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Home My WebLink AboutPermit Building 2008-11-21 (3) Electrical Permit Application .....NSPlII1.D' 1;""DEP';Rtivl~NT USE ONLy 'I kM permitno.:{!'F ~ /c/2 ~ I Date: ~/31 oj I CITY OF SPRINGFIELD, OREGON 225 Fifth StreettSpringfield,"OR 97477. PH(541)726-3753+ FAX(S41)726-3689 This permit is issued under OAR 91~309-0000. Permits are nontransferable. Permits expire jfwork is not started within 180 days of issuance or if-workis suspended for 180 da~s. I FEE SCHEDULE I 'Number of inspections per item () jQty.1 ~~~t II Residential, per unit, service included: I 11,000 sq. ft, or less (4) 1 I Each additional 590 sq. ft. or portion thereof . 1 I Limited energy (2) 1 I Each manufactured home or modular I dwelling service or feeder (2) 1 I Services or feeders: installation, alteration, relocation I I 200 amps or less (2) I $ 81,00 $ I 201 to 400 amps (2) I $ 95.00 $ dYlln,.....1401t0600amps(2) I $158.00 $ 601 to 1,000 amps (2) I $205.00 $ I ZIP: q'{ 03 lOver 1,000 amps or volts (2) I $469.00 $ I' '1 Reconnect only (~) I I $ 63.00 I $ , I ff:;~c'n{'pJ~~"}ylsc'fViC(SrO-~ fetdcrs.:d.,!~~allgt{o!Jua{f5ratjon, relocation \lIClt'laa IUtips'O(lcS's'(2),Q oy ine OregcI1 Utilit~ 6300 $ r 11I('>~Tlr,r> f I"\....f...... T'l~ __ _ , J> . n (1)201 to=49o~~pi(2)O thr~~,~U~:'~~,~~~I,~~~ ~l~$~87.00 $ JO~~1,Q1\'OI~oOampst(i)\in copies of the lrule~l-t$,126,00 $ (1"'''''1'-/ "'C' vt'IJl{..I' '''InT.,,\, ~hG fr,J z... . Sigl1ature:. nr 't9.Y~~t69Qtawp~ 9r:)~P22,Yo)~~)~'~~rv!?~S &rfl5eders section above ; CdNTRAcTOR INSTALLATION 'I I Branth:~\~S~i~~-~iil.;lifS~l~~r~~t&~~i~~p~VVanel Business name: E .}'/ M E/ <<-.7/-; t.: 'I la Fee for branch cir~uits with purchaSe of a service or fe~der fee: I Address: PC} ~;e4 I I Each branch circuit I $ 6.00 I $ I City: E'&dPNP I Stated,;<-;,,: 1 ZIP:Q74'/1.ZJ I b. Fee for branch circuits without purchllSe ofa service or feeder fee: Phone:64'f~- CJ'QtJ5"' / Fax:~_ 3'650 I First bran,h circuit (2) I [ $ 55.00 I $91 E"mailgIlMt:le:Jj..lc.~@AI1L.. Co.Nl- I Each additional' branch circuit ;.. $ 6.00' $ (S- eCB license no.: / S?4/'J/1.t::;'"'"1 BCD license no.:C45Y I Miscellaneous fees: service or ftedernot inc/udedC Signing supervisor's license no.: /5"6?5 ;'~q! 1jlEach pump or irrigation circle (2) _ _1..$ 63.00 I . 'r? 'HI"I,-mn'T CH,^,.I l.VOJlk~ IJ- IHt IVUt11\ Print name of signing supervisor: .:2=='h, L / I~at.:;'e ~ .) Eactislgn,or uth'f.lehglit~ng":<~'J_... '!. :J_1"I.....$ 63.00 I ,"U!fHI s'" ",". I It "H;'n\.H I," '-~!YIIT I , IN I Signature,of signing supervisor. ~ A.r-=> .1 '" Igna .C1fe It or-a rl Iteo-ene p,anl:l, $ 6300 $ . I'/~u/L/~ C:;,Vlln!'l!~(~1'~.n"pr~"'~i'WAimOI ED FCR . ANY 1L~e!i,li.,qUjti!i~pection: (I) I 1 $58.001 $ I APPLICANT. USE I (A) Enter subtotal,ofabove fees (Minimum' P~~~it Fee $58.00) I (B) Enter 12% surcharge (.12 x [A]) 1 (0) Tectulology F"" (5% of [A]) I TOTAL fees an" surcharges (A through C): I LOCAL GOVERNMENT .APPROVAL I Zoning approval verified? 0 Yes 0 No I CA TEGORY OF CONSTRUCTION I 0 Residential I 0 Government I 0 Commercial JOB SITE INFORMATION ';ND LOCATION I Job site address: 5~~ IN I' ~ 4-<- I City: I State: I ZIP: I Subdivision: I Lot no.: I DESCRIPTION OF WORK 1 ikuD' t{" c. (I2..UA I '\ ~ I I PROPERTY .OWNER I Name: !Jt::7v / i/""Y/,y l..- S/triPPI tt4 I Address: 33( hL\~PfLT I City:Smt FMtvSI,5c.o I State:Cf'f' I Phone: 1 Fax: I E-mail: This installation,is.being made on residential or fann property owned by me or a member of my immediate family. This property isn.o!,intended for sale, exchange, lease, or rent. OAR 479.540(1) aild,479.560(1). . \Y t5 ~'i;~ . ~ 't7\ ~ 440-2584.) (WOS/COM) $134.00 $ $ 25.00 $ $ 32,00 $ $ 63.00 $ 1 I I I 1 I I I I I I I I I I 1 I $ ~ S- I $ '"Ie-VI $? ...,,/ $ I $ $ I ? \ Total cost I I I I I I I' I I I I I _SIil'~I!\!Gl~Im.;R; j - ~:' (U ~o1 . 0~::rf CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01629 ISSUED: 11/21/2008 APPLIED: 11106/2008 EXPIRES: 08/27/2009 VALUE: $ 10,000.00 Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 533 W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703274305805 Springlield TYPE OF WORK: Store TYPE OF USE: Alteration. PROJECT DESCRIPTION: Tenant Improvement for Meat Market & Deli - James Benedetti Commerci'al Owner: Address: CENTENNIAL SHOPPING CNTR.tLC 331 FILBERT ST SAN FRANCISCO CA 94133 I CONTRACTOR INFORMATION' Contractor Type General Electrical Plumbing Contractor CHRIS LEPPMANN BHM ELECTRIC SUSAN JANE ARNOLD License 58346 . 