HomeMy WebLinkAboutPermit Electrical 2009-5-7
225 Fifth Streett Springfield, OR 97477+PH(541)726-3753tFAX(541)726-3689
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PermIt no.:
I ~ate: S-/7~ '} I
E.lecttical Permit Application
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This permit is issued uuder OAR 918-309-0000. Permits are noutrausferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
~~1!:"0~JgI!IQ0S~I;~t'JIV1I;NiTJf~~e8(;j",Ij.~J.t.~_'...,.'.~.1I;l. F.EE"'S-CHEDlfJL!!E~"""'--~R:f~~'m1.
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Zoning approval verified? DYes D No ero ,," ec Ions. . "~'~lmq2Stlllt1;!ililII:';
1~'Bll!MCt\mEO(;jB.\t':.jf.(;jF,;il\l::G)NSjl1R.l!J0i1!lG)t'J~~~~~ . ; w","~"!%_"lla"'J'!;iiiii..,,, ~ .~;\!!~aJf;;lB l!I',J,;g~tl
I Residential, per unit, service included: I
~~~~~lmEj!It'J~~RG~i;~;ANDi~~~~~~~~~~ 11,000 sq ft. or less (4) . $134.00 $ 1
1 Job site address: 10 ( S II-- S T I I ~~~~;ritional 500 S~/ft. or portion $ 25.00 $ I
I City: c::.t>itw,,_f;L-1c:!l State: oL-l ZIP: 77f{77 I 1 Limited energy (2) $ 32.00 $ I
1~;:~~~~~:~I~~[QFAwJ~~~~~:~j I ~~~~I~:nS~~~~~~r~~ ~e~~:r (~jodular $ 63.00 $ I
1 ,I C r ..'- " A- ~I r~.J. 1 I Services or feeders: {nstallatlOn, alteratIOn, relocatIOn 1
'7 I c:........ ~ -I-iI' T~""'~
I fOlio -" I fUN: 6 I 200 amps or less (2) ,$ 81.00 $ 1
^, ltlt'r"f,.._ 'earth' I
!~m:~{iRR'o~ERm~i?"QWNE_R~i1i~;;~W,1;~~ v r l,~9.Lt.? 400.amps (2) $ 95.00 $
1 Name. '" I + OQS'...'X1.-q~-"-O-''-'ULT''osJ ,leIC40Juto060b'ldnips(2) $158.00 $
. (_I*t_ u ~vQ ~1=7J,t,::I'~Je~L. ,In,...
I. --- ~ c. ~,/,l,_ .--" TT' L - . v-'n I '6(f1' I ild6'f70' (2) $ $
Address: c-. ~ > n'r;:FfJiE:!o fhn'S: "blain n~OU.'h ";': ~to<Jy,n.~Ps 205.00
I City: S r F'l) 1 Stat~~4'~UcL ZII{f[(;J,:~-27':' s ( lc;}yl~l~OOO@)1'ps or volts (2) $469.00 $
- J ., ,;'l n7 !\T"C'(:. h . '-iH~ h",,,_
I Phone:51f1 7Zb-~7SJ 1 Fax: ,:enteris-i_~';,~nyti/{v~~~~;PI)r~~0r\Jy(2) , $ 63.00 $
I E-mail: - V1.J.i:;:\!!3~ ATemp.QfJt'i:f services or feeders: installation, alteration, relocation
Th... 11. . b . d 'd. 1 ,11M amps or less (2) $ 6300 $ I
IS msta atlOTI IS emg ma e on rest entIa or larm property .
owned by me or a member of my immediate family. This 20 I to 400 amps (2) $ 87 00 $ 1
property is not intended for sale, exchange, lease, or rent. OAR 1 . I
479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $
Signature: lOver 600 amps or 1,000 volts, see services or feeders section above I
,f!l!~'iiI~!>:0NmM0jJ1(;jR.1INsifr"A~l!t\mI0Ng~ii&1~~Jt: 1 Branch circuits: new, alteralian, extensianper panel I
I Business name: (l ,.,A/ ":;1"';'/ c:<:-2('7721 ~ L.L c: I 1 a. Fee for branch circuits with purchase of a service or feeder ree: 1
1 Address: d/~~ r:-:<:r' ALA4~Narf(;r:. .. I. I. Each branch circuit 1 $ 6.00 I $ I
I City: & JnrN''::; I' .State: 0 .e!hl/&JIi>E1nrJ;t~ff,. I b.' H;;"f6i'lJiaric!i:circuits without purchase of a service or feeder fee: 1
I Phone;9,rI-35'?- I/e:) z-- 1 Fax:S'f(:;:j!J:HB~f7[} II^~'~'~ ~ ~~I~RE'b!rnl1!MfrWm!~ 1'1 $ 55.00 I $ :> ~1
1 vUIYJJJ!l.tNC - n FHb t;'f.."P'lJT' ''', -,
E-mail.:r.f)NRl...Hd~Q~#1..PI<:tT./lVIJnv_ ED OR /,<, A ?A,~f;"~!,di 1O~!6b~p'circuit ...> $ 6.00 $ / g
I CCB hcense no.: II/~c) I BCD hcense no.::!;1b'f\YI'l"atc D MlSce\latle/'j,/;ml service ar feeder nat included
1 Signing supervisor's license no.: ,/P;79.s 1 Each pump or irrigation circle (2) . I $ 63.00 $
1 Print name of signing supervisor: /?;4/-/,-vt :) /l,L,4;ff;Je I Each sign or outline lighting (2) I $ 63.00 $
I Signature of signing supervisor: __~ / r1:.1 /? I Signal, circuit or a Ij~ited-energy panel;' $ 63.00 $ I
Af'A---<-A ",. t& u; f Lh' alteratiOn, or extensiOn (2)
._, _ ,V 11~.a.,:,;:=~::.~~~0.n:(1.'~.)."M...~..:..__."",~,5.~:~~.~ I_$~ ",pJiil.,1
~'-I rU. ~~",.w;;\l[""'et_~~P'P'(g1.0~NJ!0il!J.S!:&!.i~~iJ
~.\\;~ '-- I (A) Enter subtotal of above rees $
V ~V" (Minimum Permit Fee $58.00) 7 .:s
