HomeMy WebLinkAboutPermit Electrical 2005-10-7
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)72'60.689. . .' .
ELECTRICAL PERMIT APPLICATION '.' ,,;~~/"IJ~/:"'I;'IJ ." .
City Job Number CooK ZOO~ -CO $4 ~ Date 10 - 7- OS-' 0.", "" ";:%'CI '.
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200 Amps or less
201 Amps to 400 Amps
Address 68 West "Q" Street 401 Amps to 600 Amps
, . ,~" 'IoU to
N 51~Amps<.!oJl',OOO:o;mps Tt
. City Sprinqfield Phone 747_663~nENT\0 :RJS~~8Q9>,inPW6Iis'ln Ut1I~~n
lolloW rules aRecoDneet OnIYJles are set
Notilication cem''',. ~';~;:;on OAR 952-001
. AR 952.nf.)'J''''''' ",,""M.__'_
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owu. You maY"9"" (Note: the 181"1.11 ,v'.'"
II' 9 the "enter. . 'n,.,iir.~\'On
ca In rnstaUation~Altii,;"tion or'Relocation
number lor i~~ ~:""",.::-~ C"'l.2344). .' .....
Cer"", ;'.J-'"pS.or' ess.
20 I Amps to 400 Amps
401 Amps to 600 Amps'
Over 600 Amps or 1000 Volts see >'B" above.
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LEGAL DESCRIPTION
/703343.5
OOzc>O
JOB DESCRIPTION
200 Aw-\p . S12v<. .
if
L( C-I rc.~'. h
PermitS are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
. ~'~iNSTAWTI,ON~zt
2. ,... ., r." '. ~~~~:r.r"....fc.Y;~' ",
Electrical Contractor L. R. Brabham,
Inc.
SuperVisor License Nuniber
49'44"S
Expiration Date
10/01/07
Constr. Contr. Number
8699
Expiration Date
12/18/06
Signature of Supervising Electrician
~7 ~://
A'
.c/
. Owners Name ~.if' . ~ A-s.
. Address , 2.'Z.. S- . ~JL,. ~ +- sE
City Slrlt-~Phone ~~"<L
OWNER INSTALLATION '. '2. <6lP 7
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
t
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
. $50.00
B.tv~~~,"'ft~~"":li~ti=~Imfti~
I $ 63.00 b '3
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel
. One Circuit $ 43.00
Each Additional Circuit or with I .,
Service or FeederPennit t.{ $ 3.00 '-
. .
E ~~.: :"U'-"'~S'~~f"';'I""d"~)'~' 1i1'-:'t~'ll"-
';' ~ see ~~~_ ~mC;t:l.1eeuj~CL;!!!~r.'l,,"-~~J1~I1s.t~!!.ltJ..'ill'1'
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Shared Drive(T:)/Building Forms/Electrical Pcnnit Applic:J,tion I-Q3.doc
. Status: Issued
,
, 225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00545
ISSUED: 07/07/2005
APPLIED: 05/09/2005
EXPIRES: 03/28/2006
VALUE: $ 43,000.00
SITE ADDRESS: 3233 FRANKLIN BLVD
ASSESSOR'S PARCEL NO.: 1703343300200
Eugene
TYPE OF
Gas Station
PROJECT DESCRIPTION: Natural Gas refueling station
TYPE OF USE: Addition Public
Owner:
Address:
OR DEPT OF ADMINISTRATIVE SERVICES
1225 FERRY STREET SE moo
SALEM OR 97310
.,
,.
, Contractor Type
Electrical
Engineer
Mechanical
I CONTRACTOR INFORMATION I
Contractor License
LR BRABHAM 8699
SYSYEMS WEST ENGINEERS ,rlU \0
J LOGUE GAS WORKS INC..\lesi'47H:1\'l
'-'-,' ...... \O\~.
'BUILDING,,"'~v~'fIONf .()()\.
~. U\V~e6 'O'i . IU\e'" - <;. 9":):2. s y,'j
y:'~i,\O #. of(StoriesDSe X\ Of:' \u\e .
~i,i. .., IU\~~ ~iglitluf'()' \'(\IOU':S 0\ \'(\~erl'(\O(\" (\
\~o"''' )~ ,."" -o\v \e\" r\ It)
\0' '3-\10 )'p.~ of'Heat:~O,. . \'(\e ~\\\c'"
V~O\I\\~~ 9<:>Water<t~~~; ~0\~~\1\1\'j ",00.)'
\(\ Or 'loRl&~~l.typ.~:erlO(\ v",.,.?,?,o,
B()' ,,,,e-v ,~\ '" ~..>"
()'J ~\I(\t;n~.~~(f.'dli.Vo()()'
c'a' ,Spnnkled IS nJa
....\\'(\\\J r.e\\".~
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Yrlmary Construction Type
Secondary Construction
# of Bedrooms:
',.
. 'Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer A vaUable:
Special Instruction:
Notes:
~
! DEVELOPMENT INFORMATION I
Overlay D1st:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
IP~BLIC IMPROVEMENTS I
Expiration Date
1211812006
Phone
541-747-6638
541-342-7210
541-345-7599
03/0612007
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GarageiCarport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type: 'l'lO~~
f.' Dow~ittll-~ ~ ~01
~~~~~~~i~ ~~\\ :~~~~~~~ ~Gp.
