HomeMy WebLinkAboutPermit Electrical 2009-5-6
225 Fifth Street. Springfield, OR 97477. PH(541 )726-3753. FAX(541 )726-3689
1~~;~ipE~A:~]MEft';qS~'2.~,[y,;i:"1
I Pennit no(!? -- dO; / r1
I Date .h -& - CJ9 I
Electrical Permit Application
8 D
This permit is issued under OAR 918-309-0000. Permits are nontransfera.ble. Permits expire if work is not started within 180
days of issuance or if work is suspended for 1~0 days.
l;;i~;4f;;mi)l~1!OCA(i1.GOVERNMENTkAF,'PROV At:;,;i;.:~;~;';;:';;'1 1;:';"~~lIi1lit,lZ~;"':,!F,EE~SCHEDUl!E'l:~f;F~"Ci~'i;;~;i(C''i?'1
I Zoning approval verified? DYes D No I ~~~'t2~t?;~t,-';p.f:""~-:O:!lW"'t~:J:Z;:S;c,.~;;:~;' '.~~_.<jfr:i-;'.;'~'~It'__ ''';'I'<~>,€ost~.'~I:~;'TotaE'/1
' :,.~:~,~~t;~;:,o(,~:~~p.~~,tl"?,,"*sLP!r;lt~mJ~~_)~_5i~ :~1Y,; ~~Wea_:'i_~:~ ~~;~co~~_;;~:~
I 0 Reside::i~~TEGIR~~:~:::~TRUr;;o~~:~~~~~' I : Residential, per uni4 service iueluded: ' I
G;~:~~~~;:~TE~~~~R~~~~A=CATION~'''~~'~;II ~~;~?:i:O:::~s~~:: ft or portion :1::::: I
I City: Sl><v<'\o.Q.~~ I State: 0(2, , 1~'71.{771 I Limited energy (2) $ 32,00 $ I
i~~~b1~~~~~~'~~IDESCRIP'TlbN 20F,%'W~~~~~ ;1 I ~~~~[~~n,~~i~~r~~ 7e::r i;)"odular $ 63,00 $ I
I '" r'\ f r ~,_ <' l I Services or feeders: installatIOn. a/feral/on, relocatIOn I
""to., \\VU< '" ~ P(\"'....,,c..,( vn"",,-.<>o(\Vll
f t '0'1. ' \ ;', 0...,) I 200 amps or less (2) $ 81.00 $ I
<"'<:,kA!,^ ~ ;.~ \'1\ ~","ffi l(\l\S~'" \j~ 1,
'"',,,~,;;~;'''''"J';;'';'!'''RO'''ER~'OWNER';'''';,' ~ . ~~'P: [201 to 400 amps (2) $ 95.00 $ I
7_...<...""m"''''~t~~ 17, '1:,10 "..>J: "'.J"~,M"
I Name: I I 401 to 600 amps (2) $158,00 $ I
I Address: I I 601 to 1,000 amps (2)' $205.00 $ I
I City: State: I ZIP: I Over 1,000 amps or volts (2) $469,00 S I
I Phone: I Fax: I Reconnect only (2) $ 63,00 S I
I E.:.mail: I Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 6300 $
This installation is being made on residential or farm property .
