HomeMy WebLinkAboutPermit Building 2008-04-14
Cit:y ~ Springfield
Electrical Authorization To Begin Work
E-mailedTo:deborah.perdew@christenson.com
Receipt # EC528680
4/14/20082:42:03 PM
~'%~
Check on status of perm it
By Phone: (541)726-3753 or Email: permitcenter@cLspringfield.or.us
, ,"1,
TYPE OF WORK:>>"'Mi
~ ~ , '1-"" ~ u I~ fl'l
o AddItIOn/alteratIOn/replacement
III',
" ,..CONTRACTOR
1',11 ~ ~ I,'",
".
;.
FEE SCHEDULE
DeSCrIptIOn I Qty, I Ea, I Total
Residentlal"SINGLE-.OR Imulti-family 'dwelling umt,'hicludes
atta~h~i~lig~f1i~ge~ " "II;II?~,i:tl\ijjT:::,' I'" ~~ ~~'~<),< \1 ,'& i I
ILH<<~, '"II I l'li") ,
11,000 sq ft or less
I Ea addl 500 sq ft or portIOn
l"~in1ltedJi:'1t;.r~~::: I.:: ", '\
I-Limited energy, resIdentIal
(with above sq ft)
I-Limited energy, multifamIly
resldentJaJ (wIth above Sq ft)
I-Limited energy, commercJaI
(With above sq ft)
I - Stand-alone limited energy,
reSIdentIal
I - Stand-alone limited energy,
multi-famIly
I . Stand-alone limIted energy,
commercial
I SerVices O~ feeders mstall~tlOn; aIt~r~tJon, AND/OR relocation
I 200 amps or less
120 I amps to 400 amps
140 I amps to 599 amps
. TEMPORARY serVIces 'OR feeders mstallatton, alteratIOn,
AND/OR r~lociilon::::' :, :,':' Mil; , .
1200 amps or less
120 I amps to 400 amps
1401 amps to 599 amps I
I :Branf~:~lrcUIts - NEW;:atteratlOn, 9~ extension1 p'er'panel
A Fee for branch circuits With
servIce or feeder fee, each
branch CirCUit
B Fee for branch CIrcuIts
Without service or feeder fee,
first branch CirCUit,
I each addl branch circuit
I~!s~eilir"~hu,s,
I Service reconnect only
I Each manufactured or modular
dwellmg, service and/or feeder
I Pump or lITIgation Circle
I SIgn or outline IIghtmg
SIgnal clrcUlt(s) or IImlted-
energy panel, alteratIon, or
extensIOn
I : ".
I
I
I
I
* City OfSpnngfield
'" 1<
11'11
lliJ New constructIOn
:.; ;,CATEGORy'OF CONSTRUCTION'::;-:;;::,:::,
" I'I\I'I""'~ <<~')~~ ' "[..',\111, '"'0~U""
o 1 or 2 family dwellmg 0 MultI-family lliJ CommercIal / Industnal
" . .., ., : JOS"SITE INF;ORMATIO'" ~~bCATIONP~::",,,,,,,:, '. ',.
IJObn~,: 60004'I~o~ address:::;;S~'~2~ O.....~s.f-::::,.
I City/State/ZIP' SPRINGFIELD, OR 9"7477-4671
I SUlte/bldg /apt.no,:
I Project name, JUSTICE CENTER
Cross street/dIrections to Job site:
I SubdiVISIOn
ITax map/parcel no:
I
VOICE/DATA WIRING
IL~n~: .
17033jy!iJJ300 \f103:~53 \ O\~
DESCRllmON OFWORK l'../f, .
, ' , I I" <<<"
$50 00
$50 00
-"'"
" ,( I'
,1, ~,
, ..
I::
<Ii,
srrE''C(:>NTAeT'
, ,It? , <<I'dl 1'1"
I, " ~ <i, '-
IName: DAVID STIERS
I Phone: (503) 432-7285
IEma11.
