The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-11-8 ~ ~<:o<iJ 0.... ,~ ~0 o A';; ~ ~V 9J.~ ,"li SPRIN~'ffi.~.. . . ~0 riP !!' ,,~ , "~~'('j:..~e_ "'~ 0~ .. c,' 0&; '" Date /l,A:J;;~ -.. ,. . ~ ~ / ,/ _Cm1PLETE FEESCH.E1l~}>P B~<3W', ,,;,\0 ~ '. j. ~ Z 'Q~ .~~ ..,W . . , . i "'~'.' .. , . -'..l .. ... . A. . ~ew Residential,- Single'or I\1~.lti':'Family per dwelling unit. y - - . . -. ~ ......... 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COI4A'ZOO~ -0047 C) 1. ,', LOCATION OF INSTALlATION " 3. 200 ',#o,,",^- 4,~1t-~1-fL LEGAL DESCRIPTION - '/702 -:Sfl3t.f Olf02 - -. -- , JOB DESCRIPTION <;"'PrLltVkb1. ~-k-oIISL Service Included 1000 sq, ft, or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder .. ~ $106,00 $ 19.00 Permits are nonatransferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $50.00 2. CON1'~CTOR INSTALLATlON ONLY B. :Ser.\'ices,or'Feeders-lnstallati~n, Alterations or Relocation: . ..'...J.. ~ ...._.' _... ~. Electrical Contractor j{~A/'i I.. I, Supervisor License Number -'7.::JI(." 200 Amps or less . _. , +...... O It'" ,,,qUlfeS y~- iEN20hAmtlJ"to';4 0 ~mps- ,,,.1.,,, ( ,A./ Ai IIV"," - " .h" Oregon - . /./,/ /,0' \1 r~,01,AmpS\tOI6(10)Amps e s~. 'nc'" - 10 ow v,t.;o' ,-'~. ~'-",op' rules ar ,,' l} tilical!!9.\ I';mps'to 1000 Amps OAR Q',~ 0,., _ 0 . ~",,, 11:\'0. 19n ,.... 3 J r flJ/; In OAR \.Q,vp,IOOO)~,mpSIVo~~es ollhe r".~'" . 0090 YReconnectlOnly'1 co. II t'" ,.,., '.- . v_.. - , (Nole:,e c, callin" Ih.e.cenl~r; 'PI""" ~,,'''I... I~. :~ C '" T ~ S~""''-:'' I hll'E ed . Ar emp.orar.vl ervlces or e ers nun,u<> ,y.. , " -800,;;32:c"-~" . Cenler IS 1, Installation, Alteration or Relocation $ 63,00 $ 75.00 $125,00 $163,00 $375.00 $ 50.00 Address /,;L ') J f{ /J:j../?<- C/ City E:/,. Phone Expiration Date ()c..-I-- of" Constr. Contr. Number 7c?!/fo 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50,00 $ 69.00 $100,00 Expiration Date Over 600 ~mps or 1000 Volts se~"B" above. D. Branch Cir"cuits Signature of Supervising Electrician ~LJZtw.- New Alteration or Extension Per Panel One Circuit $ 43,00 Each Additional Circuit or with ~ /JilT /' J\~ ......... ~i/ /L /' Service or Feeder Penn it ~~~~ Owners Name In ~r:n c:. uC l.- L- " ~ \~ \{<t. ~ ~O\ Address (D 7 ( 1~t....1 ~J E. Miscellaneous. (SerVicelfKtetf.'il}~~'iI~)1.~~~ Installa~ion / ' ~':\tt.. ~ ~\\~ ~ ,\\\10 ~~t.'i) ~ S:~Ff\ Phone 72-0 ~ f5S-2'] Pump~ ~ati~\-tI\ \J~'V't. .Q,t>..~1J $50,00 Sign/o.Jl~n~~~\) O? ,10 I. $ 50.00 OWNER INSTALLATION Limited t!n'i~~\i:\'y'~.?'cP. $ 25.00 The installation is being made on property I own which Limited E~w~ercial i $ 45.00 '" r <o(v is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges City Owners Signature: 4. ., SUBTOTAL OF ABOVE f.{\' "J IJ '1'50 ~26.!:... Inspection Request: 726-3769 7% State ~urcharge 10% Administrative Fee . fto.~ ~~ ~\)\j)TOTAL \}J'" ~~ - ~'!:) Slmred Dri,e(T:YBuiJding FonnslElecuic.J Pcnnit Applic.tion I.OJ,doc . - 225 FIITH ~'TREET . SPRINGFIELD, OR 97477 . FH:(54 I) 726-3 753 . FAX: (541)726,3689 Q; (Q) -' ..)~i ~} C>:$J t). Assessors Ma:- ,"" ..