HomeMy WebLinkAboutPermit Electrical 2006-1-25
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225 FIFTH STREET · SPRINGFIELD. OR 97477 . PH:(54I)726-3753 . FAX: (541)72,t~689 ~,~(.~:fj/l~ .~~ 'rv.i .
ELECTRICAL PERMIT APPliCATION ~Z"O S~~1;!J!'.,'1,{l'~. /, IVL-
City Job Numbe, CCtYJdOJ0 - (C083 Date J QM. 2..fj 20 0" .J
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I. ~LocA'fIONOFINSTALLATIO~t~;J":':'.'Z2' 3. ,COMPLETEFEESCHEDUI..EBELOW: " ':
f'~~;~~S~~~_..'- .. h .O"..A, ,',- ,.=..~.... '.". ~~-'- . ___..'
~ LEGAL.QES~RIPTION ,\~~l 15",,0 (VIa;
\. II 0 lll\+el'~-ho\.\~ WOJ.{
JOB DESC~IPTy?~ ~ 'I'1.1JM of
Sf'<v; -\1 e\ I OR r\~Ji~
Permits are oon-traosferable and .xpire if work is
nol started within .180 days ofissuance or If work is
Susp.nded for 180 days,
2. 'COf':ITRAcr(jR INS1-ALl'ATIO;/~NLYi
Ele::;COI ~~:;ra~:;''';;-/~tfr5 '€~;~
Add,ess 4.2.llo A. W.,#\ Ave.
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City
1::\1 ~e-\.2. .
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Phone to u - ~ 4-Z
Supervisor License Number
Expiration Date
ConslT. ConlT. Numbe, eC6 I ~ 7t; g 8
11/~/o7
I I
, Signaru;~is~~
Expinltion Date
,
Owners Name1~.ci:F.". ~;-br Q fks.
Address -P_ f). thf... 7Jn (,., '6 '
City~"lt'...
OWNER INSTALLATION
Phone
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signaru,e:
Inspection Request: 726-3769
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'... . " ., " ,..:'., .:- ':-~: 7.....'"7,..',..'-..... '. ','.... .~ .
A. i~.N!",,,~..id..nt!.I:'- Sing~e.~t),\1U!~'F~D1!!r,per:dwellin~.,!nil.....
Service Included
1000 sq. ft. 0' less
Each additional 500 sq. ft. 0'
portion thereof $ 19.00
Eachmfl~UI2~lL EXPIRE IF THE WORK
, ~~~~UTHORrfE'b U'N'b'tR THI~ PFRMIT ~<III:lllT
B. .~~~~~r~~~I~~~~~~~~~i~~~r~~~?~.,ti?~J:{
$106.00
200 Amps 0' less
201 Amps to 400 Amps
401 Amps to 600 Amps
. 60 I Amps to 1000 Amps
Ove, 1000 Amps/Volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c." >;T~ria'~.r~:;.;>7s;ri,ii~~ti~~:Feed~~' :.~;~ I..~(_..
!.:;;.'.._'..:.....,.....~ .-"'... .'.;..;..............;'.........". ,.- .- .'-..,
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Installation, Alteration or Relocation
200 Amps 0' I.ss $ 50.00,
201 Amps to 400 Amps $ 69.00
401A1~~~or~mf:~-\'~gon law r,.;~";'O~ ycSJOj):OO
O:f5~8~~1~~;~~fi.~~..tYI.6.1.~~_~~~~~'_:a~v~ ~t.lllty . .'_ _.
D. ,Branch ~jr~'!l"',ller:::CJ:hose n-!l.e$!l(~ li~1 forth.,; ,! '
~,u"'~';.,";.;~~".-n. nnnlthr~lj6!lOAR'952;001"....- "'-.. ".
NewtAllerationQ,r Exteasioa P.r'Panelh les b~
O MC:'~ "jj'1U may oblain copies OIl e rU$ A3 '
ne, (rcu , ... ,_ 10" 4>
Each'AdQ'" "'I[C'~-'~' I~IJi'te' "'~ w._;> , "
(n Itlona Ircult-or Wit. ....
Serv!~,~lo'JLe.ae' p.ennitregon Utilitv N~tlfll$19ro<l
t;'\',;;.:,.!,:~.:,Q,e?t&r 'S:V~9,q-,33?}~.1. )"'" :",' i'. ';~:
E. ';'Mlscclian.ous,(Serv,celfe.d.r not mclud.d) -'-Each'lnstallation:"
:.. "\1~..........- -...~..':!r ....-.. .'..._"'",,~";' 4.... .....;._.(~ ......:.....:~...._.~ . ,,_' .....l~~_ ...0.- . ..<t,."'..
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limiled EnergylResidential $ 25.00
Limited Energy/Commercial y: $ 45.00 4(,00
~
Minimum Electric P.rmit laspectlon Fee is $45.00 + Surcharges
~~~-,_;":::,,,,sr.~":1--:~:--...,~~.~.r~.~), ~_." ,', ~<{;]"~~jr,{"';',,~" '::,. -.'