I
I EI. he, no,: 26-34C I CCB he, no,:
I Busmess Name, CHRISTENSON ELECTRIC INC
I Contact: Deborah Perdew
IAddress: 11] SW COLUMBIA SUITE 480
I City/State/ZIP, PORTLAND OR 9720 I
I Phone' (541)6886121
I Emall' deborah perdew@chnstenson com
I Metro he. no,:
I Supervlsmg eleetnetan's he. no,' 4079S
I Supervlsmg electnetan's name: PAUL E HORVATH
IFax:
458
,I ilL
"'I"
I Fax: (541)6886528
I CIty he. no.:
not offered onlme at thiS Junsdlctlon
Upon review and approval by your local JUriSdiction, your
permit Will be e-malled or faxed WithIn one bUSIness day,
With Instructions on how to schedule your Inspection
"1' .. ELEcTRiCAL ~,E~MIT FEES
jl,'11 <
NOTE ThiS AuthOrization To BegIn Work expires WithIn 180
days If a permit IS not obtained
Subtotal $50 00
State Surcharge (12% of permit fee) $600
City Of Spnngfield fees * $7 50
TOTAL PERMIT FEE $63 50
10% Local AdmIn Fee, 5% Local Technology Fee
The local bUildIng department may determIne that an
AuthOrization To BegIn Work IS null and VOid If It does not
meet applicable land use laws and local ordInances
ThiS AuthOrization To Begin Work must be posted at the job site until replaced by a Permit
9
__~prl>ldHG~
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 230 4th St
ASSESSOR'S PARCEL NO.: 1703353101500
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/0112007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
Springfield TYPE OF WORK: Office
TYPE OF USE: New Public
PROJECT DESCRIPTION: Springfield Justice Center - This permit is valid only for the area of the north side of A
Street to the south side of B Street between Pioneer Parkway East and 4th Street.
Owner: CITY OF SPRINGFIELD
Address: 344 NORTH A ST
SPRINGFIELD OR 97477
Phone Number: 541-726-3672
I CONTRACTOR INFORMATION'
Contractor Type
General
Electrical
Fire Contractor
Low V oItage Electrical
Plumbing
Sewer
Contractor
JOHN HYLAND CONSTRUCTION INC
C & SELECTRIC
OMLID AND SWINNEY
MORROW MEADOWS CORP
INTERSTATE MECHANICAL INC
MORSE BROS INC
License
46071
3849
62730
91668
55190
2101
Expiration Date
07/11/2008
09/01/2008
12/15/2011
07/20/2009
11/07/2009
08/10/2008
Phone
541-726-8081
541-741-2236
541-741-1775
(503) 566-5600
503-233-7171
(541) 928-6491
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
A3
B
IB
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building
3 Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
n/a Occupant Load:
61,900
31,317
13,860
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Frontyard Setback: Overlay Dist:
Side 1 Setback: # Street Trees Rqd:
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback: % of Lot Coverage:
Solar Set~'"'~NTION: Oregon law reqlJlres \{('! I 10
fu;lu" f U;"'" ClUVtJll:'U l'Y I. 1_ ~ . 1- Ji_" ~ ' 'v
~otlflcatlOn Center. Those l!Jles aj(:>If"V~LW IMPROVEMENTS I
StreetI~~iJP1-0010 tillough Of\? 9!J2-001- NOTICESidewalk Type:
Storm Se'6:aHiA;~~~t~~~'(~f~fe'.e~~ft~~:;~~~ebY THIS PE~~~r:i~lW~PJBE IF THE WORK
Special In~uivr the Oregon Utility Notification AUTHORIZED UNDER THIS PERMIT IS NOT
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
Paee 1 of8
Total:
Handicapped:
Compact:
,
_ ~FllI fllGi~.I!tLO
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Encroachment Permit
-Mechanical Issuance Fee-
+ 1 % Seismic Fee
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Addressing Assignment
Air Handling Unit 10,000 & Ovr
Air Handling Unit Up to 10,000
Building Permit
Fire SF Fee - Non-Residential
Fixture
Furnace - Unit Heater
Gas Outlets 1-4
Gas Outlets 4+
Miscellaneous Mechanical
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Sanitary Sewer - Ist 50 Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
Sanitary Sewer Each Addtll00'
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Storm Sewer - Ist 50 Feet
Storm Sewer Each Addtll00'
Thermal Unit
Vent Fan
Water Line - 1st 50 Feet
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
22,395,060.00
Total Value of Project
~
Amount Paid
Date Paid
$45,786.42
$28,176.26
$130.00
$10.00
$734.24
$8,567.53
$3,894.53
$6,231.25
$31.00
$60.00
$32.00
$73,027.65
$7,784.60
$4,284.00
$108.00
$4.00
$6.00
$18.00
$1,681.55
$1,034.80
$45.00
$2,458.91
$3,234.23
$14.00
$10.00
$44,236.51
$4,214.80
$514.90
$4,903.78
$44,199.80
$10,019.43
$45.00
$14.00
$594.00
$174.00
$45.00
2/1/07
2/1/07
3/2/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
5/24/07
Pal!:e 2 of8
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/0112007