~ I (B) Enter 12%surcharge(.12x [A]) $ 87;:-
~ I (C)TechnologyFee(5%of[A]) $ ,S'b-'r
1 TOTAL fees and snrcharges (A through C): $ [<..;;111 I
.,;#
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440-2584-J (9/08/COM)
Status
Issued
CITY OF ~rKll~GFIELD
Building/Combination Permit
PERMIT NO: COM2009-00577
ISSUED: 05/06/2009
APPLIED: 04/29/2009
EXPIRES: 11/07/2009
VALUE: $ 27,189.00
225 Fifth Street, Springfield, OR
541-726-3753 Phonc
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 101 SA ST
ASSESSOR'S PARCEL NO.: 1703353206800
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Public
PROJECT DESCRIPTION: Install 2 ductless heat pumps
Owncr:
Addrcss:
CITY OF SPRINGFIELD to
255 5TH ST e uires 'IOU.
SPRINGFIELD OR 97477 ION. oregon laWt;e ~)(egon Ut,\\\tr1"
...,...,-t:,,\T . 1.~r\ h\J II.... ,,0\ 0
\~\\bW lules ,,"u,:,~__ ,hOSe rUl":: ::.q 0<;?--001-
Notilicationl ~0.0NTRAGi[oR 1Nt=9.RI)1\t'fION, ,I
in O!>-R 95'2.-vo . obtain CO\,,~o\1-e telep\101\~
Contract,oJ:jO. '{ou ma'lentel. lNote. ';ity Noti'il<icI!Bse
CONRICH EUE~r~~~()regon Ui~_'2.344). 149509
MARSHAI.J.llS1INCr'~~\er is ~_800-3 . 25790
I BUILDING INFORMATION'
Expiration Date
11/02/201 I
12/23/2009
Phone
541-607-3447
541-747-7445
Contractor Type
Electrical
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
B
# of Stories:
"eight of Strncture
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VB
nla
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Scthack:
Solar Setbacks:
I DE\::.El.~rMENT INFO~~1'~fjt~\tt 'N\)~1
1'tU r" ;I:RNlIi SHf',Ll- '-' ~\S pI:Rt-J\I'I" \S ~
1\-11S ~'. ~'i!Wt\lWPI:R 1 ~Jmo~I:O fOR
,,\lIt i:' W~~l@iS l{'q&:B
coM'>1l ~'jil\!Wlil:O.
Mil' o;\,lM 0 Coverage:
. REQUIRED PARKING
Total:
Handicapped:
Compact:
[ PUBLIC IMPROVEMENTS I
Street Improvemcnts:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Page 1 01"3
_l::;P.RIf!lo'P'IEL!),
r
Status
ISsued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00577
ISSUED: 05/06/2009
APPLIED: 04/29/2009
EXPIRES: 11/0712009
. VJ\LUE: $ 27,189.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I. Valuation Descrintion I
Description Tvpe of Construction
Bid Amount - Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
27,189.00
Value
Date Calculated
Total Value of Project
$27,189.00
$27,189.00
04/29/2009
L.F""< PqirIJ
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Mechanical-Value
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Amount Paid Date Paid ReceiptNumber
$36.51 5/6/09 1200900000000000356
$15.21 5/6/09 1200900000000000356
$304.21 5/6/09 1200900000000000356
$8.76 5/7/09 1200900000000000360
$3.65 5/7/09 1200900000000000360
$55.00 5/7/09 1200900000000000360
$18.00 5/7/09 1200900000000000360
Total Amount Paid
$441.34
I Plan Reviews I
SUB Review
04/29/2009
05/06/2009
OK
JF
2009-00577 - Chamber Depot.
5/5/09. Pass energy code review-
HV AC only. No inspections.
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. .
l....IVlllI~rPrlJnsne{'tions I
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Page 2 of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00577
ISSUED: 05/0612009
APPLIED: 0412912009
EXPIRES: 11/0712009
VALUE: $ 27,189.00
By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 reqnired 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 constrllction.
Owner or Contractors Signature
Paee 3 of 3
Date
225 Fifth Street
. '
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00577
COM2009-00577
COM2009-00577
COM2009-00577
Payments:
Type of Payment
lNT CHGS
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000360
Date: 05/07/2009
Description
Add, Alter, Extend Clrc
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State Surcltarge
Paid By
6l8-62224-810048-P II 00 I
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
DEPOT
In Person
Payment Total:
".,.
,,,,,,;,
)
Pa,ge 1 of I
11 :27:06AM
Amount Due
55.00
18,00
3.65
8.76
$85.41
Amount PlIid
$85.41
$85.41
5/7/2009