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Home My WebLink AboutPermit Electrical 2004-5-17 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PII:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION ~ /0 . ;~~followingprojectassUbmittedha th f ' /... c- I 109, and does not' s e ollowlOg City Job Number ~M 'Z.O'oL{ _ 00 y, L. Date ../, 7" '1 approval. reqUIre specific land use 1. : LOC41ION OFiNSl'ALLA110N 3. CO~'U'LEl'E FEE ~ft'l:lEJ~tl BtU~ I" C (l.. Qb\~l '-P -/.1/-/1 :/~ A a e - 5.::.1% -DL' o J.:>C:;:j /I,,,. c=: uthorized Signature _ ~~ I A. New Residentinl- Single or Multi-Family per1ffi~rhlle; u..:t..... LEGAL DESCRIPTION 1703 j 5'30 0-0 era-a JOB DESCRIPTION A-.~ b Z C l (Z.~.ij"''(.-.s 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. 7',','. .,:..:. .., cgNJ:RAC;rOR INS~#LATIO~ONLY : "":.'1'tr? ~;''''-':;, h '" '.' . EJectricaJContractor Bll\'ldf'(S . Uec+r,'c.lnC Address ICP:=) Macl,,~()Y\ City e:-Uj f n (' Phone 4 ~S ~ CfI~:z Supervisor License Number 3:190'- S Expiration Date I () / I - 04 Constr. Contr. Number 4:;;2Cf ( 0 Expiration Date \"J-tb- 0 I Supervising Electrician tJ,t Owners Name S iG~ e.... Pt:-V Address <6,1..-10 hblll;..,c: ?:d. City S?~ Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Service Included 1000 sq. ft. or Jess Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. Services or Feeders - Insfnllation, Alterations or Relocntion: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75,00 $125,00 $163,00 $375.00 $ 50.00 C. Temporary Services or Feeders Instnllntion, Alteration or Rrlocntion ''''W requ\res you to p ~-TENT~6)reWDl\Clm regon Utilltl $ 50.00 ('N ru~~ ~t~~~~ et1o..... $ 69.00 h 'T"'~A AS are S HY. , '\lratid1'VC.e.ntJ3s.tCH1\'M'Y\ I"S'OAR952 ""1- $100.00 ,..1. v o10throug "VIi> ;i1 O,!I,R 9fO'vQPJo91\nws 8pl~gCb~~SIb~bove. 0090. 'f5?u rnp.~n~~t~lir^"~8Rrthe teiephone' calling the can a. \1'01 .... Mnti1ication numb~roY ttI~era~aM!~\WtfS)lHi) Per Panel ~cist1-800-332-2344. I $ 43.00 Each Additional Circuit or with Service or Feeder Permit / $ 3,00 t(:J '3 E. Mjscellnneolls (Service/reNler not illc\lIlled)-Ench Inslnllation Pump or ilTigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: NOTICE: XPI.4E ,~frIABmMK OF ABOvE THIS PERM\T SHALL E t\ r TITC " AUTHORIZED UNDER THIS PE~~l<~l~Jharge OMMENCEO UMIS ABANDONtu rul'\.. . C 10% Admllllstratlve Fee ANY 180 DAY PERIOD. Inspection Request: 726-3769 . TOTAL Lfb ~zZ ..:> LfbO 5> g 2... Shnred Drive(T:l!Building Fonns/Electrical PClmit Application ),03,doc _6P.AU~Gl"la D .iiiI. ......'.. .....r,1 wlLc- ~-1J ..", : A!;. ~ . , . ...... ....-_.,."...... .~. ' - .; Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00412 ISSUED: 04/20/2004 APPLIED: 04/13/2004 EXPIRES: 11/17/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 864 BEL TLINE RD ASSESSOR'S PARCEL NO.: 1703153000900 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Add second stage cooling unit. Owner: SYCAN B CORP Address: 840 BELTLINE RD STE 202 SPRINGFIELD OR 97477 Phone Number: 541-746-8444 I CONTRACTOR INFORMATION. Contractor Type Electrical Mechanical Contractor BUILDERS ELECTRIC INC COMFORT FLOW License 4296 460 Expiration Date 12/10/2007 06/27/2004 Phone 541-485-0922 541-726-0100 I" BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B # of Stories: Height of Structure Type of Heat: Water Type: Range Type: . Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VN n/a Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: NOTICE" I DEVELOPMENT INFORMATION. THIS PERMIT SHAll EXPIRE IF THE W~K AUTHORIZED UNDER T~~fUifWiH: IS NOT COMMENCED OR IS A\JA~JOON~6qsOOid: PERIOD Paved Drive Rqd: ANY 180 DAY . % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS' ATTENTION: Ore~im~i~es you to follow rules adoptwd~stlb~&>~~tility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone i1\';;\1t,G~ fJ~ the Oregon Utility Notltlcatlon Valuation Descri ticOe er Is 1-800-332-2344). Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pae:e 1 of 3 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00412 ISSUED: 04/20/2004 APPLIED: 04/13/2004 EXPIRES: 11/17/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $10.00 4/13/04 2200400000000000353 + 10% Administrative Fee $4.50 4/13/04 2200400000000000353 + 7% State Surcharge $3.15 4/13/04 2200400000000000353 Air Handling Unit 10,000 & Ovr $15.00 4/13/04 2200400000000000353 Minimum/Adjustment Mechanical $30.00 4/13/04 2200400000000000353 + 10% Administrative Fee $4.60 5/17/04 1200400000000000749 + 7% State Surcharge $3.22 5/17/04 1200400000000000749 Add, Alter, Extend Circ $43.00 5/17/04 1200400000000000749 Add, Alter, Extend Circ Ea Add $3.00 5/17/04 1200400000000000749 Total Amount Paid $116.47 I Plan Reviews I Initial Review Structural Review SUB Review 04/14/2004 04/14/2004 04/15/2004 04/14/2004 04/15/2004 04/16/2004 APP RJB APP JMP APP JF 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. ~eouire~nsnections , 2 Rough Mechanical: Prior to Cover 1 Final Mechanical: When all mechanical work is complete. 3 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. 4 Rough Electric: Prior to Cover 5 Final Electric: When all electrical work is complete. Pal!e 2 of 3 ~~~"~~g,~l~_,.r~f,.".....,,, .. _ ~, :;~~ 1ft> CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2004-00412 ISSUED: 04/20/2004 APPLIED: 04/13/2004 EXPIRES: 11/17/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax. 541-726-3769 Inspection Line 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 Paee3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone SP.ijN;.~:.,,,,,,,,.,,, I. lIAr'. . I I' "1,: .. { '...,... -~~' ., ->.,.if t """C,,,...~,,,,:,,, .".'Jot',j City of Springfield Official Receipt Jevelopment Services Department Public Works Department RECEIPT #: 1200400000000000749 Date: 05/17/2004 2:33:50PM Job/Journal Number COM2004-00412 COM2004-00412 COM2004-00412 COM2004-00412 Description Add, Alter, Extend Cire Add, Alter, Extend ,Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By CreditCard BUILDERS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 000385 004669 In Person Payment Total: Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82 5/17/2004 Page I of I