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225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number C 7 ao 7 90 Date
. ,
1. LOCATION OFINSTALLATION:
! /7-1/ 'Z.. J ~ -y/ .., ~ Z Jt!JeJ
~ LEGAL DESCRIPTION:
~~/~ #IMP .1'1'
JOB DESCRIPTION:
'fr# /I 11/1/5'10
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
CONTRACTdR:ldvS1~LAT10N iJdvLY
2.
Electrical Contractor #, r#1!~t
Address
City
Phone
uires yOU \0
..maN: Oregon taw req re on Utility
supervim~b~We~$bpted by tn.e ,0.. Q~P. set forth
to\\?~:tion center. \ nO::it;; I J n€OAR 952-001-
EXPiratN~~52-001.001 ~ tn!~~~~ ot the rules by
\n '(au may ODll:l.IIl v~,r-'.- the telephO\,.l:l
Constr. g~~iiN~1B~rC:~~~'o~~~\~ti\iW N~tilicat\On
number for t, ''''. ~. 8~ 00-332-'~<+'t).
C nter IS ,-
Expiration Date e
Signature of Supervising Electrician
#//I/f'o):m' ~j- {!, .pb
Owners Name /2/;N~il/ ~ /l#~p~f
Add';J;:J' if"
City ~J' Phone '1t6--SJIr
OWNER INST ALLA nON
The installation is being made on property I own which
:~~~
Inspection Request: 726-3769
9/II/p1
,
3. COMPLE1'E FEE SCHEDULE BELOW
A. NewResideritial- 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
$117.00
$ 21.00
$55.00
B.
of Relocation:
200 Amps o1f'ttGsl\CE: SHALL ~)(P\RE$IVOT?,0E ~OR~
201 Amps to~~~~Mn O~O THISJ:~81l\<Dff IS NY'
401 Amps to A~_\ZEOO U~R \S '.l'I:BAND~8.lD<fOl'\
601 Amps to O@MmtWC~'{ PER\Of\ $180.00
Over 1000 A~dl~ D. $413.00
Reconnect Only $ 55.00
c. . Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less /
201 Amps to 400 Amps
. 401 Amps to 600 Amps
Over 600 or I 000 Volts see "B" above.
D.
50 a7
$~O
$ 76.00
$110.00
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
E. Miscellaneous (Service/feeder notinclude(i) -Each Installation
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
Limited Energy/Residential $ 28.00
Limited Energy/Commercial $ 50.00
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
SO . UO
;::;)-50
u - {rV
.s. o-D
(f) j, 50
4. SUBTOTALOF ABOVE
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
Shared Driye(T:)lBuilding Forms/Electrical Permit Application 7-07.doc
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00790
ISSUED: 07/20/2007
APPLIED: 06/0112007
EXPIRES: 03/10/2008
VALUE: $ 380,000000
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5810 MAIN ST
ASSESSOR'S PARCEL NO.: 1702334102300
Springfield
TYPE OF WORK: Commercial Miscellaneous
TYPE OF USE: Addition Commercial
PROJECT DESCRIPTION: Remodel and addition to existing structure - CALL BRYAN when Temp Obtained
Owner: AMIGOS III LLC
Address: 32929 ROBERTS CRT
COBURG OR 97408
Phone Number: 541-726-8795
Contractor Type
Architect
General
Electrical
Mechanical
Plumbing
Sewer
:-~.t'_.' on law requires you to
I CONTRACTOR INFQRM'1llrIcrnQ~'d b the Oregon Utility
IUIIUVV IU....... ...J~...13 Y f h
N ffi fOfl&~nter Thcwe rv1es are set ort
Contractor Ino~l~a~~_tO'.p-~'10 trfi"~,pJfi~t1J\l~3.t(JlD1-Phone
RON THIENES 000 y, u may obtain copies of the rules bY541-726-8795
CASCADE VIEW CONSTRUCTIONqlb~liin~ ~b't41ter. (Note:O~1t!6I2!o~?10~e 541-912-1412
JB ELECTRIC number l~~~~l! Oregcn Ut03l14i~oos:atlon 541-687-5770
COMMERCIAL AIR INC OM1~is i-t>OO-34~2fffi12007 541-461-4821
TWIN RIVERS PLUMBING INC 17695 03!l1l2008 541-688-1444
MCKENZIE EXCA V A TING INC 541-689-3085
BUILDING Il'Il'UKMATION I
# of Stories: NOTICE: 1 Lot Size:
Height of Strult4!6:PERMIT SJ:fAtL S'flfUiJfFT~:WORK
Type of Heat: AUTHORIZEDIUltHDER TiHII$tRlDBMj(folS NOT
Water Type: COMMENCED OR IS A6A(fl)Dtft0~R
Range Type: ANY 180 DAY P~RIOD. Sq Ft Garage/Carport
Energy Path: '"Paffi.ol Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
M
1,705