~~ ~, ~ Owner n< -<1C; Address ~ City C./! ')"A'/A/. fin .~.~.~ r;: ,.1 ~l ~ ~-'-~l ~ ~ Contractor ."~1 S. ~ Addres~ ~\ Cit:' ~ ~l ~l o .~~~ ~) ~; ~ ;?;. ~; =-- Signaturp '- ~~.Il ~~-(! ~ (Q) ~I ~l Vi ~I U; ct.j> . !l ~l . SPRINGFIELD \::.:_~_-- '\ , . ;f I;, :c O-":",:~:~c ~_<~,' ~. "-- --- .:.:.... ~y) -'-.... '".1 City Job Number COMZ-OO S-- DOt.{7', ' Job Location ?C?.'2-tMOA",,41V'-j.A-k 17oz3l{"JL{ 'bd- , -. Tax Lot 01(0 Z P.r6s/I11T GA-TE:- \Ev";!().I1",,^~+ LLC .T/f~ !07( ~n {OWphonp 7i6 ~ 85"'23 7/f(77 Statp (') ~ Zip 0 '7// 07/ uires yOU to _ .__~ I~,^, ree< ........ ATiEN\lU'~' ~.-~ t\1e OreguII u" " BACKFLOW PERMIT IS $52.65 (includeStRermitlFif'cdl~~ate'Sur,ch:irge\ .i:?'X'dministrlltive Fee) -lu"...... . tef. \lU;)t;; ,..... - 2-CU \. ~ootil~~~~~~~ _0010 tl1roug: ~~~e91~I'p , ' V In btaln cOple \1 '" 0090. You may 0 Note: the te\ep [) ~" calling tile center, (on Utility lXnt,l,c.\t .. number lor t\1e.?~e~('\n_332 .2341\). /J7" f)"r_'?/d C/. c PD- ((,.,..,/ '5 ? F-b, COli tractor [lIformatio" QALI'UI/ v~\n"'" .- /...;2 7r ~if/u- & :j R-u J.I, / I 12.0 ./ Phon~ 3 :J r - cf?J6() State &' /l.. Zip 97Y//::.. Construction Contractors Registration # 7 d / /// Expires Od- CJ~ By signing this permit/application, I agree to call for an inspection once the backl10w prevention devise has been installed and is visible for inspection (726-3769). I also state that all infoffilation on this permit/application is correct. ~~A-/2&. -L- Date of Application Date /M\-.~~ ~..,..~\""t. \\~\'\ ;') . ~O'\\~~~~~\ ~~~~\\ \~~;~~~t.\) ~\)\\ For Office ~~~Q\\\1.;~J\ Q\\ \~ ~ll ' I';U ~~'\:S~v~~ 'ft,;{-.W- 1(- X...... 0 ~ c.~~'l \'O\} \)~ ~ Checked for Delinquencip< Checked for Historical Statur v Shared Drive (T:)fBuilding FomlSiBackf1ow I'reventionl-OJ.doc . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 05/0812006 VALUE: $ 23,600.00 SITE ADDRESS: 200 Mountaingate Drive ASSESSOR'S PARCEL NO.: 1702343401102 Springfield TYPE OF Commercial Miscellaneous TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Pump building. Owner: Address: MOUNTAINGATE DEVELOPMENT LLC 1071 HARLOW RD SPRINGFIELD OR 97477 Phone Number: aU\.-' "uiles'l U\I\I\'l ~ Ie", ,,0\'1 \o\l.n _.... \2' ('lIe", _,,\ . _.\.01"'" A n\l ,,'- \es 3'~ S'2.-\Jv' I CONTRACTOR,INFORMA:fION.,."e IU XI Ol'-?> 9 u\es 'O'l r' ~ 1\.l'v'ce\'lW" ()\nlou~ 0\ \n~ I XlO\'le C tr t \0\\0 '0\'1 ~L' ~,,'I nl"s, "t''''o D"t<l on ac or .~ C'iJ.\1 IJ";lcense(\ co""xpQ;a lODe a e NORTHSTAR GENERAL CON~CTOR:>'2.-i51992''iJ.' \..~o\e" \~W'29/2006 J K GUCKENBERGER ELECTRIC INS ''{ou ~5i29\wI. eQ,o\'l u~0~hU06 4B ENGINEERING ()()~ ~\I\'IQ, ~ \~I-\ne ?\_<Q()()-?i .. REXIUS FOREST BY PRODUCTS INC'\l~'Qel 121~el IS 10/3112006 CASCADE WATER WORKS INC \'I h"7482 10/24/2005 CASCADE WATER WORKS INC 157482 10/24/2005 541-726-8523 Contractor Type General Electrical Engineer Landscape Mechanical Plumbing Phone 503-304-0500 541-746-4656 503-589-1118 541-342-1835 503-364-4888 503-364-4888 I BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: U # of Stories: Height of Type of "eat: Water Type: Range Type: Energy Path: Sprinkled 1 Lot Size: 12.00 Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: n/a Occnpant Load: 320 VB Front yard Setback: Side 1 Sethack: Side 2 Sethack: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORM{\~llO'~ ~1~~E If l\-\E W~\~~ ~. S Pr.p.tAl1 S\o\jl.