Loading...
HomeMy WebLinkAboutPermit Electrical 2003-7-15 -" 06/06/03 FRI 10: 34 FAX 5417' '689 CITY OF SPRINGFIELD 141001 ;" submitted has the following 225 FIFTH STREET . SPRINGFIELD, OR 97477 _ PH:(541)726-3753 _ ~f.l(~1.iW-~~ require specific land use approval. I'l ", . ELEl;lKICAL PERMl1'APPLIJ;,4.TION . . ~ City Job Number E.LeZoa3~ 00 j eb Date 6/6/03 . _ ZOning 'i-fs--a 3 ~ 1.:~:L(j~~TIQ&:Qf~sr4t~~~:q9i\i<.:. ..:.::. 3. :::"9g~~F;~;~~~~~.~r).~::');;: ....... ..,'. 900 Beltline Road, Springfield LEGAL DESCRIPTION j7D3.1 S3 0 ()J'OOO A. ::~~',{R~~i~~~~~#~I~..S~lJ~f~tii~~f#i~~~:~Vd:~~~l~~~~'~@'i:i;;i.: Service Included 1000 sq. ft. orles$ Each additional 500 sq. ft. or portion thereof $106.00 Shari's Restaurant JOB DESCRIPTION Install electrical for lottery conversion. $ J9.00 Permits are non-transferable and expire if work is not started within 180 days of issnance Or if work is Suspended for 180 days. . 2. (S?~fq~.i~r1~~3iq~:~~~;i';. Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. '-i:~~f~;~4~~.-~~!r~~~;~t~..H:f~i~IJ:~~?~:;~~~#.te#~~~.:~.~'*~~~~.~#~~'~;-_.!i'!. Electrical Contractor Atlas Electrical Contracto1200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Address 440::\ SF: RoptQP Roao. __~ Milwaukie, Oregon 97267 Phone (503) 659-2212. City c. .:T~'.."'Yi~~~~~.'F~ciI'ers.; ."~;~~:::':~.:::::~.:::'_;':>::.::.:".:::.:';<:>.''::''" ~~':fT... ~. ..-.... ... ,....... ...... '.. - _- ...- ~ ~e~(PA~, :\;\~', J 10/1/04 (){\\'lJ. ~e~,~~~hon orllelocation .O''O~ ....~'1'\l -~\B~:fr1~!A.~' $ 5000 O~. ~ev- Se t!W Vlp.>~ r ,U""" - ConstL Contc Number 1532 _'\;;~\~" 0..009 :~O ~~Q}'~~~~&\ $ 69.00 ~ \ ~,\)\evce~~'\()~ of~~~ps $100_00 Expiration Date 9/3/03 ~o~~""t-\~~,,~'\ o~\~~ ~dSf' ._ ~~~r l~~~ yol~s s~ "~"I.~bo.v~:y. d.. . .._. . ,.,..,.._. S. fS. - - EJ . NO bo.?9 A\e.'1_...de\ ,~^' 'Irl"'ut~ "'" " ..' .-.... -" ..,. ',', ' ..; Ignatureo upelv1sll1g ect1'lc~10""~""o\)"'eC"".'O\~v... .. ;.' ;:'-. ~-"'_-,.-'.':. ..-':',,":'_.-'-.-; . ':", .' -'. ,"'-, ._'._;,'... : iJ . . , f) ~ otf!J3' ~\v:4 \~ ~ \"(\0. '\ ..~ew Alteration or Extension Per Panel ';( )/. U/~_ c:fI) ~e'\C}eO~'\S One Circuit _ -l- $43.00 ~].(;O. (\\)~ VO' Each Additional Circuit or with 5' 4!"'" Service or Feeder Pennit A $ 3_00 -CIZ.ocr /.:> Owners Name Shari's Manaqement Corpor_ation ~'& Address 8205 SW Creekside Place E. '~~~~~ri~~~{(seI1;j~~~~-f;~iud~dj~E~~h,i~~,t.~.~~tio~'- - .. . ,.' .,. """ . - ~\'\\t,\VT~~\" \'d,\~\rJ;- . ...,. ,,,- Phone (503) 605-418_5 C~. pump~~\\\<;, ~t.~ x.\) ~a~ $ 50-00 ~\)"'\ ~~O'~~\)Q~ $ 50.00 OWNERINSTALLATTQN \~\S ~;~~~~t\i~sidential $ 25.00 _~N_' !be ~tallation is bein2 made on property T own which ~\J\ ~~ie~t~inmercial ,,1 _ $ 45.00 545.00 18 not mtended [or sale, lease or rent C~i~\lfectric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: . ~~. i~:.