The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2009-4-7 " CElectrical Permit Application I ", DEPARTMENT USE ONLY aPR'NanmD iiI ~ . '. I C.OWl zc>o8 - 0 1'('10 . 1(,_ Pemut no:: . I Date: '{-7- z..oo 7 CITY OF SPRINGFIELD, OREGON 225 Fifth Stn:ettSpringfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 , This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits ~xpire if work is not started within 180 days of issuance or if work is suspended for 180 days. 1 Total I cost 1 1 I 1 I 1 1 1 I 1 1 1 I I I 1 Signature: Over 600 amps or 1,000 volts, see serVices or fceders section above l I . , CONTRACTOR INSTALLATION Branch eircuits: new. alteration. extension per panel I I Business name:'3\-\ '(y\ <e: \..e.-,~..A-.('\'t.... Co. a. Fee for branch circuits with purcha'ic ofa service or feeder fee: I I Address: \).0. b()), a~.1 Y 1 Each branch circuit I $ 6.00 I $ I I City: e'.u.CI~ 1 State: C) P- I ZIP: q rjl.j D~ b. Fee for branch circuits without purchase ofaservice or feeder fee: 1 I Phone:ttH (9.€(o.-Oqo5' I Fax:5t-/~ l.R8lo~: I Firstbranchcircuitj2). '" v.j' I $ 55.00/ $ S'~1 I E-maH: RI-\.1JlfJe..d-r I ~ Co ~ (V)\ ,~~ER ITj SltAlbk~I<)!f.l\Ij,~{~f1~\~~~ S $ 6.00 $ 3D I I CCB license no.: 164 Doc:. 1 BCD license no.: L,' ~ . DI bIl~\ilnJJ.ll'fef., t"~~fi:eder no/included 1 I Signing supervisor's license no.: \ 5 {Q en s (;~.I~I v~~~~E~ !!.tb.~ or lITIgatIOn circle (2) $ 63.00 $ 1 I Print name of signing supervisor: Ph ~ \ S . \<..~t.' 1 uV ~A, ~~!;'s~n or outline lighting (2) $ 63.00 $ I I Signature of' . '. // ~ /1 ~ I I Signal circuit or a limited~energy panel, $ 63.00 $ I slgnmg__supervlsor. ~..p~~a alteration, or extension (2) ~ . I Each additional inspection: (1) $58.00 $ I 1 '. APPLICANT USE I I (A) Enter subtotal of above fees (Minimum Permit Fce $58.00) $ B.S- 1 (8) Enter ]2% surcharge (.]2 x fA]) $ 10-eo 1 (C) Technology Fcc (5% of [A]) $ l(ZS I TOTAL fees and surcharges (A through C): $ 99 1/61 I . LOCAL GOVERNMENT APPROVAL 1 1 FEE SCHEDULE I Zoning approval verified? DYes D No I I Number of.inspcctionsper item () IQty.1 Cost 1 CATEGORY OF CONSTRUCTION 1 ea. t Residential, per unit, service included: 1 0 Residential I 0 Government I~mercial I 1 JOB SITE INFORMATION AND LOCAJION .1 II 1,000 sq. ft. or less (4) Job site address: 115 C5 51". MN 1-1" P. 1 ~~~;ritional 500 sq. ft. or portinn City: 05 VR 1 N bf\-E: 1....:\1 I State: (') R I ZIP: t111.f 77 1 1 Limited energy (2) I Subdivision: / 70 J'5 52 Z 1 Lot no.: OS '021 I Each manufactured home or modular $ $ 1 ,DESCRIPTION 'OF WORK' . dwelling servicc or fceder (2) 63.00 _.,11.1.1/ frL;TEiL h (~~regon.' a~ Ileflll~,%~f?~rl~si installation, al/eration, relocation I follOW rules_ ~~~_lt'~h~ !sr~~~~.);.'to~l1\sM~ $ 81.00 $ I " PROPERTY,oWlIlERllI~a~~;.: j;;-;"~;;1'nfLrrltIH~~~- $ 95.00 $ 1 Name: "11-/ () /() A5 ;;..~r;:.~ m:v ~btain :O,)~ ~ ~~1Pt $158.00 $ I Address: L I II? 1... LO c-~g the ~ent;;~. \: ~~ ~~~~~J:AM;!"ilrn:lR) $205.00 I $ I City:g). '," f,;/r State:. umpZ\P~ft7tm 0- ,!i?2:l'E:\,l,lQ~.amps or volts (2) I $469.00 I $ Phon~:q'll- bf)b-lf3/ b Fax/; 'I VittI; :..tJ~ Reconnect only (2) 1 $ 63.00 1 $ E-mail: '" Temporary services or feeders: installation. alteration, relocation 200 amps or less (2) $134.00 $ $ 25.00 $ $ 32.00 $ This installation is being made on residential or farm property owned hy me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). $ 63.00 $ 87.00 $ $ $ 20 I to 400 amps (2) 40 I to 600 amps (2) $126.00 ~Q(' ~ ~ 'v-V ~/ tx:~ ~ ~-S 440-2584.J (9/08/COM) , .' rl7/^c, n \..11/~ ~;is~ CITY OF SPRINGFIELD Building/Combination Permit 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54]-726-3769 Inspection Line PERMIT NO: cOM2008-01440 ISSUED: 12/10/2008 APPLIED: 09/19/2008 EXPIRES: 10/06/2009 VALUE: $ 5,000.00 Status Issued SITE ADDRESS: 175 G ST APT A ASSESSOR'S PARCEL NO.: 1703352205902 Springfield TYPE OF WORK: Care Facility TYPE OF USE: Alteration PROJECT DESCRIPTION: Convert lower level apartments to child care Owner: NOVACK THOMAS E & TINA A Address: PO BOX 1'481 SPR]NGFIELD OR 97477 Contractor Type Architect Electrical I CONTRACTOR ]NFORMA TlON I Contractor License NAGAO PACIFIC ARCHITECTURAL P.C. , BHM ELECTRIC ]84005 I BUII,D1NGINFORMi\ffiI€lN-'~ \1 I I 1'1" ATTEN1.v... - -.. db the oreg<.1'.1 vur ,/ follow rules p.