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Home My WebLink AboutPermit Electrical 2003-9-16 bmitted has the following 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ~~:i(5r:tqm~gi)quire specific land use ELECTRICAL PERMIT APPLICATION approval. (l (i / Zonmg - - ~ City Job Number COW'lZOo,3-0 0 70S- Date ~7 -/D ~O tale ct --( <6 /U ch~ 1. LO€A110N OF INSl'ALLA110N 3. COMPLEl1iAfiY;mz$C'HP)pjf!TLE-B:E-L~l-i/' -", ~ '-/ D ~€'--'TU IV 6 1I=W~~. LEGAL DESCRIPTION A. Ncw Rcsidential - Single or Multi-Family pcr dwelling unit. 1703 /53 () 00 '700 Service Included Supervisor License Number ~& II LeA C. Temporary Services or Feeders Expiration Date /o!()s Al-(FI\iTl\JI\l:ul~s~~'~!!9J!,,~!.tt!WtiQ.I1jQJ1R~ocation .-follow wles adcq.0.0Jel.tUpst0-rCle'SSregon Utility $ 50.00 /5';;2 39 .5Notificgjioil C8ntQQnAtm1>sacr~00S\-mps set fon $ 69.00 '\ OAR 9S2.Q('l1 -@(jll @.Bfps'Jfor600'"JfuYp052aOO' $100.00 nnr.n VOL' m,:'l.Y oo~t~irJ60""Onpies of tl.bo' oQor,t}I(.l!I'tS ~ "B" b ~ . .'.. .. ver n.mp,s or .vO s see a ove. calling '~;'18 cD~t&Iir~~~lci~tlTI,~91~~ho~e . . number for th9 Oregon Ut:,HY i'Jotlhcatlon Center i~tjw~treOOi9IEw4EJfJension Per Panel One Circuit Each Additional Circuit or with ~.wlA:C~i Feeder Pennit $ 3.00 THIS PERMIT SHALLEXP1RE IF THE WORK FAU~jIf61Wl!e&~~ali~'Ff Pfr~Wr~~1ffit-Each InstaIla tion COMMENC.ED.OR IS ABANDONED FOR ~rff1~ B{i~~~.I~~RIOD. SlgnlOutlm~iglitmg Limited EnergylResidential Limited Energy/Commercial JOB DESCRIPTION CovVlVV\ - La w Vo(~p- / 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor CAb eJVc.e ~p.. Mu IV I C/+77 0'" Address :?-0377 ?e::fL~(,v~ t2-~ City \J eNenq Phone (/~S--~51 Constr. ContI". Number Expiration Date &:;; /1) t Signature of Supervising ElectIician 't-I,- tS- r "') , Owners Name '5 ~ C-A(..J Co~p, Address %10 B~LTl-INe- City gfJPD Phone '"12-b - ~t/c./'1 OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 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 B. Services or Feeders ~ Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I 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 $ 43.00 I $ 50.00 $ 50.00 $ 25.00 $ 45.00 ~) Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE L{J -- J,JJ '-I ;-0 ~? t..f:- 7% State Surcharge 10% Administrative Fee TOTAL Shared Dlive(T:)/Building Fonns/Electrical Pennil Application I-03.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-00905 ISSUED: 09/16/2003 APPLIED: 09/16/2003 EXPIRES: 03/16/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 840 Beltline Rd 202 ASSESSOR'S PARCEL NO.: 1703153000900 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial . PROJECT DESCRIPTION: Low voltage Owner: SYCAN B CORP Address: 840 BELTLINE RD STE 202 SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR INFORMATION I uta I t:;;qUlres yo \ ~i\I:urego~ law -nn.UtiUty Contractor Al ! t:.1\J I do tel!.JgeiI's~ OrE:ExplratlOn Date Phone les a P ~. , (.:)y 1011 KERRY LYNN GALLO\\i.~;y;)W ~.~_ '('~ntAr_ -l~~}95 rules ~:.e J,s1-9H7P04 541-935-5351 r BuiLiiiNG~iN'F.0~(fi0N-lo~gn ~~~;;ule~ l ~Qan.. '<pu may OOllill1 voP,~she te\eph~ne '# ofStones:he center. (Note. t Lot~IZejn HefgIW~f~Str8ctureoregon Utili.tv N(\S~'Fti~t Floor: TypJf6f?iUit: I L1''-'. s .1_800-332-234"S)q Ft 2nd Floor: \;enter, Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Impervious Surface Area: VN # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS I DEVELOPMENT INFORMATION I REQUIRED PARKING Street Improvements: Storm Sewer Available: Special Instruction: Overlay Dist: Total: # Street TrqtEo Handicapped: Paved Driv THIS 'PERMIT SHALL EXPIRE IF ~f\K % of Lot C'R'tYi~ORIZED UNDER THIS PERMIT IS NOT r.nMMENCED OR IS ABANDONED FOR I PUBLIC IMPROWW1~~Y PERIUU. Sidewalk Type: Downspouts/Drains: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paee 1 of2 ~~RING~..I.iItLJ D.ji................ Wi:-I , . ..,---'.._,~ ".' . ........' . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-00905 ISSUED: 09/16/2003 APPLIED: 09/16/2003 EXPIRES: 03/16/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid' Fee Description + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid $4.50 $3.15 $45.00 9/16/03 9/16/03 9/16/03 Receipt Number 1200200000000002138 1200200000000002138 1200200000000002138 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 InsDections I 1 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. Owner or Contractors Signature Date Pa2e 2 of2 225 Fifth Street" Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00905 COM2003-00905 COM2003-00905 Payments: Type of Payment Check Reccipt#: 1200200000000002138 Description + 7% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Paid By KERRY GALLOWAY Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department . Date: 09/16/2003 1:20:47PM Amount Paid 3.15 4.50 45.00 $52.65 Item Total: How Received In Person Payment Total: Amount Paid $52.65 $52.65