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Home My WebLink AboutPermit Electrical 2007-12-5 'City of Springfield Electrical Authorization To Begin Work E-mailedTo:kelly@builderselectric.com Receipt # EC521891 121412007 4:05:04 PM d Ii: Check on status of permit By Phone: (541)726-37S3 or Email: permitcenter@cLspringfield.or.us 10 New constmction ru Addition/alteration/replacement I D I or 2 family dwelling 0 Multi-family 5J Commercial/Industrial 1__~JOIl~~IT(INFORI\IIATION AND LOCAtlQN0' IJobllO.: 07-9543-5 [.Jobllddress: 960 16TH$T I City/SlntcIZIP: SPRINGFIELD, OR 97477-4] 75 I Suite/bldg.lapt.no.: I Project name: McKenzie Surgical Cross street/directions to job site: 960 N. 16th suite 203 is Mckenzie Surgical Group I Subdivision: I Tax map/parcel no.: 1703362204603 ~OESCRip:nONQF WORK [Lot no.: Circuits fOT server and 1 circuit fOf water heater SITE'CONTACT I Name: Russ Crane I Phone: I Email: IF." CONTRACt6R'~; I EI. lie. no.: 20-12C I ceo lie. no.: 4296 I Business Name: BUILDERS ELECTR1C INC I Contact: Kelly O'Brien IAddress: ] 95 MADISON $T 1 City/StatelZIP: EUGENE OR 97402 I Phone: (54] )4850922 I F." (54] )4854055 I Email: ke]]y@bui]derselectric.com I Metro lie. no.: I City lie. no.: I Supervising electrician's lie. no.: 5275$ l Superv~sing eleetrici~n's__name: R~~~.~~R_ ~OBBINS Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed within one business day, with instructions on how to schedule your inspection. NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained. The local building department may determine tllat an Authorization To Begin Work is null and void if it does not meet applicable land use laws and local ordinances. FEE SCHEDULE I Description Qt)'. Ea. Total 1_~~~~hCen~i:~,~;~~~,@p,R-IU'Ulti~f~'rt1i,I~'-~:[e~l,ing.',,~~.ir_Influ~~~!.:~_ 1 ] ,000 sq. ft, or less 1 Ea. addl 500 sq. ft or portion I -Limited energy, residential (WJ!h nbove so. ft.) . Limited energy, multifamily residcmia] (with above s~, f1) Servi('es.Ql{',f~derSIllstall~tioD;aIterlltion, AND/OR' relocat(@', 1200 amps ur less 120] amps to 400 amps 140] amps to 599 amps I' TEMPORARYS~rVi5,.~~()R ,feederS,installiiti?,~'f.alterati~~~,..d_ AND/OR relocllhoni,': .........~.. ..::;' 1200 amps or less 1201 amps to 400 amps 140] amps to 599 amps I Brallc~jslrl:"its ~ NEW, altcra'tion'9~,~~t~nsi()1l,[!e(pa,~,~!' I A Fee for bra,nch c,ircuits with above service or feeder fee, each branch circuit lB. Fee for branch circuits without service or feeder fec, rirstbranch Circuit 1 each addl branch circuit 1l\li~ceUa'heOiis ' I Service reconnect only I Each manufactured or modular dwelling, service and/or feeder I Pump or irrigation circle I Sign or outline lighting I Signal,CirCUil(S) or limiled- energy panel, a]teratlOn, or extensIOn. $48001 18001 I I I $4800 2 $4,00 not offered online at this jurisdiction ELECTRICAL PERMIT FEES I Subtotal $56,00 I State Surcharge (8% ofpcnnit fee) $4.48 I City Of Springfield fees'" $8.40 I TOTAL PERMIT FEE $68,88 I 1 0% Loca] Admin Fee: 5% Local Techno]ogy Fee I I I I ... City Of Springfield ~t~~ ~~~ This Authorization To Begin Work must be posted at the job site until replaced by a Permit Lll i' OF M'KIJ"tJJ:<IELD ' Status Issued Building/Combination Permit PERMIT NO: COM2007-01774 ISSUED: 12/05/2007 APPLIED: 12/05/2007 EXPIRES: 06/05/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 960 16TH ST ASSESSOR'S PARCEL NO.: 1703362204603 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration PROJECT DESCRJPTION: 2 Circnits for server and 1 circuit for water heater. Commercial Owner: Address: SPRINGFIELD PROFESSIONAL BLDG ASSOC 960 16TH ST STE 108 SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor BUILDERS ELECTRJC INC License 4296 Expiration Date 1211012007 Phone 541-485-0922 BUILDING INFORMATION I # 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 I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I 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 W"~+Ql:\b~~egon law requires you.to SpeciatqlmV/-d'H,~lI:adopted by the Oregon Utility Notification Center. Those rules are set forth N In OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK otesb090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT "" !I- ---'.r '~~.+ho'olonhnn.. - h ,- -- --'----[' -~, ....\.4..n,,~ .- __.f._. \ .. .', ' '''''''','.....l\JvCU un I'" MUMI\lL/V.... ..., IV[I number for the Oregon Utility Notlfll.lluun , "< 11 Center Is 1-800-332-2:344). I Valuation DescviMiorB, DAY PERIOD. Sidewalk Type: DownspoutslDrains: NOTICE: Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 -~-~ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01774 ISSUED: 12/05/2007 APPLIED: 12105/2007 EXPIRES: 06/05/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 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 $5.60 $2.80 $4.48 $48.00 $8.00 1215/07 1215/07 1215107 12/5107 1215107 2200700000000001772 2200700000000001772 2200700000000001772 2200700000000001772 2200700000000001772 Total Amount Paid $68.88 I Plan Reviews I 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 Reollired Insnections I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, 1 state and agree, that 1 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. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 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 Page 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone '!"'. AlNQFllIU> ~,."'" ,.b~ . ~ Job/Journal Number COM2007-0 1774 COM2007-0l774 COM2007-0 1774 COM2007-01774 COM2007-01774 Payments: Type of Payment ONLINE CHGS cReceintl RECEIPT #: 2200700000000001772 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee City of Springfield Official Receipt Development Services Department Public Works Department Date: 12/05/2007 Item Total: <":heck Number Authorization Received By Batch Number Number How Received Paid By ONLINE PERMIT CHGS ddk Page 1 of 1 ONLINE BUILDERS Online ELECTRIC Payment Total: 1 :08:09PM Amount Due 48,00 8,00 2.80 4.48 5,60 $68.88 Amount Paid $68.88 $68.88 12/5/2007