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Home My WebLink AboutPermit Building 2001-11-07SPR!NGFIELD Job# 01-01063-01 INDUSTRIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 3 Job Number: 01-01 063-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01100 Subdivision: i 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 800 S 0001Bth St Spr AssessorsMap#: 18030100 Lot: Block: Addition: Owner: Voicestream Phone Number: 425-378-5197 Address: 12920 se 38th st. City/State/Zip: Bettevue, WA 98006 Scope Of Work: Communication (Cell) Tower New Value: $141,000 $141,000 Adding antennas to existing 150' tower, at 67' above grade. Also adding Equipment Board on sile Contractor Type Contractor Registration # Expiration Date Phone GeneralContr Lorentz Bruun Co lnc 33 912612004 503-232-7106 ElectricalContr Po Box 42188, Portland, OR97242-0188 ADK Electric lnc 148882 Po Box 2676, Battle Ground, WA 98604-2676 53Bl3112 crTY oF SPRiNGFTELD, OREGO^ Office Use - -\)\O' Quad Area: # Of Units: Constr. Type: Water Heater: Land Use: Zoning Code: QMO Bedrooms: Range: # Of Buildings: Occupancy Group: ((\o \ne Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. 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 followi ng working day Required lnspections Build -After trenches are excavated. -When all Fire Department requirements have been met. -After all requirements have been met for Minimum Development Standards or from the Develop -when all required inspections have been approved and the building is complete. ,c..,-.^'1-'JfFooting Final Fire Final Site Plan FinalBuilding ,<{ Zoning: QMO FloodPlain? [ Wetlands? [ Journa! numbers 1: 2: Comments: Planner: Urban Growth Boundary? Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Overlay District: # of Street Trees: 3 Additional Requirements: tr Glenwood Area? [ Required Attachments: Source Locn: Material: Flood PIain FEMA: Job# 01-01063-01 Page 2 of 3 Land Use: Pave Driveway? Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main:Accessory: # Of Stories: Height (feet): Current Units: Proposed Units Census Code: Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check lndustrial Plan Review Fire & Life Safety Plan Review Total Plan Check 0912812001 11107t2001 6843 7194 141,000 141,000 Building Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 1110712001 11t07 t2001 11t07 t2001 7194 7194 7194 141,000 $6e8.90 $48.e2 $55.91 $803.73 Planning 1110712001 7194 1Planning Plan Review Total Planning $s0.00 $50.00 Grand Total Plan Check Type lnitial Review-C/l/P Engineering-C/l/P Planning-C/l/P Structural-C/l/P Fire Marshal-ClllP Checked By Lisa Hopper Pam Ownby Liz Miller Tom Rogers AlGerard Date Completed 1010412001 1011212001 10t29t2001 10t17t2001 1011612001 $1,587.58 Comment Provide Landscape around perimeter of of lease site or around base of tower and equipment shelter if not already installed. $4s4.29 $279.56 $733.85 1 Job# 01-01063-01 Page 1 of 2 Location Of Proposed Site: 800 S 00018th St Spr Assessors Map#: 18030100 Lot: Block: Addition Tax Lot#: 01100 Subdivision: Owner: Voicestream Address: 12920 se 38th st. Scope Of Work: Communication (Cell) Tower Phone Number: City/State/Zip: New 425-378-5197 Bellevue, WA 98006 Value: $141,000 Adding antennas to existing 150' tower, at 67' above grade. Also adding Equipment Board on site. Contractor Type GeneralContr ElectricalContr Contractor Lorentz Bruun Co lnc Po Box 42188, Portland, OR 97242-0188 Adk Electric lnc Po Box 2676, Battle Ground, WA 98604-2676 Registration # 33 Expiration Date 9t26t2004 Phone 503-232-7106 360-666-01 531488828t31t2005 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check lndustrial Plan Review Fire & Life Safety Plan Review Total Plan Check 09t28t20Q1 1110712001 6843 7194 141,000 141,000 $454.29 .-e $733.8s Buildins Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Tota! Building 11t07t2001 11t07t2001 11t07t2001 7194 7194 7194 141,000 $698.90 $48.92 $55.91 9803.73 Electrical Minimum Electrical Permit Fee Permanent: 200 Amps or Less Branch Circuits With Feeder or Service State Surcharge - Electrical 8% Admin Fee - Electrical Tota! Electrical 11t20t2001 11t20t2001 11t20t2001 11t20t2001 11t20t2001 7297 7297 7297 7297 7297 1 3 $.00 $63.00 $9.00 $5.04 $5.76 $82.80 Plan Planning Plan Review Total Planning 11107t2001 7194 1 $50.00 $s0.00 Grand Total $1,670.38 City Of Springfield Development Services Gommunity Services Division Building Safety 225 ITYIH STREET SPRINGFIEI,D, OREGON INSPECTION REQIIBST: OFFICE: 726-3759 Authorized Signature 1. TOCATION OF INSTALI,ATION 11 O oo ol DESCRIPTION 225 FIFTH STREET SPRINGFIELD, OB 97477 (541) 726-3753 0ryrO BI.ECTBICAL PERHTT APPLICAT?dil54 1 ) 726-3689 o,ty Job Nunber ol - o to63 -ol D EVELO P M ENT SERVI CES D E PARTM E NT The following project as submifted has the fofiowing zoning. and does not reguire specific land use approval Zoning zoo rs N, for sale, lease or rent' Ovners Signature: DATE: Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACf,OR INSTALI,ATION ONLY Etectrical contrac,o. flDK E\e.