\.\' ~\i_Q>lfR'm-NG Overlay Dist: l~\\-\OP.llr.O U~OER~\t1i}O~EO fOR # Street Trees ~ OtAtAE~CEO OR ISO andicapped: Paved Drive Rqd: C ~ \&1) \)t.'J li'~p.\ om pact: % of Lot Coverage: Mil u IPUBLIC IMPROVEMENTS I Street Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains Notes: 1 of 4 Status: Issued 225 Flfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Pavine Type of Construction Estimate Use Bid Amount . Fee Description Copies - Ea AddU @ 50 Cnts Ea Copy 6th @ 75 cents Plan Review CommlIndlPublic -Mechanical Issuance Fee- + 10% Admlnistratlve Fee + 7% State Surcharge Add, Alter, Extend Clrc Ea Add Building Permit Minimum/Adjustment Mechanical Paving Perm ServlFdr 200 amps or less Plan Review CommlIndlPublic SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbnrsement Storm Drainage Impervious Area Vent Fan + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge Backnow Device Low Voltage - Commercial Indus Minimum/Adjustment Plumbing Total Amount . . CJTYOFSPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 05/08/2006 VALUE: $ 23,600.00 I Valuation Descriotion , $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 22,600.00 $1.00 1,000.00 Value Date Calculated Total Value of Project $22,600.00 $1,000.00 $23,600.00 05/03/2005 05/03/2005 Fpp< PIiILI Amount Paid Date Paid 4/25/05 4/25/05 4/25/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 11/8/05 11/8/05 11/8/05 11/8/05 11/8/05 11/8/05 11/8/05 Receipt Number 2200500000000000484 2200500000000000484 2200500000000000484 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 1200500000000001697 1200500000000001697 1200500000000001697 1200500000000001697 1200500000000001697 1200500000000001697 1200500000000001697 $1.50 $0.75 $100.23 $10.00 $37.98 $23.44 $18.00 $208.80 $39.00 $45.00 $63.00 $40.56 $15.66 $3.76 $61.35 $13.91 $313.10 $6.00 $4.50 $4.50 $3.15 $3.15 $14.00 $45.00 $31.00 ~ ~ $1,107.34 I Plan Reviews I 2 of 4 . CITY OF SPRINGFIELD Building/Combination Permit- PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 05/08/2006 VALUE: $ 23,600.00 . Status: Issued 225 Flfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review 04/26/2005 05/04/2005 OK GRG Initial Review Plannin2 Review Public Works Review 04/25/2005 04/25/2005 04/25/2005 04/25/2005 04127/2005 05/03/2005 APP RJB APP EMM APP SB Structural Review 04/25/2005 05/03/2005 WE JMP Structural Review 05/04/2005 05/04/2005 10 JMP Structural Review SUB Review 05/04/2005 04/26/2005 05/04/2005 05/02/2005 APP JMP APP DH Plans Review: Temporary pump station building. Job #COM2005-00479. Occupancy Classification: U. Construction Type: V-B. Provide address numbers In contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (2004 Oregon Structural Specialty Code 501.2 and 2004 Springfield Fire Code 505.1). Provide fire extinguishers with a minimum rating of2-A:I0-B:C