HomeMy WebLinkAboutPermit Electrical 2008-9-26
SP~INOFfIl:LD
225'FlFfH STREET ~. SrmNGfIE~. OR 97477 . PH:(541)726-3753 . FAX~:,'(S41)726-3689
ELECTRICAiHERi.p'I( APPLICATION ...-
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LEGAL DESCRIPTION:" ,..
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Service Included :.. "
,- ,I :", " j, ~ , il., I
10.0.0 sq~ fL oriless )~. .1 .
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Each additional 500 sq, ft.. or
portio.Ii th~reof !'~. " L'
~, .~:' ',.l -.. I:Jt.r
Each Manufact'd Rome or
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Modular Dwelling Service or
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F:~eder I' ' ,',1'
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B. ;~iScri'iccrfo"i.;-'F(irders::2t~In'stalhltion;tA ltcfiitiori's:;or';Rclocation:f.:c;\;i~
;"~:-i/q~'~';Htii',~~;:JrH.;i};:.::t~.!;l";' ,j~qi--l~~'i~:~'; 'o<:i:o '('1;;J;:,-;,.",t!'].~-~<<:;;1lr.'[)'.(:.;:;':'~""i'<";it":~'i.i,l;tf.M':6\;':'Tr~;'j;"i~fF,~
,. "," ' 7$
~crn LJ XA...)L.- 206AmPsorl~ss., Z- $J6.00
, 201 Amps to 400 AjDps: $ 83.00
"'~V jI r f 401 Amps to 600 Amps $138:00
. ~' . , '11'
" g8brI'ffiW ~~00lM.'flPll to '$18000
'6 L/ J ~ -,tJi1ift'!I~~~r6r~ff l!J<ph&.i6\lllllWilllJJtility $413 00
1OIIUV, . , j o'Rc'l'lWSetrul1lll are set.forth $ 55 00
. Nolificatlon Center: hOAR 952-001-
~AR 952-001-00,1Q,\!1rOug ," ,. I 'P.~u., -, ..." "0""'--- , "$' ""'w.",,,"
, / ( ) .'~ . -..:J:+h~:rllp.S ~"r "'ii'l,k-~M~S1 P"'i!'>'W\,} "'~~
Supervisor Licen~e Number.. ,_' ''-1'1: 1 ,C::; '" an V~u ma,rnbtili!li~;'I:'C\'1"'"l!:(Tr; dei'. .:';"c '. :,,,,,. :~;".1';i:j!~r':1{:, ,~,
- " y~, '(N fe' the telepllone, ,,".." ...',' "........ """-",,.,
I calling the center:, ~ '., ~'licatiOft '
, ...~r for the ~il;ll~i1'it Ion or"R'elocation : I
: i' , ,.., , Center l~olr~%l~fi~ :'. $ 55.00
Constr.. Contr.. N~ber,<i :') /2.'1' 20 l' Amps to 40Q Airips ,\ $ 76,00
40 i.Amps to 600 Amps/--- $110.00
Expirati~nDatb.'! ~\- L:+~ I U Ove;6bo'Am-ps or 10~.'Volts see ''B'' abov~.
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Signature of Supervising Electrici~ ,i! D.~~~!f~~~~l~~~~~~t~$:~SY@~lif,p;r.fi\~;~ll~itB~!li*~'l~i!&'It ,;.'
. ~~___' _ ' " NewAltc.rationor'~xtcnsion.Per:Pancl
~~l ..-' OncCircwt ,If I.'. $48.00
1 ~'I' 'J " 'I' ~ 1 ., ~;,~I Ea~,?:Ad,',ditiorui,I\8ii',C)Jit;orwith
OwnersNke"'U4CICbit-be :Lh(~~/tfE"" Seiice'o~FecdcirP~fmit . $ 4.00
Address ',1'{b u GsJ- · ,. ....,~~lRr~~~1~t\11\~r~\J~'~;f~~~:J]~~~J;~:~i~€t,i,I~!~~;~l;~~~~h11~~t~~~~!~1
CIty _ St?~.', ,'> R~on~ .i' ',NOTICE: plII'?por;ITII';' ..B~~THEWOfu<
, ,I . ::,,, ,( , 'i';\ '. . ,," THISPER~u.; ';1!~~IT'SNOT $5500
O~NER,IN,S~A~LApON' \ ,. . . AUTHORIZEQ;\MlI~!! Ji\I.~m FOR' $ 28.00
The installation is being made on property [own wh,OOMMENQilJ,QS~ ~lMfMerclal '.' $ 50,00
is not j,{tended for, sale, lease?r rent.. :." ANY ~i~IEEi!lQ ':ermit In.pection Fee is $50.00 + Surcharges
Owners Signature: ':,' 4. ;;~~~K~g~1:!Jig~~~e~~l~ifJ~J~~i,~\?~~~~~ti~?~tWj IlIb
" m..'St~te SUrcharge ,:' f7 yz
y-.- IO%"Administrative Fee 1'1600
5% Technology Fe.;' .. 730
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JOB DESCRIPTION:
t, ,~;
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$117,00
-AJb','O~t\~i; b:.i;"k Aet~
1.A.1'~' ''A/-pP ,~"'~ Tt!'i-V'\
Permits are non-triDsfe..a'biewand e_xpire iftwork IS
not stal1ed;~itJiln180'daysi ofi~suance or if work is
Suspende..d fo.r180 'd~y.. :" ," ", "
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~;~;;:,r;1:,nf1l.2-?~~,~i1.:B2il;i~~~f1-i1f:;:,,;~:?:;~!;,:,:;,'y)?S~?~I:-,,;:;,,'''''.i-\t:~'j~t?1::::i:,~;:
2. ~~@lNl';lJ4ljll/k~t~~'C,~!iJ!~1Jrf!t!Jg~f::r,;:J
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Electrical Contractor',. \ K (~ . C-:I
3.0 ~"A-
$ 21..00
$55.00
1'1(,.
