.;!: :o:.:.::_~~_~ ""t.19. o~_ l;>)/l;>)..,~~ <;>.:.0..., o~ 9;. IS' <9" ~~ .. 0" IS' . ~ 11'" ~ 3 r? ~ ~~ , - d' <S>~ .: "::~7:.~r~l~,< ':>~o~ o ... .'''.~.sll:'~ .. ..'>.~'~.~~;"'}~< 141001 Date 8/3/04 3. :::<;Qim?EETE;~1i~..,s(;ni:ilii}tii' . . " .... . :,:~.\.\.', ., . .... Oregon 97477 A':;:N~~fii~i~~#~~f~S~~fM~tf(. ... . . Servic:c Included 1000 sq. fl or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home 01' Modular Dwelling Service or Feeder $ 19.00 $50.00 R. '::~~f~~5~;?t::E~-~~~~~,f~~~lt~~i~-.~I~~f,e#~~~:~t-~~~~~~~i~~~;__,,:'- Electrical Contractor Atlas Electrical ContractorWO Amps or Jess $ 63.00 201 Amps to 400 Amps $ 75.00 Address 4403 SE Roethe Road 401 Amps to 600 Amps $125.00 , NotiCE: 601 Amps to 10AA~W'HE WOP),'. $163.00 City Milw~~kie/OR 97~~Jne 659-22l2THIS PERMI1JS:MMOO~~~~~MIT IS NOT $375.00 AUTHORlZElJ~WWEd'ia;bI}.s P OR $ 50-00 COMMENg.ED O~JS ABA~P9~~P.- ~ -, , - , ,-- ". ;- . u._- '-:._- _" _ ,- '- :'- Supervisor License Number 2581S Air' 18Q b'A V. ~u&,{S~e~s_o!1 Fe~d~~~ "' -, -::.:.::';.' -,'.,-" "',--,<-" ',' u;:' ,:,-,.'_.. -, -- Expiration Date 10/1/04 Constr. Contr. Number 1532 Expiration Date 9/3/05 Signature of Supervising Electrician ~ I/. fJJ~ Owners Name sit M.,r\ . 1- Address ~OC> JSe/+t'nt:!. City syp 1\ Phone S?FD JZ.ci OWNER INSTALLATION The installation is being made on property T own which is not intended [or sale, lease or n:nt . Owners Signature: Inspection Request; 726-3769 Installation, Alteration or Relocation 200 Amps Or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50_00 $ 69.00 $] 00_00 Over 600 Amps or 1 000 Volts ,~ee "B" above. D.~i:~:;::~~::~:=:'?jlt;~:iirTIi!:'~:~;'~t!~;J, . One Q~.c.\l.\t OtegQn \a~ ore9~ ~:W3.00 $43.00 ,::~~~1io~i'"W'It!1-. ~e pt AM _d ~~\\~~~'~~~ijfr~e ~~ ~~2.-\NJ_OO ':iit\ , ':(":~"'~:-;~..'..~';...~~..-'."~~~~:4~~.~ij. :1ris.:.t~4~h.i~~:-: \\,,0. ''(ouro~. '-Note~\"e\e~~~otfm.. ......... ....""..--.. o~ ~let ~ 011 \)\\1i\'J tl~ . S 50.00 ~~i~tiwdg~\elOo-332..~'. $ 50_00 ~ihited E6e.~esldential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges /4. ,~:~~?r~;:~~~~i-f!"___".:::~;'l),l;,~_]::!r:--J,;_j,',l';:~,!,-";:,:43. 00 i-I )~ 7% State Surcharge ~ .01 3 ~ 10% Administrative Fee .4 . 30 '1 ~ TOTAL ' 50.3L45z< ~ ) ~ ~ Snared Drivc(T:)lBuilding FormslElectrical Pennit AppHcatio1l1.Q3.doc CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01073 ISSUED: 08/27/2004 APPLIED: 08/27/2004 EXPIRES: 02/2712005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 900 BEL TLINE RD ASSESSOR'S PARCEL NO.: 1703153001000 Springfield TYPE OF WORK: Electrical Work Only I!EQUlRED PARKING Overlay Dist: . Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: ~ct: % of Lot Coverage: tEAU\te5 \)\\\\\1 ot' \a'1I ot8Qon \o~ ~~"'\' Oteg j....'J \\,\8 _ ""a set (.~". I PUBLIC IMPR~~lit.60?~O 1nose tu~o~~ 9~~~s-~1 'to'lv.I ~et\\6' ~n~,oUg ~\ne tU 8 ~.w\c0.'dO O()~.GDo~acls~B \6\8?no" ~o Of:\~ 9'02. 0.1 ~~9.\~~ft~~i\l'tO\\f\cat\ot\ \f\ eO 'Iou ~ cen\~' f\ u~ ... A<\) ()o a\\\f\C} \ne \ne Otego Q-3'37/l~ · (# bet \at \S "\.,&0 ~u(f\ cen\et TYPE OF USE: PROJECT DESCRIPTION: Add outlet for lottery machine Owner: SHARI'S OF N SPRINGFIELD Address: 9400 SW GEMINI DR BEA VERTON OR 97008 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor License ATLAS ELECTRICAL CONTRACTORS INC 1532 I BUILDING INFORMATION I 'N C) "''' # of Units: \\t. t(\O~S\~I~~()\ Primary Occupancy G!:y!\;t:. ~~\.\. t.'f..~X I~~o ructure Secondary OccupaIlf~\\p~~\,,\ ~ t.~ \\'\\'2> t'af t: Primary Constructi~\wp~'C. \It.G U~\) \'2> ~'O~~ ater Type: Secondary constructi~t~~ Ct.\) ()~ a\). Range Type: # of Bedrooms: C()~~t.~ ~~'( ?t.\\~ Energy Path: ~~'( \ roU Sprinkled Building: n/a I DEVELOPMENT INFORMATION. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Pal!e 1 of 2 Addition Commercial Expiration Date 09/03/2005 Phone 503-659-2212 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Value Date Calculated ._WtL~e8'j~~~!I;~! , --"~"----" , __H<' h_ CITY OF SPRINGFIELD BUIlding/Combination Permit PERMIT NO: COM2004-01073 ISSUED: 08/27/2004 APPLIED: 08/2712004 EXPIRES: 02/27/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L..-Fees Paid' Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum! Adjustment Electrical Amount Paid Date Paid Receipt Number $4.50 $3.15 $43.00 $2.00 8/27/04 8/27/04 8/27/04 8/27/04 2200400000000001101 2200400000000001101 2200400000000001101 2200400000000001101 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 Insnections 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 Pa2e 2 of2 225 Fift}1 Street Springfield, Oregon 97477 ., 541-726-3759 Phone ~.1iI r<~ty of Springfield Official Receipt ,velopment Services Department Public Works Department RECEIPT #: 2200400000000001101 Date: 08/27/2004 9:51 :06AM Job/Journal Number COM2004-0 1073 COM2004-0 1 073 COM2004-0 1 073 COM2004-0 1 073 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum! Adjustment Electrical Payments: Type of Payment Paid By Check ATLAS ELECTRICAL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 35995 In Person Payment Total: Amount Due 3.15 4.50 43.00 2.00 $52.65 Amount Paid $52.65 $52.65 8/27/2004 Page 1 of 1