#':lSr~rOrie~:e rules are .set.IQrlll . c~rH'o[., "w 52 OQ~ Elo3lilicallon ~eiglit(j>t\Structure\R 9. -." . in OAR 952-0 t'y~i,~f H~;t;ies of the rulr>s QY Y U~"' "\.Il~'\' --, \ h~n~ ~fl90.. 0 "'''~la,~'i!rTyp.~:.e: the te ell"";" ca\ling the R~'nge.:rype:\Jli\ity NQI\hcatlQf\ number for E~"'ergy:R'ath:i'32.a344), Cenl"'l \'" . J Sprinkled Bnilding: n/a # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type. Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: . % of Lot Coverage: I PUBLIC IMPROVEMENTSI Residential - Phone Nnmber: 541-606-4316 Expiration Date Phone 54] -687 -9600 09/19/20 I 0 541-686-0905 Lot Size: Sq Ft ]st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 930 REQUIRED PARK]NG Total: Handicapped: Compact: Sidewalk Type: . NOTICE: Downs~outs/Drains: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Street Improvements: Storm Sewer Available: Special Instruction: Notes: Page] of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , Description Tvpe of Construction Bid Amount Use Bid Amount Fee Description Plan Review Comm/lnd/Public + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee. Building Permit Plan Review Fire & Life Safety + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Initial Review 09/22/2008 Planning Review 09/22/2008 Structural Review 09/22/2008 Public Works Review 09/22/2008 Fire Department Review 09/22/2008 Public Works Review. 12/10/2008 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2008-0I440 ISSUED: 12/10/2008 APPLIED: 09/19/2008 EXPIRES: ] 0/06/2009 VALUE: $ 5,000.00 . I v al.uati~~ Desc~intion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 5,000.00 Total Value of Project F~PI~' ~ Amount Paid Date Paid $39.56 $7.86 $9.43 $3.93 $78.58 $24.34 $10.20 $4.25 $55.00 $30.00 9/19/08 12/10/08 12/1 0/08. 12/10/08 12/10/08 12/10/08 4/7/09 4/7/09 4/7/09 4/7/09 $263.15 I Plan Reviews ~ 09/22/2008 APP LLH 09/23/2008 APP EMM 10/06/2008 APP CJC . 11/01/2008 APP CTM 11/05/2008 APP GRG 12/10/2008 10 LKW Pa2e 2 of 3 Value Date Cakulated $5,000.00 $5,000.00 11/26/2008 Receipt Number 2200800000000001422 1200800000000001215 1200800000000001215 1200800000000001215 1200800000000001215 1200800000000001215 1200900000000000248 1200900000000000248 1200900000000000248 1200900000000000248 Needs Finlll Site Inpsection prior to occupancy and use as daycare center. Please call Mark at 726-377, for Final Site Inspection. Please giv, 48 hours notice. See enclosed e-mail form Mark. Need clarification of multiple issues See attached document for Fire Department Plans Review comments. SDC's on deferred payment plan with Finance/Mary Smith _e:f!!I!lINq~I"""O.. , > CITY OF SPRINGFIELD Building/Combination Permit Status Iss u ed PERMIT NO: cOM2008-01440 ISSUED: 12/10/2008 APPLIED: 09/19/2008 EXPIRES: 10/0612009 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Reouirerllnsneetion~ I Firewall: Located and constructed according to plans. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Site Inspection: To be made after excavation but prior to setting forms. Final Building: After all Conditions have been completed as required on Development Agreement. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 I street, that th.' ',:71 ~,", ,""",,, ", '''0'"'''' ,,,,,,,,,,, ", .""", ,,' "",... om rem.',""", """." ;;;;1/ ;~uL- ;/~ ;J-{)f . Owner or cont;.actts Signature Date ( Page3 of 3 225 Fifth Street Springfield, Orcgon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Serviccs Dcpartmcnt Public Works Department Job/Journal Number COM2008-01440 COM2008-0] 440 COM2008-0 1440 COM2008-0 1440 Payments: Type of Payment Check cReceintl RECEIPT #: 1200900000000000248 Datc: 04/07/2009 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 12% State Surcharge Paid By THOMAS NOVAK Item Total: Check Number Authorization Received By Batch Number Number How Received 7933 In Person Payment.Total: djb Page I of I 2:50:22PM Amount Due 55.00 3000 4.25 10.20 $99.45 Amount Paid $99.45 $99.45 4/7/2009