EXPIRES: 10/0912008
VALUE: $ 22,395,060.00
Value
Date Calculated
$22,395,060.00
$22,395,060.00
OS/24/2007
Receipt Number
2200700000000000151
2200700000000000151
1200700000000000228
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
1200700000000000623
~~'NG!PlaD
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Water Line - Each Addtll00'
+ 10% Administrative Fee
FLS Safety Systems Review
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ Ea Add
Low Voltage - Commercial Indus
Perm ServIFdr 1000 amps/volts
Perm Serv/Fdr 200 amps or less
Perm ServIFdr 201 to 400 amps
Perm ServIFdr 401 to 600 amps
+ 10% Administrative Fee
FLS Safety Systems Review
+ 10% Administrative Fee
FLS Safety Systems Review
+ 10% Administrative Fee
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
FLS Safety Systems Review
Low Voltage - Commercial Indus
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
Total Amount Paid
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/0112007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
$14.00
$12.00
$120.00
$648.40
$324.20
$518.72
$2,268.00
$45.00
$375.00
$2,646.00
$900.00
$250.00
$210.00
$2,100.00
$156.60
$1,566.00
$5.00
$46.74
$6.00
$2.50
$467.40
$50.00
$5.00
$6.00
$2.50
$50.00
$5.00
$6.00
$2.50
$50.00
5/24/07
8/16/07
8/16/07
11/28/07
11/28/07
11/28/07
11/28/07
11/28/07
11/28/07
11/28/07
11/28/07
11/28/07
12/18/07
12/18/07
2/1/08
2/1/08
2/8/08
2/8/08
2/8/08
2/8/08
2/8/08
2/8/08
4/7/08
4/7/08
4/7/08
4/7/08
4/14/08
4/14/08
4/14/08
4/14/08
1200700000000000623
1200700000000001049
1200700000000001049
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001743
2200700000000001857
2200700000000001857
2200800000000000144
2200800000000000144
2200800000000000175
2200800000000000171
2200800000000000175
2200800000000000175
2200800000000000171
2200800000000000175
1200800000000000315
1200800000000000315
1200800000000000315
1200800000000000315
1200800000000000350
1200800000000000350
1200800000000000350
1200800000000000350
$309,183.75
I Plan Reviews I
Fire Department Review 11/29/2007 FM-200 System by Omlid and
Swinney
Initial Review 02/02/2007 02/02/2007 APP LLH
Structural Review 02/02/2007 02/02/2007 10 LLH Dave Puent will deliver plans to
Tom Rogers the week of February 5,
2007.
SUB Review 02/02/2007 02/02/2007 10 SKG Steve Graham delivering set of plam
to Springfield Utility Board
SUB Review 02/09/2007 02/09/2007 WE JF JMP left a voice mail at the office of
Heery International requesting the
missing energy code forms.
SUB Review 03/12/2007 03/12/2007 APP JF
Pa2e 3 of 8
,
._a~ml/!iG~.I~LP
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Review
02/02/2007
Public Works Review
Structural Review
OS/23/2007
OS/23/2007
Fire Department Review
08/15/2007
Initial Review
11/29/2007
04/13/2007
OS/23/2007
OS/23/2007
08/15/2007
11/29/2007
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/01/2007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
APP GRG
See attached document for Fire
Department Plans Review
comments.
APP JHJ
APP DJP
Attached SDC Worksheet. (JHJ)
Plans reviewed by Tom Rogers,
Rogers Engineering, under contract
with the City of Springfield.
OK GRG
Plans Review: Underground fire line
stub up for sprinkler system. Job
#COM2007-00157. Plans show a six
inch fire line of approximately 10
feet in length coming from a future
12 inch public water main and valve
to a 90 degree ell with stub-up from
ground.
Plans appear to meet code
requirements.
APP LLH
Received plans from Om lid and
Swinney for FM-200 System.
Forwarded to Gilbert Gordon, Fire
Marshals Office for review.
Pal!e 4 of 8
,
__-'I!llI:NQFlao
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fire Department Review
12/14/2007
12/1412007
OK
Pal!:e 5 of8
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/01/2007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
GRG
Plans Review: Sprinkler/standpipe
system for Area B/Phase I
(Police/Courts building) of Justice
Center. Job #COM2007-00157.
Designer: Shawn Fenneran.
Contractor: Omlid and Swinney.
Note: This project is being reviewed
under the 2004 Oregon Structural
Specialty Code, 2004 Springfield
Fire Code, 2002 edition of NFP A 13,
Standard for the Installation of
Sprinkler Systems and the 2003
edition of NFP A 14, Standard for
the Installation of Standpipe and
Hose Systems (the building plans
were submitted prior to April 1,
2007 when the 2007 OSSC/OFC
went into effect for the State of
Oregon).
