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Home My WebLink AboutPermit Electrical 2006-11-7 ZON (C INITIALS N JVl DATE \\ -OI-CJ~ SOURC~:5~ HUj Date /1-7-O~ 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COv4-'\ Zoo 6 - () I J f 7 1. 3. LEGAL DESCRIPTION: /703274] A. o S 80S- Service Included JOB D~ERIPTION: 1000 sq. ft. or less A I I ~ / i / - ~Eac~ additional 500 sq. ft. or ci do- 14( b-)(~~ b c.r rCJA. I ,iportlOn thereof 'I ' Permits are n n-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. NOTICE: Feeder 2. IT SIBJ.\ ED UNO , Electrical Contractor ~~;SM4"S{.~/J f6MM~efO OR lSOIfu'AAsrOWfD FOR ANY 180 DAY PE~~mps to 400 Amps Address r.O. ~1J)(L/101 '40t'Amps to 600 Amps 601 Amps to 1000 Amps City LI'N v/lI/;5 Phone )tJ 'J 7''/ J ')/75 Over 1000 AmpsN olts Reconnect Only $106.00 $ 19.00 $50.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Supervisor License Number LJ .3 S~ S Expiration Date /O~ 7 Constr. Contr, Number / 6? () 2 S" Expiration Date 7 /,:J~ c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Signature of Supervising Electrician Over 600 Amps or 1000 Volts see "B" above. D. f.'-\,', !"illW );''likMr.6J \jfiE<<lWllI<!JtJ\l...~~ :~ .- o OW6U'e5'. rid',y\t 'd' '. ""1 /}'1- Notifica' ne"9r,~:t~,'~_ ,oy !11e ~rego t I' $ 43.00 7-' . 0 ' ~!?dli1\:~at1!l(jnall<rafl$.ll (l!JM9~are S6Hortl In AR ~~i66.br-fe:e<l.6'n""rn1ah OAR ,.:>' $ 3.00 0090. Yo . r ~ , ' ," ,::10'::-UUl callm number or th~ qr~gon Utiiit\/ Noff' t' l@~t~fr'JSl9a~ -:1' I Ica Ion $ 50.00 Sign/Outline LighRn~.~2-2344).' $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges v~,L~d /' //~ Owners Name D........ JI4~/J"';:u fc! / ' Address 2O,7'Sb.4 (,/."...,..,rl." Or '541 City ,4/~,,/ Phone 5"rJ'J9.17/?:J / IS OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 4. Inspection Request: 726-3769 'JJP ~ ~'\ <:\ \I:J'tV/\) 8% State Surcharge 10% Administrative Fee 5% Technology Fee )9~ V,/pI( ~.~ J.,9d TOTAL Shared Drive(T:)/Building FormslElectrical Pennit Application g,06,doc 7 / ~ 5'1 CITY OF SPRINGFIELD" Building/Combination Permit Status In Review PERMIT NO: COM2006-01387 ISSUED: APPLIED: EXPIRES: VALUE: 10/27/2006 05/02/2007 $ 100,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 671 W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703274305805 Springfield TYPE OF WORK: Medical Office Contractor Type Architect Electrical PROJECT DESCRIPTION: Cascade Animal Clinic Rem~~\.)"" ...,o~ \r \\".. \c ~\.)\ Owner: CENTE!I~OJ?-f~'N~~\T{~ ~t."l-l\\ \~" Address: 7831 SE ~~\t\j'r'E ~~t."~'OQ~t.'O PORTLA~~ ~~~~~ (\~, \S ~'O~ ~\:,\ 't:.~\Jc.J \\\\..)V' (jQ~~ o.\) \)~'{"~ I CONTRACTOR INFORMATION I ~\\'{ "\ \J Contractor License ROBERT SHAW DOUG MANSFIELD ELECTRIC LLC TYPE OF USE: Alteration Commercial 167025 Expiration Date Phone 541-485-4963 10/26/2007 503-990-3173 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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: n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I REQUIRED Pt~KING , "8CilWes yOU . Overlay Dist: _ \ IUi'>l:uregon \aVIiToflI~ on Utility # Street Trees Rqd:Al fE.N I adopted by t\"'PfaJdic~P9b~t fort'" Paved Drive Rqd: follOW r.u eilcenter. ThosectldiR8a'E~ 952-001 % of Lot Coverag~:otificatlon 001-0010 through A "" rules b\ p..R 952- , s on"e . in 0 obtain cop,e hone - -I) "1"\1\ ma\l _ ~ ~_d!n,:.tAlep I PUBLIC IMPROVEMEN!ftt\\ing the center. \1 ~"Utmty NotificatlOl1 f rthe Oregon 344). numbe~i~~~'~sry~0-332-2 Downspouts/Drains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pa2;e 1 of3 CITY OF SPRINGFIELD- Building/Combination Permit Status In Review PERMIT NO: COM2006-01387 ISSUED: APPLIED: EXPIRES: VALUE: 10/27/2006 05/02/2007 $ 100,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Estimate Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 100,000.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $100,000.00 $100,000.00 10/27/2006 ~ Fee Description Plan Review Comm/lnd/Public + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $367.67 10/27/06 1200600000000001575 $5.80 11/7/06 2200600000000001553 $2.90 11/7/06 2200600000000001553 $4.64 11/7/06 2200600000000001553 $43.00 11/7/06 2200600000000001553 $15.00 11/7/06 2200600000000001553 Total Amount Paid $439.01 I Plan Reviews I Fire Department Review Initial Review Plannin2 Review Public Works Review Structural Review SUB Review 11/06/2006 10/30/2006 11/06/2006 11/06/2006 11/0212006 11/06/2006 11/0212006 APP LLH Received 11/612006. 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. Ueouire~nSDections I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Pa2e 2 of 3 CITY OF SPRINGFIELD - Building/Combination Permit Status In Review PERMIT NO: COM2006-01387 ISSUED: APPLIED: EXPIRES: VALUE: 10/27/2006 05/02/2007 $ 100,000.00 225 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 Pae:e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone C' . f Springfield Official Receipt opment Services Department Public Works Department Job/Journal Number COM2006-01387 COM2006-01387 COM2006-01387 COM2006-01387 COM2006-01387 Payments: Type of Payment CreditCard cReceintJ RECEIPT #: 2200600000000001553 Date: 11/07/2006 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JON SIMONSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb 032557 In Person Payment Total: Page 1 of I 9:03:02AM Amount Due 43,00 15,00 2,90 4,64 5,80 $71.34 Amount Paid $71.34 $71.34 I 1/7/2006