[t,.'I*,,b \\,-t* COI{PI,BTE EEE SCEEDTILE BELOS Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost $ 8s.00 s 1s.00 $ 40.00 3 A loc)Sum f rz,3c Zc\ ssdreAd o B D. 8,o<) $/5gr00s 60.00 s100. 00 $130.00 $300.00 $ 40.00 G3.oo Ci ty 3A \\\c k".*,"\-Phone 3rO-{rCZ CGLs Supervisor License Number qtSs.S Expiration Date or z Constr Contr. Number lLl ??, Expiration Date a o Siguature of Supervising Electrician {o,.n >k eil,vt Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 over 4b1 to 6oo amps I S 80.00 over 600 amps or fbOO voTts see uBu a666 Branch Circuits Nev, Alteration or Extension Per Panel E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0ut1ine Light ing- Limited EnergY/Res - Linited EnergY/Comm c OPNER INSTALI,ATTON The installation is being made on property I ovn which is not intended Address I 7 1zo ,€s7+L 5r Ci ty Phone t/Zi - <t8'9177 One Circuit Each Additional Circuit or vith Servi or Feeder Permit ce 3 SUBTOTAL OF ABOVE 7%, State Surcharge 82 Administrative Fee TOTAT $ 40.00 s 40.00 $ 20.00 $ 36.00 -72 5,,,OL( "(, -CITY OF OREGO'V RECEIVED BI: 5 <1j t3C.t) u --- SPFlINGFIELD 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Eome or Modular Dwellj.ng Service or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less I 201 amps to 400 amPs - 401 amps to 600 amPs - 60L amps to 1000 amPs- 0ver 1000 amPs/volts - Reconnect 0n1Y Job# 01'01063-01 Page 3 of 3 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project address is readable from the street, that the permit card is located property, and the approved set of plans will remain on the site at all times d //-7-o/ Date En q,tEn 0nraoH )ARTMENT or Geouoev lHD lltHg . IxousrntEs I,IINED I.AND RECI.AMATION PERI,II T Springfield Quarry Rock Products, Inc. P 0 Box 692 Springfie'ld, Oregon 97477 ISSUNJCE OF THIS PERIIIT IS NOT A FINDING OF COIiT- PLIANCE WITH STATEWIDE PLA}TNING GOALS OR THE ACKNOWLEDGED COMPREHENSIVE PLAN. THE APPLICANT MUST RECEIVE LAND USE APPROVAL FROM LOCAL GOV- ERNI{ENT BEFORE USING THIS PERMIT. IssuED suBJEcT T0 ANy coNDITIo{s oH txr REVERSE srDE * IFF'T st,{7.? 18S 3I^|Sec. Twp. Rge. Location Lane t'n no RENEWAL Jul v 1991- Renbial l,tonth Fee 415.00 20-0005 I.D.# This permit sha'|l be in effect, unless revoked or suspended for cause, from the date of issuance and shall remain in effect so long thereafter as the Permittee pays the annual fee to renew the permit, corplies with: the provisions of ORS 517.750 through 517.955 as applicable, the Rules as promu'lgated to administer the Oregon l.lined Land Reclamation Act, the approved rec'lamation plan, and any conditions attached to this permit, and maintains a performance bond as required by the Act. Issued this 7th day of ust 19 90 STATE NT OF AND ERAL IilDUSTRIES S!{LR-S Rev. 2/85 Supervlsor ry ned Land Reclamation County 8., CONDITIONS: 1 No slopes shall be let, steeper than LL:!. NOTE: RECLAMATI0N PLANS MAY BE M0DIFIED AS PR0VIDED BY ORS 517.830(4) AI{D OAR 632-(30) (35)-035. The conditions of this permit are considered to be acceptable to the permittee unless written notice is received prior to the beginning of surface mining under this permit. Upon receipt of such notice by the Department, this permit is invalid and will be reissued when the conditions in question have been solved. A provisional operating permit may be issued (0RS 517.830(3)) to operators subject to the orovisions of OAR 632-30-030(2) pending reissue of the operating permit. ELECTRICAL INSTALLATION RECORD Job Addressi 8oo 5 / *T l/Property Owner: Tenant:ner's Address z /t6o /U qgn/ ST Electrical Contractor. J- K G 1-/e._7-" 5Fl76P,. Address:D 1fi-# 6r4-o-luR-er€ SupervTSTnfT a Description of Work: Inspection Resul ts e Electrical Fee Surcharge Total s#a."a- 2,2-{ t a=zra-ji--= riiYrTffE^ry- #451 9)tlr>t --?- /-8 7