owned by me or a member of my immediate family, This I 201 to 400 amps (2) S 87,00 $
property)s not intended for sale, exchange, lease, or rent. OAR
479,540(1) and 479,560U), 401 to 600 a;"ps (2) $126.00 $
Signature: Over 600 amps or 1,000 volts, see services'or feeders section above
. [~,r,g"~;~;,)~;e~.>ii:JCONTRAC;r()R-;;:fNSTAClZAT'ON~r:;!7f~~>;:ij{<:,;";,:r~"!:JI I Branch circuits: ne\1; alteration, extension per panel
I Business name: ~tt.\.lrJrt'(,_~ .W'(. I I a.:Fee for branch circuits with purchase ofa service or feeder fee:
I Address: l'llia ~\II ~~l- s--:,k (~) I I Each branch circuit I I S 6,00 I $
City: SP"""-"~lIli~ r State: bQ. I ZIP: c; 7lfT7 I [b, Fee tor branch circuits without purchase ofaservice or feeder fee:
Phone:SYI-zl'fr?lYI I Fax: I I First branch circuit (2) $ 55,00 $
I E"mail: D~ kG) s,tCWt't.f a~. N.d- I I Each addi\ional branch circuit $ 6,00$
CCB license no.: \11\'\ 5 I BCD license no.: '?,- 3.~ I Miscel)aneous fees: service or/eeder 110t included
Signing supervisor's license no;: I Each pump or irrigation eircle (2) $ 63.00
Print name of signing supervisor: I I.Each.sign or outline lighting (2). $ 63.00
Signature of signing supervisor: I I Signal.cir,ell(t, or a limited-energy panel, $ 63.00 $t '2
.... alteratJOn. or extension (2)' \PV'P\::l
I Each additional inspection: (1) $58.00 $
1~~~_~tilARRElcAN;r;lDsE'~::I'~"'K1\(:;;;:t'~~;:~~)
(A) Enter subtotal of above fees , I
(Minimum Permit Fee $58.00) . -S ~'S. 00
I (B) Enter 12%surcharge(.12x [A]j $ 7, 51.
I (C) Techriology Fee (5% of [A]) $ :'S.\ <,
I TOTAL fees and surcharges (A through C): $ 73, 7t
S
$
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440,2584,.1 (9/08/COM)
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00614
ISSUED: 05/06/2009
APPLIED: 05/0612009
EXPIRES: 1110612009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3110 PIERCE PKWY
ASSESSOR'S PARCEL NO.: 1702300001000
SPRINGFIETYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Low Vollage Permit
Owner:
Address:
STATE OF OREGON MILITARY DEPARTMENT
PO BOX 14350
SALEM OR 97309
, CONTRACTOR INFORMATION I
Contractor Type
Low Vollage Electrical
Contractor
SECURE COM INC
License
117195
BUILDING INFORMATION'
Expiration Date
09/29/2010
Phone
541-988-3585
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms: '
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Fl Garage/Carport
Sq Ft Other:
Occnpant Load:
n/a
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Fronlyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay DiSl:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Descrintion I
Description
Type of Construction
$ Per Sq Fl
or mulliplier
Square Footage
or Bid.Amount
Value
Date Calculated
Paee I 01'2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
Total Amount Paid
Amount Paid
, $7,56
$3,15
$63.00
$73.71
Total Value of Project
~ee~ Paid.
Date Paid
Plan Reviews 1
5/6/09
5/6/09
5/6/09
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00614
ISSUED: 05/0612009
APPLIED: 05/06/2009
EXPIRES: 11/06/2009
VALUE:
Receipt,Number
3200900000000000312
3200900000000000312
3200900000000000312
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.
Low V ollage: Prior to cover.
Renuired Insnectinns I
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 withont permission of the Community Services Division, Building Safely.
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 locate~d at the fro t of the property, and the approved set of plans will remain on the site at all
times duri con:uc:on. / I . .
JL.{~AMI:! j r--t-t1<j
ntractors S~t(Jl/
Paee 2 01'2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-00614
COM2009-006 '4
COM2009-00614
COM2009-00416
COM2009~00416
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
3200900000000000312
Date: 05/0612009
Description
, Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 12% State Surcharge
FLS Safety Systems Review
***+ 10% Administrative Fee***
Paid By
SECURECOM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
44273
In Person
Payment Total:
Pa,ge 1 of 1
10:35:26AM
Amount Doe
63,00
3,15
7,56
145,53
14,55
.)~.)j.f':l
Amount Paid
$233,79
$233.79
5/6/2009