~\}i\-\On D Op. \121 "
COt/l~.t&~Ct;~,< ?~p.\OQ.
p.~'< ,~\) t)
~
1 of 4
Status:
Issued
225 F1fth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
. . Description Type of Construction
Bid Amount Use Bid Amount
Fee Description
Plan Review Comm/IndlPublic
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Plan Review CommlInd/Public
-Mechanical Issuance Fee-
+ 1.0% Administrative Fee
+ 7% State Surcharge
Gas Outlets 1-4
MinlmumlAdjustment Mechanical
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm ServlFdr 2.0.0 amps or less
Total Amount
Fire Department Review
.05/1.0/2005
I nitlaI Review
PIannin2 Review
.05/1.0/2005
.05/10/2005
Puhllc Works RevIew
.05/10/2005
Structural Review
05/1 0/2005
.
" CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00545
ISSUED: 07/07/2005
APPLIED: 05/09/2005
EXPIRES: 03/28/2006
VALUE: $ 43,000.00
I Valuation Descriotion I
$ perSq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
43,000.00
Value
Date Calculated
$43,0.00.00
$43,.000.00
07/07/2005
Total Value of Project
F....s Paid I
Amount Paid
$130.65
$32.97
$23.08
$329.70
$83.66
$1.0.0.0
$4.50
$3.15
$4.00
$41.00
$7.50
$5.25
$12.00
$63.00
$750.46
Date Paid
Receipt Number
519/05
7/7/05
7/7/05
7/7/05
7/7/.05
7/28/05
7/28/05
7/28/05
7/28/05
7/28/05
1.on/05
1.017/05
1.on/05
10n/05
120.0500000000000591
120.0500000000000962
1200500000000000962
12.00500000000000962
12.0.05.0.0.0.0.00.0.0.0.0.0962
12005.0.00000000011.01
120.05.00000000001101
120050.0000000001101
12.0050000.0.0.00.0.011.01
120.0500000000001101
12005.00000000001477
12005.00000000001477
1200500000000001477
120050.0000000001477
I Plan Reviews I
.07/05/2.005
05/10/2.0.05
06/30/2.005
.06/01/20.05
OS/20/2005
OK GRG
See attached document for Fire
Department Plans Review
comments.
APP LLH
APP EMM
needs Minor Modification of Site
Plan Application through the
Planning Division before building
permit approval F(per Colin
Stephens). Minor Site Plan Decision
issued 6/30/.05. Development
Agreement received 7/l/.o5.
No SDC fee's apply existing hard
surface change to concrete pad
sloped to existing CB 6/1/2005 CAS
See attached 6 structural comments
faxed to Jeff Graper.
APP CAS
WE JMP
2 of 4
.
. CITY OF SPRINGFIELD
Building/Combination Permit"
PERMIT NO: COM2005-00545
ISSUED: 07/07/2005
APPLIED: 05/09/2005
EXPIRES: 03/28/2006
VALUE: $ 43,000.00
Status: Issued
225 Fifth Street, Springfield, OR
, 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Structural Review 07/01/2005 07/01/2005 10 JMP Sent emall to Jeff Graper, Public
Works, Fire, and Building personnel
to update status.
Structural Review 07/07/2005 07/0712005 APP LLH All conditions of John Pearsons
letter met.
SUB Review 05/10/2005 05/18/2005 WE JF JMP called Jeff Graper and
requested the energy code forms and
worksheets.
SUB Review 05/19/2005 05/31/2005 WE JF WE. Received HV AC and Lighting
forms only. JMP called Jeff Graper
to request building envelope form.
. SUB Review 06/08/2005 06/13/2005 APP JF Received BE Form. No energy code
Issues or inspections.
To Request an inspection caD 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. wiD be made the following
work day.
~ft'!In.~
Footing: After trenches are excavated.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are In
place but prior to concrete.
Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide Inspection test reports to
City Building Inspector.
Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector.
Provide results to City Buiding Inspector
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.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Rough Gas: After line is Installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas work is complete.
Electric Service: Approval required prior to utility cnmpany energizing service.
3 of 4
.
. CITYUl' M"K1NGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00545
ISSUED: 07/07/2005
APPLIED: 05/09/2005
EXPIRES: 03/28/2006
VALUE: $ 43,000.00
Status: Issued
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 wiD 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 wID remain on the site
at all times during construction.
Owner or Contractors Signature
Date
4 of 4
,
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
COM2005-00545
COM2005-00545
COM2005-00545
COM2005-00545
Payments:
T)lle of Payment
Check
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1On/2005
.
RECEIPT #:
.!'A~_._~_~~8LD._",__._. __..,__"'__",
wr. ,
'-,..ti 1
.Jiilty of Springfield Official Receipt
.veIopment Services Department
Public Works Department .
1200500000000001477
Description
Perm ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
LR BRABHAM INC
Recei ved By
djb
I of I
Date: 10/07/2005
Item Total:
LnecKNumDer AutnonzatlOD
Batch Number Number How Received
32438 In Person
Payment Total:
9:24:33AM
Amount Due
63.00
12.00
5.25
7.50
$87.75
Amount Paid
$87.75
$87.75