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Home My WebLink AboutPermit Electrical 2009-9-23 .....;. .,' ....r. .~. .. :~ '~".: . ,':~ . ';" t>' ,,;;:;;,: :1~~~> " Electrical Authorization To Begin Work E-mailedTo:gmdelectric@comcast.net ,> Check on status of permit or Email: permitcenter@ci.springfield,oLus " r;,\S(;.\;;J/~-(:.,-,.. ,.' ,~'. ^ }',':';:','>ByPbone: 541-726-3753 .. . ;'.\^ ~ ..-,. . . . 10 : I;,' ':;. ~\,,;~, < . ....,,- .', ::' ~;' ~~:~,j~~itiOnf~t~~atiOnl~ePhic~ment NewConstructiilll '" 1~i\Yt ~!,!,L'1\\';?JficAfEGOR'({OF.::c6ijST~i:JC:rION:~~a",!J!l(l'<{'!,~r~1 101 or 2 family d~q~;~g'~;';~: 10'Milti-familY o Commercial o Access01)' I ..' I ~. . '. Job Address: 175 W B ST .. City/State/ZIP: SPRI!'JGF!ELD,:',OR 97477 I Suitelbldg.lapt.no.: :". "~':' Project Naine:.Dr. 'Da~ci_~etsst" .,' Cross Street/directions' to'job' site'tPio'ileer Parkway'- . :1 'i .... t~O\ Dental Office Remodel I Name: David Weiss Phone: Fax: Email: :~ CCD Iic. no.: 162191 Business Name: GMD ELECTRIC INC HI'ttlll." II Contact: TI-IIQ Dt:DrIlHT QW611 J:YDU::U= It: TWJ: 'MnO\( Address:P}?I~~XJtf~17J:n 111\1nt:R TI-H"C: DI=RI\i1IT Ie: t\IIlT I City/State/ZI~:,EUGENE.OR.97401029'~ ^ ~^'lnn'I"'-n "nn , ., '!!II"...".I 1-, I I'..... .... 01-( 1\ 1\ I- I- I-< I Phone: 541,'i~t,lJ]~9Q('t n ^0 DeD Inn Fax: 541-988-]800 I Email: gmde]ectric@cO,mCllSt;ne,t I Metro lk. no.: City Iic. no,: I Supel"Vising Electrician's lic. no,: 4874S I Supel"Vising Electrician's Name: Michael K Gowins Number ofimpectio,DS indude~ in paid sel"ViCes: Residential$ervice: 4 Reconnect Dilly: I All Other Services: 2 d .:. - .:;. Upon review and approval by your local jurisdiction, your permit will be a-mailed or faxed within one'buslness day, with instructions on how to schedule your Inspection,; . NOTE: This Authorlzatl~n To Begin Work expires withln'180 days if a pennit Is not obtained, The local building department may detennlne that an Authorization To Begin Work is null and void If it does not meet applicable land use laws and local ordinances ., ....: Pleasecbeck all tbat apply: o A service or feeder beginning al 400 Amps wbere the available fault current exceeds 10,000 Amps al 150 Volts or less to ground exceeds J4,OOO Amps for all other installations o Fire pumps o EmergencysySlems o Addition ofn new motor load of IOOHPormore o Six or more residentiPJ units in one structure o Heallhcare faci]ities 69600-BE L-09-00 14 7 9/2312009 \2,34 pm Approval Code: 055497 DHa7.ardousJocations DA service or feeder rated at600 amps or more DSuildings more than three stories DMarinnsandooatyards OFloalingbuildings Dcommerrjal-useasriculturnJ buildings DlnslallationofalSOKVAorlarger seperatelyderivedsys D"A". "E",or"J,r or "l-J" DRecreationalVehidePnrks DSUpply voltage for more than 600 5upplyvoltsnominal IDes~riPtion I Branch circuitswithoul service or leeder I Branch circuits each additional cirellit without service Total $55.00 $55.00 $6,00 $6.00 561,00 $7.]2 H05 $71.37 ICIZ.. otl23!DS ATTENTION: Oregon law requires you to foilow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by cailing the center. (Note: the telephone number for the Oregon Utility Notification Center is 1,800,332-2344). ~~ ~l\~ o.:\\) ~ \\. ~ Subtotal I State surcharge (12% of penn it total) I Technology fee (5% <?f permit lolal) I TOTAL PERMIT FEE t9-1L\ \3 . ~~l,. a/t. be [f\ ~~~ \J\ ~; This Authorization To Begin Work must be posted at the job site until replaced by a Permit t .,:; t-~ Status Issued ," CITY OF :srK1j~lj1<lj<,LD Building/Combination Permit PERMIT NO: COM2009-01413 ISSUED: 09/23/2009 APPLIED: 09/23/2009 EXPIRES: 03/23/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 F,ax, " ,i>, ' 541-726-3769 Inspection'Line .