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HomeMy WebLinkAboutPermit Electrical 2009-7-10 ill FIllI> Stree..SprllllDeld, OR"477.'H\SCI)n6-37S3.FAX(54t)'n6-36II'J --...... I DEPARTMENT USE ONLY I permitno.:~C\ - \nl~ I Date: '\ AD - C9\ .. Th.. permit "Iuued under OAR 918-309-0000. Perml" are nontransferable. Perml.. expire If work .. not started wltbln 180 days of issuance or If work Is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoning .<<. .,J verified1 0 Yes 0 No CATEGORY OF CONSTRUCOON o Residential lOG. ._.._.._.1 j gc_.._.....:al JOB SITE INFORMATION AND LOCATION Job site addrcss: 3;:<"T1 ?;\\/Pf"he.v-,d l'l-r. ,S-tI.RDb'-- City: ~'\Y\"+ie. \d I State: ~ I ZIP:. Cn--tll Subdivision: '---' I Lot no.: DESCRIPTION OF WORK ~fi:1""'-" f"D..h\(v-g, "\'" F'\DQY" PRO~",,,,,' OWNER Name: Address: City:. Phone: E-mail: This installation is being made on residential or fann Y' .y...y owned by me or a .._.___~._ of my immediate family. This ,....'r'" .~' is not intended for sale, exchange. lease, or rent. OAR 479.540(1) and 479.560(1). Signature: I CONTRACTOR INSTALLATION I Business n8JT1C: LD.Y\ Te-l <:..u--vices, \nc.... I I Address: \ ~N") \r v iVlA Rd.. fl..,14e-.. r I City: F uq ~Yle.. -J [ State: tJR 1 ZIP: li'l4 {)~ Phone: ~YI- (~--IL/clfl I Fax:S'-t1 -ltEE-L/.!d;1 E-mail: dcbve.r@ 1a.n~_L'~lfi(e.s. e.c.rv, CCB license no.: 2C -3S3t.LE..l BCD license no.: Signing supervisor's liccnseno.: W:,)"il'll.-Ep., "'._"'..~__~~" "du" / Signatw-eofsigningsUpcM') - ....., C/~ ATTENTION: Oregon law reqc,;, es you to . follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 1\ 0090. You may obtain copies of the rules b~ ' calling the center. Note:the telephone -A number for the' 9rp.~ :::1., Utility NotlflcatlOJ U ^' C:~~)0-332-2344). 0<..f:J~Q./ 44O-~:-t1l8l~T' ~ "p ~ .s ~ I><.,;\; I State: I Fax: I ZIP: 1 I FEE SCHEDULE I 1 I Namborofl.,. -".. perltem() IQty.1 Cost Total I I ... cost I I RnId.ntial, per UDt~ ..rvtcolndndod: I 11,000 sq. fl. or less (4) 51".00 5 I Each additional 500 sq. fl. or portion 5 25.00 5 I thcn:of Limited energy (2) 5 32.00 53':'.""1 Each manufacnned borne or modular 5 83.00 5 I dwelling serviee or i:odcr (2) C __':~-.J or feedtl'l: i1Ul4JllDtion, alieNI/ion. r-e/ocation I 200 amps or less (2) 5 Bl.00 5 20110 400 ~ (2) 5 85.00 5 40110 600 ~ (2) 5.158.00 5 601 10 1,000 amps (2) S205.00 5. Over 1,000 amps or volts (2) $48B.00 5 Reconnect only (2) 5 83.00 5 Temporary services or feeden: inslllllariti", alteration; relocation 200 amps or less (2) 5 83.00 5. 201 10 400 ~ (2) 5 87.00 5 40110 600 ~ (2) 5126.00 5 Over 600 amps or 1,000 volts, see services or feeders section abo-.e BraDch drcalll: n~ alteration. extension per paMI 8. Fee for branch cireuits with purchase of 8 service or feeder fee: Each b,""ch cin:uit 1 $ 6.00 \ 5 b. Fee for branch circuits without purchase of 8 service or feeder fee: First branch cin:uit (2) Each additional brancb circuit I I 5 55.00 I 5 5 6.00 5 MilcellantoUl fea: service 0'" feeder not included Each pump or irrig~tion circle (2) Each Bign or outline lighting (2) Signal circuit or 8 limited-energy panel. allenltion, or extonsion (2) Each addldooaJ . . ',. ..:," (1) -... " APPLICANT USE (A) Enter subtotal of above fccs (MInimum P.rmlt F.. 558.00) 5 ~.m I (B) Enter ~&ji~ (.I2x [A]) 5 f n .qL. I (C) Technq1~1iY2F~,:(~~,!!fjf.o\Jl..J ^ hi. r-vi'.' ~ - . L>l-'1 D I TOTALi...-"Ii~.brcb(:':t1i 'ii"h'~' " rw t~~1 - l., ,..,. ~\_f~l!~llgft \r- ,.....,rto...'1~.... ' COMMENCED .."I:. ~"''''']v" I ANY 180 DAY ~E~:~;BANDONED FOR 5 83.00 5 5 83.00 5 5 83_00 5 558.00 5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01014 ISSUED: 07/10/2009 APPLIED: 07/10/2009 EXPIRES: 01/1012010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. SITE ADDRESS: 3377 RIVERBEND DR ASSESSOR'S PARCEL NO.: 1703220004102 SPRINGFIETYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Speaker Cahle - Earth Quake Brace - 5th Floor Commercial Owner: PEACE HEALTH Address: PO BOX 1479 EUGENE OR 97440 I CONTRACTOR INFORMATION ..1 Contractor Type Low Voltage Electrical Contractor LAN TEL SERVICES License 90461 Expiration Date 04/19/20 I 0 Phone 541-688-1427 . BUILDING INFORMATION I # 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 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION' Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: , Downspouts/Drains: Notes: I V aluation Descri~tion I Description Tvpe of Construction $ Per Sq Ft or multiplier . Square Footage or Bid Amount Value Date Calculated Paee I of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01014 ISSUED: 07/10/2009 APPLIED: 07/10/2009 EXPIRES: 01/10/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Low Voltage - Commercial Indus Amount Paid Date Paid Receipt Number $6.96 $2.90 $58.00 7/10109 7/10/09 7/10/09 2200900000000000782 2200900UU0000000782 2200900000000000782 , Total Amount Paid $67.86 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. I Rc>(IL' 'c>d hsnect'oos - ,il.......lllllllflllllr... Low Voltage: Prior to cover. By signature, I state and agree, that I bave carefnllyexamined the completed application and do hereby certify that all information bereon is true and correct, and I further certify that any and all work performed shall be done in accordance witb 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 he 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 street, tbat 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. Owner or Contractors ~ignature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009cOl014 COM2009cO I 0 14 COM2009-01014 Payments: Type of Payment Check cReceintl RECEIPT #: 2200900000000000782 Date: 07/10/2009 Description Low Voltage - Commercial Indus + 5% Technology Fee + 12% State Surcharge Paid By LAN TEL SERVICES Item Total: Check Number Authorization Received By Batch Number Number How Received 27854 In Person Payment Total: Ilh Page I of I II :26:33AM Amount Due 58.00 2.90 6.96 $67.H6 Amount Paid $67.86 $67.86 7/10/2009