HomeMy WebLinkAboutPermit Electrical 2007-9-27
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRIC~,PERMIT APPLICATION
City Job Number ' .fYJ?tJTT7-- ()(l~h7
_, . - - ~
(} _:d.i-tJ7
Date
1, LOCATION OFINSTALLATION:
IYS? ^- (S'/- $~ &K
LEGAL DESCRIPTION:
\ 10'3, 3<,... ~d () (p?;[)V
JOB DESCRIPTION:
Pt:.;,~=uo:~~~u
not started within 180 days of issuance or if work is
Suspended for 180 days.
3. COMPLETE FEE SCHEDULE BELOW
A. NewResidential-Sil1gle or MuIti-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
CONTRACTORINSTALLATION ONLY
B,
or Relocation:
2.
Electrical Contractor 7c~~ ~L-. .1/1C-
Address ?/..r;jg ;:5ve--r- #
200 Amps or less $ 70.00
20 I AmpsAOlif)@JIH}JN: Oregon law requirE$ aJP~oto
401 AmdqgC(j~oK~p'sadopted by the ure~rslt!OOty
Notifj~~Uon Center, Thu::;t;: I ult:::; a!{ ~~t forth
601 Amq~ \3AFi~~~-0010thm,-'g... 0At't'9~Q5b1-
Over I O~OO!piO(,plWay obtain copies of t~A}I~~ by
Reconnecttallrng the center. (Note: the tefepMfle
nu~ber fOL!~e Oregon Uti.lity NotiIication
c. ... TemporarYSe~JElr3efjQQ;-332..2344).
~LC-
Phone 19$? - .9/c1O
City
1/;2 t-Cff
/~fi /c:r8
/ /
/.s-~ J 2 ccc7
Supervisor License Number
Installation, Alteration or Relocation
200 Amps orpl.~s~rl""E' $ 55.00
k" k '! It, .
201 Amps t01~~{jfRMIT SHALL [Xrll1~lf:6fqE WORK
401 Amps to ~~~~ JRs'ZED UNDER T:-ttS-~t{R,,(? I&-NOT
Over 6??~'lQfv~~C'~sgffl~'~fJ'ANDONED FOR
D. . Brllhch C~~~8ltDAYPERIOD:
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
Expiration Date
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
~~
c. y
Owners Name Jtr~ '1 g/ ~
Address / Y.J/ "'./ (; ...f r:-
City.s;/11/ Phone
$ 48.00
$ 4.00
E. Miscellaneous (Service/feeder not included) -Each Installation
Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
Limited Energy/Residential $ 28.00
Limited Energy/Commercial ( $ 50.00 SO . cr-
Minimum Electric Permit Inspection Fee is $50.00 + Surcharges
J:;() . (}lJ
E).GC!
4.(J()
LS . ()C/
1!1 (/? /.50
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
4.8UBTOTALOF ABOVE
Owners Signature:
8% State Surcharge
10% Administrative Fee
5% Technology Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007 -00367
COM2007-00367
COM2007-00367
COM2007 -00367
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200700000000001514
Date: 09/27/2007
Description
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
GREG LAND
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm 417200 417200 In Person
Payment Total:
Page 1 of 1
12:00:39PM
Amount Due
50.00
2.50
4.00
5.00
$61.50
Amount Paid
$61.50
$61.50
9/27/2007
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00367
ISSUED: OS/2212007
APPLIED: 03/13/2007
EXPIRES: 03/27/2008
VALUE: $ 2,690,514.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1457 G ST
ASSESSOR'S PARCEL NO.: 1703362206800
Springfield
TYPE OF WORK: Medical Office
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Urology Healthcare, p,c. New IMRT Facility
Owner: OREGON UROLOGY INSTITUTE PC
Address: 2400 HARTMAN LN
SPRINGFIELD OR 97477
Phone Number: 541-343-9259
I CONTRACTOR INFORMATION I
Contractor Type
Architect
General
Electrical
Fire Contractor
Low Voltage Electrical
Mechanical
Plumbing
Sewer
Contractor
YOUNG & WIEPRECHT ARCHITECHTS
MCKENZIE COMMERCIAL CONTRACTOR 45539
J K GUCKENBERGER ELECTRIC INC 45129
INTEGRA TED ELECTRONIC SYSTEMS
TELECOM LABS INC.
COMFORT FLOW
TWIN RIVERS PLUMBING INC
EMERALD EXCAVATING INC
License
Expiration Date
07/21/2009
04124/2008
Phone
503-378-7990
541-343- 7143
541-746-4656
541-485-4456
541-687-9100
541-726-0100
541-688-1444
541-345-1505
156946
460
17695
14173
06/01/2008
06/27/2009
03/11/2008
07/14/2008
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
B
# of Stories: 1
Height of Structure: 25.50
Type of Heat: Forced Air Gas
Water Type: Electric
Range Type:
Energy Path: Path 1
Sprinkled Building: n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
10,199
lIB
r DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
Pal!e 1 of 7
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Type of Construction
Estimate
Pavinl!