184005 '49561 Expiration Date . 11/21/2009 09/19/20 I 0 12/16/20 I 0 Phone 541-914-8088, 541-686-0905 541-484-3787 . BUILDING INFORMATION I VB # of Stories: Height of Strncture Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft I st Floor: Sq Ft 2nd.F1oor: Sq Ft Basement: Sq Ft Garage/Carport . Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Constrnction Type Secondary Construction Type: # of Bedrooms: . B No I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: . Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: . % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS ~ . ',ns 'lOll (I) Sidewalk,;r,ype'~ r8qlll' ,U"I'\(V . TE'\T\I ." '-"" ~'- '. ("".(11)(1 " AT I'...)'. rl....dP.r1 h.\1 tr,c '\<';:'~'::'>t t rth io\l.oW r~\IDO~~~~~~uf~{Rr~i.~-,~.:;~, a~~e s~( -gol- . No(i\\ca\\O(1 Cen'08010thlOUgh or,r\ 9v2\eO bV R c02-001' , - ]the rll 0 i~o~~' ~6u \loaV obtain ~~f~e~h~ telephone cal\ing th~ cente~~ (on uiility Notilicatlon number tor the. 01_~OO.332-2344). Center IS Notes: NOnCE: '. ms PERMIT SHALL EXPIRE IF THE WORK A~THORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pa~e I of 3 I Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Descriotion Tvpe of Construction Estimate Estimate Fee Descriution + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Building Permit Fixture Plan Review CommlInd/Public Plan Review Fire & Life Safety Sanitary Sewer - Improvement Sanitary Sewer - Reimbursemeni SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ. Add, Alter, Extend Circ Ea Add Total Amount Paid CITY OF SPRINGFIELD Building/Co~binati6n Permit PERMIT NO: COM2008-01629 ISSUED: 11/21/2008 APPLIED: 11/06/2008 EXPIRES: 08/27/2009' VALUE: $ 10,000.00 1 Va.luation l)escriDtion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid.Amount 10,000.00 Total Value of Project Fp,~< f1LIU Amount Paid Date Paid $20.79 $24.95 $10.39 $122.88 $85.00 $79.87 $49.15 $378.66 $497.97 $10.00 $1,903.01 $184.61 $148.71 $7.80 $3.25 $50.00 $15.00 ll/21/08 ll/21/08 11/21/08 11/21/08 11/21/08 11/21/08 11/21/08 11/21/08 ll/21/08 ll/21/08 11/21/08 ll/21/08 ll/21/08 2/26/09 2/26/09 2/26/09 2/26/09 $3,592.04 Plan Reviews 1 Initial Review ll/06/2008 11/06/2008 APP LLH Plannin!! Review 11/06/2008 11/13/2008 APP EMM Public Works Review 11/06/2008 11/14/2008 APP RP Fire Department Review ll/06/2008 11/20/2008 APP GRG Structural Review ll/06/2008 ll/2112008 APP CJC Paee 2 01'3 Valne- Date Calculated $10,000.00 $10,000.00 11/06/2008 Receipt Number 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1200800000000001164 1io0800000000001164' 1200800000000001164 1200800000000001164 3200900000000000130 3200900000000000130 3200900000000000130 3200900000000000130 , Asked applicant to call with contractors prior to permit issuance. See attached document for Fire Department Plans Review comments. Approved as noted in Planr Review Letter Status issued CITY OF SPRINl.l'mLD Building/Combination Permit PERMIT NO: COM2008-01629 ISSUED: 11/21/2008 APPLIED: 11/06/2008 EXPiRES: 08/2712009 VALUE: $ 10,000.00 225 Fifth Street, Springlield, OR 54]-726-3753 Phone 541-726-3676 Fax 54]-726-37691nspection Line .To Req!lest 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. .' I Reo,lIked Jns.'.ections , Underlloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Grease Trap: Prior to Cover. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Site Inspection: To be made after excavation but p~jor to setting forms. 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 fnrther 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 on'ly contractors and employees who are in co",pliance with ORS 701.005 will be used on this project, I further agree to ensure that all required inspection.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. J Owner or Contractors Signature Date Pa~e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 1629 COM2008-01629 COM2008-0 1629 COM2008-0 1629 Payments: Type of Payment CreditCard cReceintl RECEIPT #: -City of Springfield Official Receipt . Development Services Department Public Works Department 3200900000000000130 r Date: OU26/2009 Description' Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add +. 5% Technology Fee + 12% State Surcharge Paid By JAMES BENt;DA TTI Item Total: Check Number ,Authorization Received By Batch Number Number How Received cjc 062664 In Person Payment Total: Page I of I 8:32:21AM Amount Due 50.00 15.00 3.25 7.80 $76.05 Amount Paid $76.05 $76.05 3/4/2009