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Home My WebLink AboutPermit Electrical 2007-9-27 GO NI'^ q -'2--7-Of N\JOS Of.; . - . ZON INITIALS DATE SOURCE 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