Estimate
Use Bid Amount
Fee Description
Plan Review CommlInd/Public
Plan Review Fire & Life Safety
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Temp Power 200 amps or less
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 401 to 600 amps .
Temp Power 200 amps or less
~Mechanical Issuance Fee~
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Backflow Device
Building Permit
Fire SF Fee - Non-Residential
Fixture
Furnace - more than 100,000
Furnace - Unit Heater
Gas Outlets 1-4
Not Covered Mechanical
Paving
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
2,469,013.00
221,501.00
Total Value of Project
~
Amount Paid
$4,142,71
$2,549,36
$5.00
$2.50
$4,00
$50,00
$42,40
$21.20
$33,92
$249,00
$125,00
$50,00
$10,00
$1,133,53
$515,77
$748,25
$42,00
$8,268,15
$1,020,00
$630,00
$30,00
$12,00
$4.00
$90,00
$962.15
$1,698.45
$1,045,20
$45.00
$494,75
$650.75
$10.00
$1,401.90
$133,56
$70.70
$336.25
Date Paid
3/13/07
3/13/07
3/23/07
3/23/07
3/23/07
3/23/07
5/7/07
5/7/07
5/7/07
5/7/07
5/7/07
5/7i07
5122/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
5122/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
5122/07
5/22/07
5122/07
5/22/07
5/22/07
5/22/07
5/22/07
5/22/07
Pal!e 2 of 7
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-00367
ISSUED: OS/22/2007
APPLIED: 03/13/2007
EXPIRES: 03/27/2008
VALUE: $ 2,690,514.00
Value
Date Calculated
$2,469,013,00
$221,501.00
$2,690,514.00
05/09/2007
05/09/2007
Receipt Number
3200700000000000145
3200700000000000145
2200700000000000399
2200700000000000399
2200700000000000399
2200700000000000399
1200700000000000507
1200700000000000507
1200700000000000507
1200700000000000507
1200700000000000507
1200700000000000507
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SDC Transpo Improvement
SDC Transpo Reimbursement
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtll00'
Vent Fan
Water Line - 1st 50 Feet
Water Line - Each Addtll00'
+ 5% Technology Fee
+ 5% Technology Fee
+ 5% Technology Fee
+ 5% Technology Fee
Encroachment Permit
Encroachment Permit
PW Disc - 2nd Permit
PW Disc - 2nd Permit
Refund - + 5% Technology Fee
Refund - + 5% Technology Fee
Refund - Encroachment Permit
Refund - Sidewalk Permit
Sidewalk Permit
Sidewalk Permit
+ 10% Administrative Fee
FLS Safety Systems Review
Plan Review/Com,Ind,Pub Hourly
+ 10% Administrative Fee
FLS Safety Systems Review
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Low Voltage - Commercial Indus
Total Amount Paid
Fire Department Review
06/22/2007
Fire Department Review
08/0812007
$4,441.30
$1,006,78
$45,00
$70,00
$30.00
$45.00
$42.00
$6,50
$6.50
$18,50
$18,50
$130,00
$130,00
$-30.00
$-30,00
$-18,50
$-6,50
$-130,00
$-240.00
$240.00
$240.00
$59,40
$594,00
$90.00
$72.60
$726,00
$5,00
$2.50
$4,00
$50,00
$34,246.08
I Plan Reviews I
06122/2007
Pal!e 3 of 7
5/22/07
5122/07
5122/07
5/22/07
5/22/07
5/22/07
5/22/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/18/07
6/22/07
6/22/07
7/30/07
8/16/07
8/16/07
9/27/07
9/27/07
9/27/07
9127/07
OK
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO:. COM2007-00367
ISSUED: OS/22/2007
APPLIED: 03/13/2007
EXPIRES: 03/27/2008
VALUE: $ 2,690,514.00
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
2200700000000000793
3200700000000000405
3200700000000000407
3200700000000000405
3200700000000000407
3200700000000000405
3200700000000000407
3200700000000000405
3200700000000000407
3200700000000000406
3200700000000000406
3200700000000000406
3200700000000000406
3200700000000000405
3200700000000000407
1200700000000000804
1200700000000000804
1200700000000000976
1200700000000001049
1200700000000001049
2200700000000001514
2200700000000001514
2200700000000001514
2200700000000001514
GRG
Plans Review: Six inch underground
fire line for sprinkler system, Job
#COM2007-00367. Designer: Mike
Tennant. Contractor: Omlid and
Swinney,
Installation of approximately 200
feet of six inch underground fire line
with three ells and thrust blocks,
Plans appear to meet code
requirements.
Deferred Submittal - Fire Alarm
System
CITY OF SPRINGFIELD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-00367
ISSUED: OS/22/2007
APPLIED: 03/13/2007
EXPIRES: 03/27/2008
VALUE: $ 2,690,514.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Electric Service: Approval required prior to utility company energizing service,
Final Electric: When all electrical work is complete,
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service,
Temporary Electric: Approval required prior to Utility Company energizing pole,
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 ofthe property, and the approved set of plans will remain on the site at all
times during construction,
Owner or Contractors Signature
Date
Pal!e 7 of 7