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Home My WebLink AboutPermit Electrical 2007-11-20 ZON rn llt./ INITIALS ~ DATE J I ..- 2/- 07 SOURCE~~) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO"""'1 z..ao 7 - 00 'J' 7'1 Date 1, ~~:~gp{liigliFff/if.y~tJL}!iffj.iiWJ):;;',.,;,~ lL/bO &- ~t- LEGAL DESCRIPTION: I /D ""3 3bZ Z o <ibo ( JOB DESCRIPTION: /lI:5{ ~ c...4-[t:;." CU,. c.l,\' ~ h - Ji v. V';.l:' c-nL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. COZ\lTRACTOR INSTALLA TION ONLY 2. Electrical Contractor --.J~ b (-; LL---c...TYI u :t::t\J e...-, Address 2J&S'1 JCf\ ,cst /410 -Lf-hS~ City Spy In&c\ Phone Supervisor License Number <.f- cg l '5 S Expiration Date 10 - I - -, 2-0 -2-1'"1 L Constr, Contr, Number Expiration Date I - I -O<g Signature of Supervising Electrician ~ <J Owners Name WC{CtAlet&' L.I: ltAw..~fh- Address .po 00-,( I 907&0 City 9Al RA<<.c.,sc:.u Phone G) OWNER INST ALLA TION ~ The installation is being made on property I own which is not intended for sale, lease or rent. t \ ,~2-0- LtltJ1 '~T ,":.:"'. ': ., . h -, . ,-;::.~.- !':"',"-' -;-~'><:-;i.':'~ i. ,.:-:,.._~ ,fr,""_ ']' ~-.~?~".. . "-;:.-"':,~~., .. _. ~. ~. :::-;:;'!. ",.. ::f: :,'^ 3",qOMPL1!-1~:FE1lis'PHEPJJL,E BEL,OW,; : -':"C"" .":.. '.. ~. .><'.. ",-_, --; ,'....'.a..._<,. ", ~ ..'_: _ <'" . "1;., .A; . _,-' .',.',", ._,...,,' '" ."' . '~"-',:" ~r "'/"~~ ',.; "',.-"- ,:..: A. . New Rcsidclltial- Siitgle o~'Multi-FamiIY:Jlcrdwe11ing unit. " Service Included 1000 sq, ft, or less Each additional 500 sq, ft or portion thereof $106,00 $ 19,00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. Seniccs or Feedcrs - Installation, Alterations or RcIocat-ion: 200 Amps or less $ 63,00 20 I Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125,00 601 Amps ~Q 1000 Amps $163.00 Over lrXt,~g~: Oregon law requirfiVdWtf' Reco~~I~~~,es adopted by the Oregowmility loti Icatlon Center, Those rules are set forth n OAR,952-001-M1 n.th h 0 C. T<:Il~m}tP'Y6'rYiccs nl"rC~(/\'IJ;;oug AR 952-001- . ': u may otitaln copies of the rules by call1!19 the cen~ {Na~' th t I h InstallatWJm~rnpmeP ~~cal h. e e ep one egon tlhty Notification 200 Amps or lesCenter is 1.800-332-2344~ "S01J(J 201 Amps to 400 Amps $ 69,00 401 Amps to 600 Amps $100,00 Over 600 Amps or'1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit I $ 43,00 If J Each Additional Circuit or with Lf / 2. Service or Feeder Permit $ 3,00 E. 1\1isccllancous (Ser\'icc/ft.'C(lcr not included) -Each Inshlllation < Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Owners Signature: NOnCE: 4. SUBTOTAL OFAB01/E S") TUft"' r[ - 8% State Surcharge C{<<tO AUtHO RMfT i:>HAll EXPIRE IPm~w6~ativeFee s~~ RIZED UNDER THIS PEffivfrf1~CfP Fee Z 7r COMMENCED OR IS ABAND 17 bJ Inspection Request: 726-11Y{J( 180 DAY PERIOD. ONijQ,f~B (;) - Shared Drive(f:}'Building FonnslElectrical Permit Application 8-06.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00974 ISSUED: 08/10/2007 APPLIED: 06/29/2007 EXPIRES: 04/30/2008 VALUE: $ 42,857.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1460 G ST ASSESSOR'S PARCEL NO,: 1703362204601 Springfield TYPE OF WORK: Interior TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Nurse station / surgery locker rooms Owner: MCKENZIE WILLAMETTE REGIONAL MEDICA Address: PO BOX 190700 SAN FRANCISCO CA 94119 Contractor Type Architect General Electrical Low Voltage Electrical Plumbing Phone Number: 541-726-4400 I CONTRACTOR INFORMATION' Contractor License GERALD MCDONNELL AND ASSOCIATES IN LINE CONSTRUCTION 51880 J K GUCKENBERGER ELECTRIC INC 45129 SECURECOM INC 117195 TWIN RIVERS PLUMBING INC 17695 BUILDING INFORMATION I Expiration Date Phone 541-344-9157 541-642-5117 541- 7 46-4656. 541-988-3585 541-688-1444 11/13/2007 04/24/2008 09/07/2008 03/11/2008 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: 12 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: 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: IA ATTENTION; ENT INFORMATION NfOOtl/'Of'W rt~!eSCadoPted by the Oregon Utility I lea Ion enter Tho~Ml in OAR 952-001-00'1 0 thrWlSi~~:Bset forth 0090, You may obtain c' IJh ~1- calling the ce t (N D;1.i~~<PIJllI~tfe4d:by n er. o~: J~~d~~~ee' number for the, Oregon Utility Notification' Center IS 1-800-332-2344t I PUBLIC IMPROVEMENTS I N (Jf\<6!