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Pa!!:e 1 of6
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00790
ISSUED: 07/20/2007
APPLIED: 06/01/2007
EXPIRES: 03/10/2008
VALUE: $ 380,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Estimate
Pavin2
Tvpe of Construction
Estimate
Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
299,149.00
80,851.00
Value
Date Calculated
Description
Total Value of Project
$299,149.00
$80,851.00
$380,000.00
07/03/2007
07/03/2007
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Comm/Ind/Public $959.17 6/1/07 1200700000000000670
-Mechanical Issuance Fee- $10.00 7/20/07 1200700000000000948
+ 10% Administrative Fee $236.17 7/20/07 1200700000000000948
+ 5% Technology Fee $109.56 7/20/07 1200700000000000948
+ 8% State Surcharge $135.97 7/20/07 1200700000000000948
Backflow Device $14.00 7/20/07 1200700000000000948
Boiler/Comp Up To 100,000 btu $12.00 7/20/07 1200700000000000948
Building Permit $1,215.65 7/20/07 1200700000000000948
Fire SF Fee - Non-Residential $170.50 7/20/07 1200700000000000948
Fixture $196.00 7/20/07 1200700000000000948
Furnace - up to 100,000 btu $36.00 7/20/07 1200700000000000948
Miscellaneous Plumbing $45.00 7/20/07 1200700000000000948
Paving $491.55 7/20/07 1200700000000000948
Plan Review Fire & Life Safety $590.26 7/20/07 1200700000000000948
Sanitary Sewer - 1st 50 Feet $45.00 7/20/07 1200700000000000948
Storm Sewer - 1st 50 Feet $45.00 7/20/07 1200700000000000948
Storm Sewer Each Addtll00' $14.00 7/20/07 1200700000000000948
Vent Fan $18.00 7/20/07 1200700000000000948
Water Line - 1st 50 Feet $45.00 7/20/07 1200700000000000948
Water Line - Each AddtlIOO' $14.00 7/20/07 1200700000000000948
+ 10% Administrative Fee $49.60 8/27/07 2200700000000001349
+ 5% Technology Fee $24.80 8/27/07 2200700000000001349
+ 8% State Surcharge $39.68 8/27/07 2200700000000001349
Add, Alter, Extend Circ Ea Add $45.00 8/27/07 2200700000000001349
Perm Serv/Fdr 200 amps or less $63.00 8/27/07 2200700000000001349
Perm Serv/Fdr 201 to 400 amps $225.00 8/27/07 2200700000000001349
Perm Serv/Fdr 601 to 999 amps $163.00 8/27/07 2200700000000001349
+ 10% Administrative Fee $5.00 9/11/07 2200700000000001424
+ 5% Technology Fee $2.50 9/11/07 2200700000000001424
+ 8% State Surcharge $4.00 9/11/07 2200700000000001424
Temp Power 200 amps or less $50.00 9/11/07 2200700000000001424
Total Amount Paid $5,074.41
Pa2e 2 of6
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Review
Initial Review
Initial Review
Plan Review Comments
Plan nine: Review
06/04/2007
06/0112007
06/19/2007
06/04/2007
I Plan Reviews J
07/02/2007 OK
06/0112007
06/19/2007
07/03/2007
APP
APP
10
WE
Pae:e 3 of6
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-00790
ISSUED: 07/20/2007
APPLIED: 06/0112007
EXPIRES: 03/10/2008
VALUE: $ 380,000.00
GRG
Plans Review: Remodel car wash to
three tenant space commercial
building. Job #COM2007-00790.
Occupancy Classification: M.
Construction Type: V-B. Existing
structure: 2,439 sq. ft.; addition:
1,707 sq. ft.; total addition and
remodel: 4,142 sq. ft. Three retail
spaces divided into 1,412 sq. ft.,
1,275 sq. ft. and 1,308 sq. ft.
Provide or maintain address
numbers and suite numbers or
letters in contrasting color from the
background positioned plainly
visible and legible from the street or
road fronting the property.
Numbers shall be a minimum of 4
inches high (2007 Oregon Structural
Specialty Code 501.2 and 2007
Springfield Fire Code 505.1).
Provide fire extinguishers with a
minimum rating of 2-A:I0-B:C
every 75 feet of travel distance. The
top of the extinguisher(s) shall be
between 3 and 5 feet above finished
floor (2007 Springfield Fire Code
906).