This proposal features a manifolded
system with an indoor backtlow
preventor valve and two OS& Y
valves with a wall mounted FDC.
There are four risers. The first riser
will feed the future Area A/Phase II
jail building. The second riser feeds
the police/courts building
wet/manual standpipe system. The
third riser is the police/courts
building wet sprinkler system. The
fourth and last riser is the dry
system riser for the corridor
between the police/courts building
and the future jail.
The system is primarily
hydraulically calculated for a .10
gpm/sq. ft. light hazard occupancy
(being primarily offices) while the
third tloor mechanical
penthouse/broiler room is classified
as an Ordinary Hazard Class I at .1:
gpm/sq. ft over 1500 sq. ft. The light
hazard areas were calculated with a
reduced square footage because of
lower ceiling heights, use of quick
response sprinklers and a wet
system as allowed in NFP A 13-2002
edition, Section 11.2.3.2.3.
,
._a~~NG~.iJil;LO
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/0112007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
The standpipe portion is a wet
manual system controled by the fire
department engine company.
1. Per meeting with Deputy
Chief/Fire Marshal Al Gerard,
Deputy Fire Marshal Gilbert
Gordon and Shawn Fenneran,
NICET Level III CET, Omlid and
Swinney, standpipe hose valves shall
be relocated to the intermediate
stairway landings below the second
and third floors. Will verify on
inspection.
Fire Department Review
02/07/2008
02/07/2008
APP GRG
Plans Review: Clean Agent system
installation for server room. Job
#COM2007-00157. Designer: Steve
Francalancia. Contractor: Omlid
and Swinney.
The proposed system is a Chemtron
FM-200 heptafluoropropane system.
The system includes Gamma Series
150 lb cylinder and associated
appurtenances, piping and two
discharge nozzles protecting
approximately 3740 cubic feet.
The associated alarm system
includes a hazard panel tied into the
fire alarm system, two photoelectric
and two ionizatIOn smoke detectors.
1. Provide and install a horn strobe
for the computer server room.
2. Field verify drop down panels are
clipped.
3. Field verify HV AC shutdown
upon trip test of clean agent
suppression system.
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.
Pa!!:e 6 of 8
1
~ ~"'AI1NG"'I~LI:)
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/01/2007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Ueouire<unsoections I
SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
SUB Final: After all required energy inspections have been requested and approved.
SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover.
SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
SUB Ceiling Grid: Interior Lighting
SUB Exterior Lighting
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Roof Sheathing
Firewall: Located and constructed according to plans.
Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to
plastering.
Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector.
Provide results to City Buiding Inspector
Roof Sheathing/Nailing: Before covering sheathing with finish material.
Ceiling Grid: After drywall approval but prior to cover.
Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector.
High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection
results to City Building Inspector.
Fire Department Sprinkler System: Prior to cover. Hydro pressure test, fire line flow test.
Fire Department Underground Sprinkler System: Prior to cover. Hydro pressure test, fire line flow test.
Fire Department Alarm System: Fire Department Alarm System Acceptance Inspection. This inspectIOn must be
requested and approved prior to requesting any occupancy approval.
Fire Department Clean Agent System: Coordinate inspection with City Fire Marshal's Office
Fire Department Kitchen Suppy System: Coordinate inspection with City Fire Marshal's Office
Underslab Plumbing: Prior to filling the trench and including required testing.
Rough Plumbing: Prior to cover and including required testing.
Paee 7 of 8
!
_~~R;NGPlae
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00157
ISSUED: OS/24/2007
APPLIED: 02/01/2007
EXPIRES: 10/09/2008
VALUE: $ 22,395,060.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Underslab Gas: After line is installed and required testing and capped if not attached to an appliance.
Underslab Mechanical. Prior to insulation or decking and including required testing.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Final Plumbing: When all plumbing work is complete.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
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 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 8 of 8
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00157
COM2007-00157
COM2007-00157
COM2007-00157
Payments:
Type of Payment
ONLINE CHGS
cRecemtl
RECEIPT #:
1200800000000000350
DescrIptIOn
Low Voltage - CommercIal Indus
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstratlve Fee
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 04/14/2008
Item Total:
Check Number AuthorIzatIOn
ReceIved By Batch Number Number How Received
Paid By
ONLINE PERMIT CHGS
ddk
Page 1 of 1
ONLINE CHRISTEN Onlme
SON
ELECTRIC
Payment Total:
2:56:43PM
Amount Due
5000
250
600
500
$63.50
Amount Paid
$63 50
$63,50
4/14/2008