~ \ r: Ii , SITE ADDRESS: '.175 ,W BST ASSESSOR'S PARCE,L NO.: . 1703353201601 Springfield TYPE OF WORK: Electrical Work Only \ " . II ,I PROJECT DESCRIPTION: Dental office remodel TYPE OF USE: New Commercial . ;1 ;' ." l CONTRACT~R INFORMATION' Contractor Type " C,!ntractor Electrical GMD ELECTRIC INC License 162191 Expiration Date 11/19/2010 Phone 541- 726'860 I BUILDING INFORMATION' # ofUnits: Primary Occupancy qroup: Secondary Occupanc~ Group: Primary Construction,1 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 I REQUIRED PARKING NOTICE: F~ontyar~:~J~b~f!mIT SHALL EXPiRE IF THE wo'R~rlay Dist: , S~de 1 Slit~~f~0RIZED UNDER THIS' PERMIT IS N~; reet ~rees Rqd: SIde 2 Se\bacK:F~Jr. ;; Pi ed Drive Rqd: Rearyat(j'S~'t'tilack:,ED OR I,S ABANDONED FOR % of Lot Coverage: Solar Sltb\i\:~s~O DAY PERIOD. " Total: ATTENTION: Oregonfl.a~<llC!!p.p~!!:you to follow rules adopted ~qOlnl!a~~:3gon Utility Notification Center. Those rules are set forth In OAR 952'001-0010 through OAR 952,001- noon Vr\ll m!:l.\1 .....ht...i.... '"'........;~_ _.I. '-'_ __..' . I PUBLIC IMPROVEMENTS' calling the center, (Noie: the t~l~ph;;;e-' , . numb~r for the Oregon Utility Notification . Sldg~.~!!5r1j~pr:BOO'332-2344). DownspoutslDrains: . Street Improve~ents:: Storm Sewer Availahle: Special Instruction: :1 Notes: "'I \ ".. : r I Valuation Descriotion I Description " Type of Construction , " $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 00 Status Issued" .. :.l~ : ,." , .;! 225 Fifth Street; Springfield, OR 541-726-3753 Phone', 'i;. 541-726-3676 Fix; :',' .." :'.. 541-726-3769 Inspectio~"Lin'~"" " '":. . ~: .... ii' ," f ., ; .I~ \, Amonnt Paid Fee Description' + 12% State Surcharg'e + 5% Techuology Fee' Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add $7.32 $3.05 $55,00 $6.00 , . ,." . Total AmOlhit Paid $71.37' ,t~, I; ~. " ~: '~ Total Value of Project Fees Pa~~ .1 Date Paid Plan Reviews ~ 9/23/09 9/23/09 9123/09 9123/09 CITY OF ~rK.lj'\iGFIELD Building/Combination Permit PERMIT NO: COM2009-01413 ISSUED: 09/23/2009 APPLIED: 09/23/2009 EXPIRES: 03/23/2010 VALUE: Receipt Number 3200900000000000665 3200900000000000665 3200900000000000665 3200900000000000665 , To Request an ins~,ectio'n 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: ~., , . I~enuired Insneetinns I I. I 1 , Rough Electric:, Prior to Cover Final Electric: Whenjall electrical work is complete. II By signature, I state'anlI agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true a"d 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 co~tractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensufe that all required inspections are requested at the proper time, that each address is readable from the street, that the permit ~ard i~ 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 Cont~acto,rs ~ignature ., Pa2e 2 on Date ", " 225 Fifth Street.~., Springfield, Oregon 97477 ~ "", ' : 54'1-726-3759 Ph,one' Job/Journal Number COM2.o.o9-.o1413 COM2.o.o9-.o1413 . COM2.o.o9-.o1413 COM2.o.o9-.o1413 Payments: Type of Payment ONLINE CHGS cReceintJ RECEIPT #: i~7~;jI tttit;. J , '"._-, ....-- -- - ,',' .. .. -~.,.. .,'.' ,3200900000000000665 Des'cripti~'n .., r ...- Add, Alter,E~tend Circ , 1",_ ,'r ',," iA?d, Alter, EXtend Circ Ea Add "+'5% Technology Fee . ,'V2% ~tate Su~charge :1'. \-";" /' /. I Paid By ONLINE PERMIT CHGS .)~ , . " -..J ,1 ,. / City of Springfield Official Receipt Development Services Department Public Works Department Date: 09/23/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received KR Page I of 1 ONLINE GMD Online ELECTRlC Payment Total: 2:24:45PM Amount Due 55..0.0 6..0.0 3..05 7.32 $71.37 Amount Paid $71.37 $71.37 9/23/2.0.09