Above the main exit door, provide
sign stating "THIS DOOR MUST
REMAIN UNLOCKED WHEN
BUILDING IS OCCUPIED" if key
locking hardware is employed. The
sign shall be in letters 1 inch high on
a contrasting background (2007
OSSC 1008.1.8.3, exception 2.2).
LLH
LLH
JMP
Complete Revised Sets
WI. Received responses from Ron
Thienes.
Needs signed Development
Agreement. Linda Pauly Planner -
DRC2007-00015 Site Plan Review
Minor Mod.
CITY OF SPRINGFIELD -
Building/Combination Permit
Status Issued PERMIT NO: COM2007-00790
225 Fifth Street, Springfield, OR ISSUED: 07/2012007
541-726-3753 Phone APPLIED: 06/0112007
541-726-3676 Fax EXPIRES: 03/1 012008
541-726-3769 Inspection Line VALUE: $ 380,000.00
Public Works Review 06/04/2007 06/05/2007 APP JHJ Attached SDC Worksheet. No New
SDC's. (JHJ)
Revised Plan Review - Fir 06/19/2007 07/14/2007 OK GRG Plans Review: Revised submittal for
remodel of car wash to three tenant
space commercial building. Job
#COM2007-00790. Occupancy
Classification: M. Construction
Type: V-B. Existing structure: 2,439
sq. ft.; addition: 1,707 sq. ft.; total
addition and remodel: 4,142 sq. ft.
Three retail spaces divided into
1,412 sq. ft., 1,275 sq. ft. and 1,308
sq. ft.
Provide or maintain address
numbers in contrasting color from
the background positioned plainly
visible and legible from the street or
road fronting the property.
Numbers shall be a minimum of 4
inches high (2007 Oregon structural
Specialty Code 501.2 and 2007
Springfield Fire Code 505.1).
Provide fire extinguishers with a
minimum rating of2-A:I0-B:C
every 75 feet of travel distance. The
top of the extinguisher(s) shall be
between 3 and 5 feet above finished
floor (2007 Springfield Fire Code
906).
Above the main exit door, provide
sign stating "THIS DOOR MUST
REMAIN UNLOCKED WHEN
BUILDING IS OCCUPIED" if key
locking hardware is employed. The
sign shall be in letters 1 inch high on
a contrasting background (2007
OSSC 1008.1.8.3, exception 2.2).
Note: These comments replace the
original plans review submittal
comments dated 7/2/07.
Revised Plan Review - PIa 06/19/2007 06/21/2007 APP EMM Development Agreement received
6/21/07. To be constructed per
approved Minor Site Plan Review.
Revised Plan Review - Pu 06/19/2007
Revised Plan Review - SU 06/19/2007
Pal!e 4 of 6
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-00790
ISSUED: 07/20/2007
APPLIED: 06/01/2007
EXPIRES: 03/10/2008
VALUE: $ 380,000.00
. 225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Structural Review 06/19/2007 06/19/2007 10 JMP Complete revised sets. See attached
documents for 9 structural
comments faxed to Ron Thienes.
Structural Review 07/19/2007 07/19/2007 APP JMP Received final internal approval.
Structural Review 06/01/2007 06/19/2007 WE JMP Received 6/4/2007. See attached
documents for 9 structural
comments faxed to Ron Thienes.
SUB Review 07/03/2007 07/18/2007 ' APP DO See attached documents for
approval memorandum
SUB Review 06/04/2007 06/19/2007 WE DO See attached documents for Item 5
of JMP's structural comments for
requested energy code forms and
information.
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.
~eouiredJnsDections ,
Site Inspection: To be made after excavation but prior to setting forms.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Roofing: Prior to installing any roof covering.
Roof Sheathing
Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to
City Building Inspector.
Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to
placement. .
Ceiling Grid: After drywall approval but prior to cover.
Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector.
Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Pal!:e 5 of6
CITY OF SPRINGFIELD.
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-00790
ISSUED: 07/20/2007
APPLIED: .06/0112007
EXPIRES: 03110/2008
VALUE: $ 380,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Final Fire Department. After all requirements of the Fire Department have been met.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Grading: After gravel is in place but prior to placing concrete.
Final Paving: After paving is complete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
SUB Final: After all required energy inspections have been requested and approved.
SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
SUB Exterior Lighting
Electric Service: Approval required prior to utility company energizing service.
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 6 of6
225 Fiftb Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00790
COM2007-00790
COM2007 -00790
COM2007-00790
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Temp Power 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
RONALD E. THIENES,
ARCHITECHT
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001424
Date: 09/11/2007
9:15:13AM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
50.00
2.50
4.00
5.00
$61.50
Amount Paid
nJm
2460
$61.50
In Person
Payment Total:
$61.50
Page 1 of 1
9/11/2007