Address ,"7 ') "'"1 . U()V\ '
City SpnLI~~> )~i Phon~
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Expirationp~te,
I0-l-Ii)
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$ 55.00
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TOTAL " ,"
, Shared Drivc(f:Ylluilding F6nnslElectrical Pennit Application l-08_doc
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18~ 'tZ
Inspection ~e~uest: '726-3769
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CITY OF SPRINGFIELD
,;Buil{ling/Combination Permit
PERMIT NO: COM2008-01475
. iSSUED: 09/26/2008
APPLIED: 09/26/2008
EXPIRES: 03/26/2009
VALUE:
Status
Issued
225 Fifth Street, Springtield, OR
541- 726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection,Line ,
SITE ADDRESS: 1460 G ST
ASSESSOR'S PARCEL NO.: 1703362204601
Springlield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Add 100a ckt for new 30kva UPS info syslem
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I PUBLIC IMPROVEMENTS I '" ~'i:. \t~~~ \S ~CI\
, SillCW~~,}~Pl'i:.'?-~ ('\ <:CI'?-
" ~ ~~~ y.,\'t5. ~'i:.'v'
~l;)"\\~ 'i:.~~~ \ ~~~1~~\\Ii~ns: '
,y.,\S ~ CI'?-\1.'i:.~ CI'?- 'IS ~
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I Valuation DescriDt[on I
Owner: MCKENZIE WILLAMETTE REGIONAL MEDICA
Address: PO BOX 190700
SAN FRANCISCO CA 94119
I CONTRACTOR INFORMATION'
.
,Contractor Type
Electrical
Contractor
J K GUCKENBERGER ELECTR.IC INC
Licertse
45129
# of Units:
Primary Occupancy'Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I BUILDING INFORM~nON I,
, \0
# of Stories: . as 'loll '\i '
Height of ~~l!ctuij:eQOI' 0\\ ~'(\
;r:Ye~(!lf. Il'-l''tt<e Ola ale sa\ ~(Y\'
,,-<"O~\', Wateud9pe:, 1\l\eSO':i\ 9\)'2., 0 tl~
~,.,_...},\ \' ,aO\,-l' _\~D':)'J ""' t'"' IU\e;;;J
r5', ,,,.' Ie'; 'Range TY.lle(): Il'd" . .~e rta
, t'.> -1\" "G 1"\)1: ' 0' , :1\0"
, .\': "~:,~,O(\ C~C{\~~ !a,teiJ.Il\~S e 'Ie\ell. 'a'iJ.O~
, ';:'''\\ 0~'2.-('SPfJlrr"le~!o'iJII1"I,\)\'l ~o\\\\1 n/a
t '''.\ ,((\"0:, ~"'c ~ \ \X\~1 _" ^-\.
'\;'JI'Di:VEEOiMENii.oo.-~A TION I
ill ;
,,- :pe"- 'leI ,0
(\\l(\' Ce(\
Overlay Dist:
# Street Trees Rqd:--
Paved Drive Rqd:
% of Lot Coverage:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
.-" - '!I '."
..::~#.f:",~",:-f
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Street Improvements:
Storm Sewer Availahle:
Speciallnst,"uction:
Notes:
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Page 1 01'2
Commercial
Expira!ion Date
04/24/2010
Phone
541-746-4656
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
, Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
,.;.'
REQUIRED PARKING
Total:
Handicapped: "
Compact:
Value
Date Calculated
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2008-01475
ISSUED: 09/26/2008
APPLIED: 09/26/2008
EXPIRES: 03/26/2009
VALUE:
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
'I Fees P9id I
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Perm Serv/Fdr 200 amps or less
Amount Paid
$14.60
$17,52
$7.30
$146.00
'Date Paid ;
d
9/26/08
9/26/08
9/26/08
9/26/08
Receipt Number
2200800000000001450
2200800000000001450
2200800000000001450
2200800000000001450
Total Amount Paid
$185.42
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.
Reouirecllns.n~c.ti.,!~,~ ,
/
Electric Service: Approval required prior to utility company energizing service.
By signature, I 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 fu.rther certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springlield and the Laws of the State of Oregon p~rtaining to the work described herein, and
that NO OCCUPANCY will be made of any structllrewithout permission of the.:Community Services Division, Building Safety.
I furlher eertify that ollly 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 constructioll. '
Owner or Contractors Signature
Date
Paee 2 of 2
225 Fifth Stteet
. \~..
Springfield, Oregon 97477
541-726-3759 Phone"
Job/Journal Number
COM200S-0l475
COM200S-0 1475
COM200S-01475
COM200S-01475
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Penn Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
+ 1 0% Administrative Fee
Paid By
JEFFREY GUCKENBERGER
/
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000001450
Date: 09/26/2008
1:17:50PM
Item Total:
<":heck Number Authorization
Received By Batch Number i~. Number How Received
Amount Due
146,00
7.30
17,52
14,60
$185.42
Amount Paid
djb
$185,42
$185.42
02S02D In Person
Payment Total:
Page I of I
9/26/200S