every 75 feet of travel distance. The top of the extlngulsher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code 906). approved per Jim Donovan- Planner SDCs added. Caution required to avoid damaging stormwater Inlet in driveway. LDAP application not required per Billy Curtiss Left message for Ed Butts requesting information on plumbing, site work, and cost/value verification. WI. Received fax from Sean Ramstead correcting the seismic calculations for the current IBC. 'We can Issue as soon as LDAP is approved. Received final Internal approval. To Request an inspection caD the 24 hour recording at 726-3769. Ail inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. wiD be made the following work day. ~p..tinrU Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 3 of 4 . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 05/08/2006 VALUE: $ 23,600.00 Final Electric: When all electrical work Is complete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all req,nlred energy inspections have been requested and approved. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Foundation: After forms are erected bnt prior to concrete placement. Slab: To be made after all inslab building service equipment, conduit piping and other equipment Items are in place bnt prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Walllnsu1allon: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building Is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work Is complete. Backflow Device: Prior to covering and provide a copy of the test report on site at the time of Inspection. Low Voltage: Prior to cover. 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 wiD be made of any structure withont 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 street, that the permit card is located at the front of the property, and the approved set of plans wiD remain on the site at all times "fA~truction. ""- ';;.h;, d~",,4;LR- // / rf 11 r- Owner or Contractors Signature Date 4 of 4 225 Fifth Street Sprh.1gfield, Oregon 97477 541-726-3759 Phone . .!'.~RINClFI' '!L'?, _ _, ". Wir~ : , -. f - " I Rty of Springfield Official Receipt .veIopment Services Department Public Works Department Jnb/Journal Number COM2005,00479 COM2005,00479 C'OM2005,00479 COM2005,00479 COM2005-00479 COM2005-00479 COM2005-00479 Payments: Type of Payment CfeditCard u :j '(~ , :' " '(' 11/812005 RECEIPT #: 1200500000000001697 Date: 11/08/2005 Description + 7% State Surcharge + 7% State Surcharge + 10% Administrative Fee + 10% Administrative Fee Backflow Device Minimum/Adjustment Plumbing Low Voltage - Commercial Indus Paid By JERRY DELAPLAIN Received By djb 1 of I Item Total: Lheck Number AutbortzalIon Batch Number Number How Received 618065 In Person Payment Total: 2:54:04PM Amou nt Due 3.15 3.15 4.50 4.50 14.00 31.00 45.00 $105.30 Amount Paid $105.30 $105.30 -Ut:~ ' ~" . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectlon Line SITE ADDRESS: 200 Mountaingate Drive ASSESSOR'S PARCEL NO.: 1702343401102 . CITY OF SPRIr'<lul'l~LD Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 11104/2005 VALUE: $ 23,600.00 Springfield TYPE OF WORK: Commercial Miscellaneous PROJECT DESCRIPTION: Pump building. Owner: Address: MOUNTAINGATE DEVELOPMENT LLC 1071 HARLOW RD SPRINGFIELD OR 97477 TYPE OF USE: Addition Commercial Phone Number: 541-726-8523 I CONTRACTOR INFORMATION I Contractor Type General Electrical Engineer Mechanical Plumbing Contractor NORTHSTAR GENERAL CONTRACTOR J K GUCKENBERGER ELECTRIC INC 4B ENGINEERING CASCADE WATER WORKS INC CASCADE WATER WORKS INC License 151992 45129 Expiration Date 06/27/2006 0412412006 Phone 503-304-0500 541-746-4656 503-589-1118 503-364-4888 503-364-4888 157482 157482 10/24/Z005 10/24/2005 BUILDING INFORMATION I # of Stories: Height of Structure Type of Heat: _ Water Type: , ,0'" "Range Type: ",' .-J E ~, ...... nergy Path: , ~ <'2 ,,__ Sprinkled Building: nla " ~ ,,'V " -f.'{.-v ~'<,'<'i :DEVELOPMENT INFORMATION 1.::.,0" "#' if . 'v~ "-~ ;)'-' . ,,0"> ",'5 Q;-.....O <:><:>" -",REQUIRED PARKING V",:,'" ,srfJo;0;fo-<:J Frontyard Setback: -;..~- ,:5'. ~' Overlay Dist: ,0<::>: O,Q.; ~0 0)'" .:sO >:,To.!-al: Side 1 Setback: ':. ~ c:, .# -V ~\J' # Street Trees Rqd: #' ~0 ",0"> Oo$' ~q, <:. ~o ,!:!ilndicapped: Side 2 Setback: " : >' Q;:-~ ~ <;:)'<:- <:i:' Paved Drive Rqd: O~~;::\" 0 ,.::i ~ ;y" Q;-0~Compact: Rearyard Set,back: "''..; <~ ,,<S> ,~'<.; % of Lot Coverage:~~ o-<:J 00; o~CB~., ~0"":--'0 ,. , . ~ '.... '" .... ,,~ Q.; -<.,'<::' ~ .~ ,y .....- ~, Solar Setbacks: ~ -0" ,<.,.....' ~,~ .O?f ~ 0<< ~':'.~ ~ " ,", _~ \:... v, .:s.. )...0 _,....<:;) (i ~ ......' c), '\ 'c..,0/~ ....." I PUBLIC IMPRO~I!:NI~"'..?'" '!S-<ii" ~ 0<::- ~ 6i;,v ~' ^~ ',' ,,_ \," .,0 ",q,' ,q,CB ~ Street Improvements: , .:::-' ~ ;::,O,i); "''I;.... Side:walItlType: , , '$,.0, v'li CSJ "0 (j q" fo .,0 ~ S ~O" ~ Q~wnspoutslDralns: ~O 0' . 9>.....0 f:>'" ,~ 9.><:> ~<::' q;. CJQ.; ~c:, v'1i~ <::-.::i # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: U VB Storm Sewer Available: Special Instruction: Notes: Pa2e 1 of 4 1 12.00 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 320 _~8"'iI/N~I!I~ ' I ' , . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descrintion Estimate Pavin2 Tvpe of Construction Estimate Use Bid Amount Fee Description Copies - Ea Addtl @ 50 Cnts Ea Copy 6th @ 75 cents Plan Review CommllndlPublic -Mechanical Issuance Fee-- + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Building Permit Minimum/Adjustment Mechanical Paving Perm Serv/Fdr 200 amps or less Plan Review CommllndlPublic SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Vent Fan Total Amount Paid . UJ f OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 11/04/2005 VALUE: $ 23,600.00 I Valuation Descriotion I S Per Sq Ft or multiplier SI.00 SI.00 Square Footage or Bid Amount 22,600.00 1,000.00 Value Date Calculated Total Value of Project S22,600.00 SI,OOO.OO S23,600.00 05/03/2005 05/03/2005 Fpp<, P\WIJ Amount Paid Date Paid Receipt Number 2200500000000000484 2200500000000000484 2200500000000000484 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 2200500000000000533 SI.50 SO.75 S100.23 S10.00 S37.98 S23.44 S18.00 S208.80 S39.00 $45.00 S63.00 $40.56 S15.66 S3.76 S61.35 S13.91 S313.10 S6.00 4/25/05 4/25/05 4/25/05 ' 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 5/4/05 SI,002.04 I Plan Reviews , Pa2e 2 of4 Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 11/04/2005 VALUE: $ 23,600.00 . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review 04/26/2005 05/04/2005 OK GRG Initial Review Plan nine Review Public Works Review 04/25/2005 04/25/2005 04/25/2005 04/25/2005 04/27/2005 05/03/2005 OK RJB APP EMM APP SB Structural Review 04/25/2005 05/03/2005 WE JMP Structural Review 05/04/2005 05/04/2005 10 JMP Structural Review SUB Review 05/04/2005 04/26/2005 05/04/2005 05/02/2005 APP JMP APP DM . Ll1 t OF SPRINGFIELD Plans Review: Temporary pump station building. Job #COM2005-00479. Occupancy Classification: U. Construction Type: V-B. Provide address numbers in contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (2004 Oregon Structural Specialty Code 501.2 and 2004 Springfield Fire Code 505.1). Provide fire extinguishers with a minimum rating of2-A:I0-B:C every 7S feet of travel distancc. The top of the extingu1sher(s) shall be between 3 and 5 feet above finished Door (2004 Springfield Fire Code 906). approved per Jim Donovan- Planner SDCs added. Caution required to avoid damaging storm water Inlet in driveway. LDAP application not required. per Billy Curtiss Left message for Ed Butts requesting Information on plumbing, site work, and cost/value verification. WI. Received fax from Sean Ramstead correcting the seismic calculations for the current IBC. We can Issue as soon as LDAP is approved. Received final Internal approval. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 I?P'lMirl~tI Tn~"p("tinn", I Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Paee 3 of 4 -iii . . CITY OF ~rlUl~ld'I~LD Building/Combination Permit PERMIT NO: COM2005-00479 ISSUED: 05/04/2005 APPLIED: 04/25/2005 EXPIRES: 11/04/2005 VALUE: $ 23,600.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Final Electric: When all electrical work is complete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy Inspections have been requested and approved. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturhance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for Inspection In conjunction with footing and/or foundation inspection. Foundation: After forms are erected but prior to concrete placement. Slab: To he made after all ins1ah building service equipment, conduit piping and other equipment Items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Final Fire Department. After all requirements of the Fire Department have heen met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work Is complete. By signature, I state and agree, that 1 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 he done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed 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 readahle 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 construction. .,1fQ))j'(J f:ijL) 5-L/-d5 Owne~ or Contractors Sig~e Date Pal!e 4 of 4 -i ATIACHMENT A CITY AuNGFIELD SYSTEMS DEVI:;LOPMENT CHARGEAJ;sHEET JOURNALORJOBNUMBER: ~S:00479 -- NAME OR COMPANY: Mountainqate Development LOCATION: 200 Mountaingate Drive MAP & TAX LOT NUMBER: 17 02 34 34 01102 DEVELOPMENT TYPE: Temporary PumP Station NEW DEVELOPED AREA (S,F,): 320 EXlSTING DEVELOPED AREA (S,F,): TOTAl.. IMPERVlOUS SURFACE (S,F,): ITE: ITE: LOT SIZE (S,F,): 170 nla . -;3 t '" ~~.t' .; Ii 5~~ 18 I STORM DRAINAGE IMPERVlOUS SQ, IT, 1010 $ 0.310 PERSF x TOTAl.. STORM DRAINAGE SDq $313,10 1070 j 2 SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B, IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) o x $ 24,04 PER DFU o x $ 18,28 PER DFU TOTAL WCAL SAN,SEWER SDC:' $ ~ $ 3 TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 0,320 x 2,5 x $ 18,30 PER TRIP x 0,95 NTF 1$ 13,91 I B, IMPROVEMENT COST: 0.320 x 2,5 x $ 80,72 PER TRIP x 0,95 NTF 1$ 61.35 I EXlSTING A. REIMBURSEMENT COST: 0,000 x 0 x $ 18.30 PER TRIP x 0 NTF 1$ B, IMPROVEMENT COST: 0,000 x 0 x $ 80,72 PER TRIP x 0 NTF 1$ TOTAL TRANSPORTATION REIMBURSEMENT SOC:\ $ TOTAL TRANSPORTATION IMPROVEMENT SOC: $ TRANSPORTATION SDc:1 $ 75.26 I $ $0.00 1091 $0,00 1092 13.91 1093 61,35 1094 75,26 4 SANlT.A'RY~FWF.R-MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0,000 B, IMPROVEMENT COST: NUMBER OF FEU's 0,000 x $46,88 PER FEU 1$ 1$ x $494,46 PER FEU EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's B. IMPROVEMENT COST: NUMBER OF FEU's 0,000 x $0,00 PER FEU 1$ $0,00 PER FEU I $ I INDUSTRIAL STRENGTH INCREASE I $ TOTAl.. MWMC REIMBURSEMENT FEd $ TOTALMWMC IMPROVEMENTFEE:I $ MWMC ADMINISTRA TlVE FEE:' $ TOTAL MWMC SDC:I $ ~ S SUBTOTAl.. (ADD ITEMS 1.2,3,&4) 1$ 388.36 ~ 0,000 x MWMC CREDIT IF APPUCABLE (SEE REVERSE) 1054 1054 1055 1056 5 ADMINISTRATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) $ 388.36 x 5% $ 19.42 TOTAL TRANSPORTATION ADMINISTRATION FEq $ TOTAL SEWER ADMINISTRATION FEE:I $ 3,76 ]078 15,66 1079 steve"" W, 'B-ea",;rl:j 'B-ar.....e.< 5/3/2005 Cl%2~~'l1~~ Pump station, 200 MountaingaPet&s TOTAL SDC CHARGES 407.77 , $ , JULY 2004 ~225 Fifth Street . Springfield, Onigon 97477 i 541-726-3759 Phone Job/Journal Number COM2005-00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005,00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005-00479 COM2005-004 79 COM2005-00479 COM2005-00479 Payments: Type of Payment Check \ 5/4/2005 . ~ RECEIPT #: aity of Springfield Official Receipt _evelopment Services Department Public Works Department 2200500000000000533 Date: 05/04/2005 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add Building Permit Paving Plan Review Comm/Ind/Public Vent Fan Minimum! Adjustment Mechanical -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Storm Drainage Impervious Area SDC Transpo Reimbursement SDC Transpo Improvement SDC Transpo Admin SDC Sanitary/Storm Admin Paid By LAND PLANNING CONSULTANTS Received By jmp Page 1 of I Item Total: Check Number Authorization Batcb Number Number 10824 How Received In Person Payment Total: 2:57:02PM Amount Due 63.00 18.00 208.80 45.00 40.56 6.00 39.00 10.00 23.44 37.98 313.10 13.91 61.35 3.76 15.66 $899.56 Amount Paid $899.56 $899.56 ~'IIt.. 0 . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPUCATION City Job Number(OloCA ZOO~ -('>0 4 7 'l Date ~~ ,-,,*, Supervisor License Number t..t ~ '5 S ~\:i ,,-v" \, ' ,\J (0 - l _ ore~~ .:J:..~"_ '<'\)~ Installation, Alteration or Relocation ..1.'," ~'v :>:-v 200 Amps or less , <-I" -s ~" Constr. Contr. Number "-I6Jl.,~'. "'\) , 20 I Amps to 400 Amps 4.,0'::' ,~" i:? $ 69.00 c~" x~ ",'~F 401 Ampst0600A",~, ",v"'~,o_'C>", , $100.00 Expiration Date...<i. _~'=t:~~~{0.k" ,~ ~ c,f?, C);~ ''0' ..~'" ~'~~'V W :-,v Over 600 Amps ~I'o<t 0, ,olts ~.'.:~:~ aqove. Signatur?":'>'~~ing'EleclriCi8h~<0 D.I!JD'iiCiiIG!f ',I'A' ~ :' ",p~~~~~J~ ' ,,' ~~,,~\) ~~'.J ~~ " New Alte~IQ~rJ:~t~T~~::-r~~1 ~ #'7~0;",~~'''''':..~ 0"".0' 0 ~~ ~ -.: 0""- ~ ~(! One 9fbbiR'~ "'~ ~o R'f?, . >s-f?, ~~, $ 43.00 ?/ v \~' '1 Ea~4~'il1tYd ~~uiL'6ro'~i~~:~'!r b $ 3.00 OwnersName MtM...~...~",-Ie:- 'pel!. LLL <t~~~~~dir~rs::~ o"'J/ Address 7 I , I .... W "I ~ MMi~i1iite~lh';;~\..{~Ilt~'IIa\ifil't1illf~if,'lE~'Thm~mIUltfif.:lJ 10 "'R'~/O ~Q ~~~3~Cl1J~~"'~lii:illiir-"'-"'}'1~,~...."-""",,,,..\llI C,'ty ""'" ~c'" 7"6 _ Q 5Z" ,o~" 5i-- ~Q '&of?, is' ~I!? ~""" I) Phone" Q ~ .jlilOUl~~~rtI~lI!i'o~ # $ 50.00 S~tl'P~ Li..iht~ $ 50.00 Limited E~lResidential $ 25.00 Limited Energy/Commercial $ 45.00 I. m'oeA:Tid~~~iAdtAi!.@!.1Y;~ .f.....~~~.l~~,. ~tii..,.T. Zc:>c::> Il\A.T. 0-A-ic :bit LEGAL DESCRIPTION 1702. 5'13'1 JOB DESCRIPTION CO"''''l:::'~ + 0"0'2... r""...... f'S Permits are non-transferable and expire If work Is not started within 180 days oflssuance or If work Is Suspended for 180 days. tiui'i~:.lemi"'l~.Air;'fl'4.m.~[<<~ 2.L1lOl'\"fii::il.t.'i.-\,,~~~... . Electrical Contractor ~I~{"" ~ 1) dl r', c Address 2...\ 0::., ~ City ~f,y..fP.I& Phone ~. 1'%-4(""Sk> Expiration Date OWNER INSTALLATION The installarion is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~/Z~J .~ 3. i!i€b"Jr~L1ftE~Fliili.~Btit;ii.;iJ~tl"IWi!1,l!IAII!af~ ~,o,~.t~~,_-:.._-,.....~.f.tll~~~~~~~~~ ot-of$! ~ . o 0;>/ "o-;S>.o A. Lr.Nt,v.RrsJii~tiljil';:'Sili'~"r~~~iilll''''~~ed~liIlirilltllh.~a I!t_...A!!.. "'--"'r,,;.'~~'" .. ~ ,:,Y; _..>'"".",~. ,~_ ~ Service Included &0- ~&9. v6", &. ~~ "i....: 1 000 sq. ft. or less ~-:> ' &.. &~ 106.00 Each addirional 500 sq. fl~~ ~ ~ "\./ ~"'< ' portion thereof ~~~-P t~ '>-.1 "0- 't Each Manufact'd Home or .'-J v'" "'-.. Modular Dwelling Service or ~~ ::0& ;s> Feeder '(~~ ~ B. ~"':m@'o1';'Jfie'iim'0'f~llfi~Hok.~lt.~~rrii~~i;JiUtm!ll ' ~ "':'\'~~:'f"'~,'iV"-"""'-':""'::::!:i.aA."''''''17I''''''f'',t~~"o.t,,~'~.....:&ii.l:i~. , 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only I bJ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. f;t~Mn!mS~Bi1c~'D!:f~~':'..lI" " $ 50.00 /8 Minimum Electric Permll1nspectlon Fee Is $45.00 + Surcharges 4. r;'~;}.8:c;)~:t1}ii)p.H,'OVE."'~, !'!:i~~~m,')~\,'~1!t1l 81 ~t~lU't...;t\tW'oo.',;..-r~I'''':'i:~~''~~~~~'2Bl~ 51::.7 8'0 ?~~ 7% State Surcharge 10% Administrative Fee TOTAL Sha.red Drive(T:)IBuilding FormslElecrrical Permit Application I-03.doc