~lk Type: THI$>~.wpij~t~aM!f!sEXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. REQUIRED PARKING Total: Handicapped: Compact: Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 42,857,00 Type of Construction Estimate Estimate Total Value of Project ~ Fee Description Plan Review Comm/Ind/Public + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Miscellaneous Plumbing Plan Review Comm/Ind/Public Plan Review Fire & Life Safety Plan Review Fire & Life Safety + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $202,90 $37,97 $18,99 $30,38 $329,70 $50,00 $11.41 $7,02 $124,86 $5,50 $2,75 $4.40 $43,00 $12,00 6/29/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 11/2107 11/2/07 11/2/07 11/2/07 11/2/07 Total Amount Paid $880,88 I Plan Reviews' Pa2e 2 of 4 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-00974 ISSUED: 08110/2007 APPLIED: 06/29/2007 EXPIRES: 04/30/2008 VALUE: $ 42,857,00 Value Date Calculated $42,857,00 $42,857,00 08/09/2007 Receipt Number 1200700000000000843 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001280 2200700000000001668 2200700000000001668 2200700000000001668 2200700000000001668 2200700000000001668 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-00974 225 Fifth Street, Springfield, OR ISSUED: 08/1012007 541-726-3753 Phone APPLIED: 06/29/2007 541-726-3676 Fax EXPIRES: 04/30/2008 541-726-3769 Inspection Line VALUE: $ 42,857,00 Fire Department Review 07/10/2007 07/1 0/2007 OK GRG Plans Review: Remodel of 2nd floor ICU nurses area and separate area men's and women's locker rooms, Job #COM2007-00974, Occupancy Classification: 1-2. Construction Type: I-A Sprinklered, 1. Maintain 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), 2, If more than 20 sprinkler heads are added or require relocation, submit sprinkler plans and calculations to City of Springfield Development Services Division Building Permit Technician for Springfield Fire Marshal's Office review and approval. If less than 20 sprinkler heads are relocated, provide submittal showing relocation of sprinkler heads and ensure system maintains compliance with NFP A 13 requirements, 3, Fire Alarm changes are shown on Plans Sheets El and E2, Project Manual Section 16721; Part I-General, paragraph 1.3 A notes requirements for plans submittals. Subcontractor shall submit fire alarm plans to Springfield Development Services Building Permit Technician for Springfield Fire Marshal's Office review and approval (2007 Springfield Fire Code 901.2), 4, Contact Deputy Fire Marshal Gilbert Gordon (541-726-2293) for witness testing and approval of fire alarm systems changes, Initial Review 07/0212007 07/0212007 APP LLH Public Works Review 07/1012007 07/10/2007 APP JHJ Attached SDC Worksheet. No New SDC's. (JHJ) Structural Review 07/02/2007 07/27/2007 APP DJP Pal?;e 3 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00974 ISSUED: 08/10/2007 APPLIED: 06/29/2007 EXPIRES: 04/30/2008 VALUE: $ 42,857.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line SUB Review 07/27/2007 07/27/2007 APP DR 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, I ReQuired Insoections I Final Plumbing: When all plumbing work is complete, Framing Inspection: Prior to cover and after all rough in inspections have been approved, 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, SUB Final: After all required energy inspections have been requested and approved, SUB Ceiling Grid: Interior Lighting Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, 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 Pal!e 4 of 4 225 Fifth Street Spri,!gfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number CO M2007 -0097 4 COM2007-00974 COM2007-00974 COM2007-00974 COM2007-00974 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 2200700000000001668 Date: 11/02/2007 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JEFFREY GUCKENBERGER Item Total: Check Number Authorization Received By Batch Number Number How Received djb 05511 C In Person Payment Total: Page 1 of 1 1 :52:28PM Amount Due 43.00 12.00 2.75 4.40 5.50 $67,65 Amount Paid $67.65 $67,65 11/2/2007