4. . SUBTOTAL,OF ABOVE,:;",. :"1,,, !',
~r...,_. ':~:,:,:: ~'fl::~,,1';"~_, :;Jr..:"i: :L.;":~_..,.':':;" . t~~..:~i-~, ~:'.;:,..
4s-.() 0
~,'O
4.~o
;3.(0
8% State Surcharge
10% Administrative Fee
TOTAL
SImrcd Drivc(T:YBuilding FonnsIEIectricnl Permit Applicmion 1-06.doc
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CITY OF SPRINGFIELD
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
,541-726-37691nspection Line
Building/Combination Permit
PERMIT NO: COM2006-00083
ISSUED: 01/25/2006
APPLIED: 01/2012006
EXPIRES: 0712512006
VALUE:
SITE ADDRESS: 110 INTERNATIONAL WAY
. ASSESSOR'S PARCEL NO.: 1703154000100
Springfie'lt~t~?F Mechanical Only
l~~~Tl.BIJtr.,ll.{l.w-Ifl~~F THE WCommerclal
PROJECT DESCRIPTION: Add computer room and UPS cooling. THORIZED UNDER THIS PE URK
COMMENCED OR III 6D^"rs-.~~~/S NOT
"I" Jau IJAY PERIOD. - .." 1 un
PACIFIC HOSPITAL ASSOCIATION
PO BOX 7068
EUGENE OR 97401
Owner:
Address:
I CONTRACTOR INFORMATION'
Contractor Type
. Electrical
Low Voltage Eleclrical
Mechanical
Contractor License
BUILDERS ELECTRIC INC 4296
THE HD STORE LLC 157588
COMFORT FLOW 460
I BUILDING INFORMA nON,
Expiration Date
12/10/2007
11/0312007
0612712007
Phone
541-485-0922
541-683-4848
541-726-0100
#ofUnits:
Primary Occupancy Group:
Secondary Occupancy
I'rimary Construction Type
Secondary Construction
# of Bedrooms:
B
# of Stories: Lot Size:
Height of tlTTENTION: Oregon la\~qd'JL.~~!JfIJl9~:to
Type of Hear- s ado ted by ',~II'~lt~dJf.I~l!rc:ty
Water Type: 011 ow rule, P SgFt Bascment:.:>rth
.. 'f' t'on Center Thos... h..tS u, ~ ~_. .
Range Type:OtllCa I . Sq Ft.Garage/Carp.ort
, OAR 952-001-0010 thr(>"~" c",,, _J<- v' .
Energy Path: , Sq Ft Olher.:.Jles by
Sprinkled 0090. You may ("rii~am cO'Oc~uLlp,ih'fLoad:
~_'l:_... ~"'..... ....n.ntpr tNnte: tnt;; telelJllUlle
I DEVELOPMENT INFORMATION ,'regon Utility Notlllcatlon
verlltl' I~ 1-800-332-234REQUIRED PARKING
lIB
Fronlyard Setback:
Side I Sethack:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
.
IPUBLIC IMPROVEMENTS'
Street
Storm Sewer Available:
'.. Special Instruction:
Sidewalk Type:
Downspouls/Drains
Notes:
I of 2
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CITY OF SPRINGFIELD
.
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Building/Combination Permif
PERMIT NO: COM2006-00083
ISSUED: 01125/2006
APPLIED: 01120/2006
EXPIRES: 07/25/2006
VALUE:
I Valu 3tion Descriotion I
111111111
, Description
Type of Construction
$PerSqFt
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
L.Ff'f'S PlIid I
:
Fee Description
+ 10% Administrative Fee
+ 8% Slate Surcharge
Low Voltage - Commercial Indus
Amount Paid
$4.50
$3.60
$45.00
Date Paid
1/25106
1/25106
1/25/06
Receipt Number
1200600000000000072
1200600000000000072
1200600000000000072
Total Amount
$53.10
I Plan Reviews I
SUB Review
01/20/2006
, 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 I
work day. :;
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical 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 wID be made ohny structure without permission ofthe 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 thai 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 wID remain on the site
.
at all times during construction.
Owner or Contractors Signature
Dale
2 of 2
225~ifth Street
. Springfield, Oregon 97477
541-726-3759 Phone
JoblJournal Numbe,
, COM2006-00083
COM2006-00083
COM2006-00083
Payments:
TWe of Pa)1llent
Check
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1/2512006
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RECEIPT #:
iii~~
~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200600000000000072
Description
Low Voltage - Comme,eial Indus
+ 8% Stale Su,eharge
+ 10% Administrative Fee
Paid By
THE HD STORE '
Reeel ved By
ddk
1 of 1
Date: 01125/2006
Item Tolal:
Check Number AuUlortZ8lion
Batch Numbe, Number How Received
6484 In Person
Paymenl Total:
8:23:4IAM
Amou 01 Due
45.00
3.60
4.50
$53.10
Amount Paid
$53.10
$53.10