~~~?rM::e~~g~<:';:-/{:L:;;j'_;':'jj);-"iii'i;;.i/;;i _100 _ 00 Supervisol' License Number 2581S Expiration Date City Beaverton 7% State Surcharge 10% Administrative Fee 6,0 -=t-:-OO '1 zo -J:O .00- b.o ~~'7~1>70 ~ Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElootrical Pcmlit Applicatio1lJ.03.doc City of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO.: ELE2003-00166 ISSUED: APPLIED: EXPIRES: 7/1412003 7/14/2003 1/14/2004 . SITE ADDRESS: 900 BEL TLINE RD ASSESSOR'S PARCEL NO.: 1703153001000 Springfield TYPE OF WORK: Addition TYPE OF USE: Commercial PROJECT DESCRIPTION: Install electrical for lottery conversion OWNER/APPLICANT: SHARI'S OF N SPRINGFIELD % SHARIS MNGT,CORP BEA VERTON OR 97008 ELECTRICAL CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS 003-659-2212 4403 SE ROETHE ROAD MILWAUKIE OR 97267 CCB # 1532 Expiration Date: 09/03/2003 Descriotion Amount Paid Date Paid Receiot Number + 10% Administrative Fee 6.00 07/14/2003 1200200000000001756 + 7% State Surcharge 4.20 07/14/2003 \01200200000000001756 Add. Alter, Extend Circ Ea Add 15.00 07/14/2003 es'iO~~\\~00200000000001756 Low Voltage - Commercial Indus 45.00 07/14/2003 '(eo..U\~"of\" :~'n200000000001756 'fJ-..H C1- _.\:~ 0"\ ~"nce fA,\~~,N"!,' To Request an inspection call the 24 hour recording at 726-3769. ~~~~I~'4etlU~~'e~~,~.wi1l be made the same working day, inspections requested after 7:00 a.m. will be m'!~il\~~a~~~~~O~\'(\8 ~~ :,,"\~ fl\eS re.t. e'~ .e-O\ ~t~-ilf1(\ ~\O"" ~ \J J:P' CO'Y' (i\e '\: ~'(\V'" ReQuired Insoections: ~ ~\\\c&.\w,~$'\ O'O\~(\ ~o\rI' ~~\-\~;'\. 1 Rough Electric: Prior to Cover ~O O~~ ~ou <<,e.~\e\,~o(\ \)~ ~'l.~ 2 Final Electric: When all electrical work is comPI~%da().~\\(\~\"~'(\,,eO\..~O()"~ 3 Low Voltage: Prior to cover. ~ ~'( \0 ~\e'( \S '(\u'#:\ oe 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 Shi~'ih)lle in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to t~~ ~~\ribed herein. I further certify that only contractors and employees who are in compliance with ORS 701.0~~\~le~~-ep this project. I further agree to ensure that all required inspections are requested at the proper time, th~~~~<3'b.Tt~S~hW~ rom the street, and that the approved set of plans, if applicable, will remain on the site ~~lim~ ~:::\nlfi~~~~~~ ~~" '?~~~' \) \)~\J ,S ~<o~ ...u\S ()~,1~ - f)~ R)~ Owner or Contractors Signature \ ~\.)\~ ~~~c,~~Ci(<t.\\'\ c,(J~ \ 'O~ \)~ ~~'{ Page 1 of 1 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number ELE2003-00 166 ELE2003-00 166 ELE2003-00 166 ELE2003-00 166 Payments: Type of Payment Check Receipt #: 1200200000000001756 Description Add, Alter, Extend Circ Ea Add Low Voltage - Conunercial Indus + 10% Administrative Fee + 7% State Surcharge Paid By ATLAS ELECTRICAL Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 07/14/2003 2:33:10PM Amount Paid Item Total: 15.00 45.00 6.00 4.20 $70.20 How Received In Person Payment Total: Amount Paid $70.20 $70.20