HomeMy WebLinkAboutPermit Electrical 2009-10-28
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Commercial Electrical Authorization To Begin Work
69600-BEL-09-00210
Approval Code: 028186 10/28/2009 1:48 pm
E-mailedTo:tena@orelectricservice.com
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10 New cons~ructio~~~::' ,_ ,:':/ii.:~fi~: ' .,<(,:4..:-','.,~'1Rl Addltion/~lterationlreplacement
11~~E~'!1,1,*~l::ATE~QRYlQ~W6N$TRifCffQf,j~&;'~~~fi''l!
] 1&]1 or 2 famil~ cfw'e~ji.~i{"~', D. Multi~family, 0 C9mmercial 0 Accessory
'.IIIt~~JOBiSfiE:1NF,.OFlM""'fION:i.NDIiYQC~'j'iO~IC!i'J~~l'ilr4'!
I Job Address: 612
I City/StateJZlP: sPRirIIGFIELD:OR 9741'7'"
I Suitefbldg.lapt.no,: '. -,. ,"'-:
.1 Project Name: Don'M'~I~n-;&'46t,~:I15::::~:~:~:~'~,~,;~~~~.'))~l::\;:; "..:; ''-;'
o Hazardous locations
o A service or feeder rated at
600 amps or more
. 0 Buildings more than three stor
o Marinas and boat yards
o Floating buildings
o Commercial-use agricultural
buildings
o Installation of a 150 I0/A or
larger seperately derived sys
o "A", "E", or "1-2" or "1-3"
o Recreational Vehicle Parks
o Supply voltage for more than
600 supply volts nominal
Please check all that apply:
o A service or feeder beginning
at 400 Amps where the
available fault current exceeds
10,000 Amps' at 150 Volts or
less to ground exceeds
14,000 Amps for all other
o Fire pumps'
o Emergency ~ystems
o Addition of a new motor load
of 100HP or more
o Six or more residential units in
6ne structure
o Health care facilities
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Cross Streetldirectio~s k; jbb '~iie:.,
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Tax map/parcel no,:~, 1703353108800
I Qty. Total
$55.00 $55.00 I
2 $6.00 $12.00 1
Description
Wire gas furnace with AC: receptacle & condensate pump
I Branch circuits without service or
feeder
I Bra~ch circuits each additional
circuit without servIce
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I Name: Jeff Brooks .~
Phone: 541-343-1681Jt~~_ \
I Subtotal
I State surcharge (12% of permit
total)
I Technology fee (5% of permit total)
I TOTAL PERMIT FEE
$67.00 I
$8.041
$3,35 I
$78.39 I
.
Fax: 541-343.1683
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Email:
cce lie, no,:
181997
'.'
Elee lie, no.: C408
I Business Name: OREGON ELECTRIC SERVIC'{lLC
Q \Olo~101
c.~ - l610B
Contact:
Address: PO BOX 2237 .
City/State/ZIP: EUGENE:'OR 97402
>....,.......
I Phone,5413431681 NU1IGE: '" F.x, 5413431683
: t'lI::> t'tKIVIII :iHALL I:XPIKt: If fl1t WUf\1t'-
',;::'1 !3f..::n: li:\iDCF: Till:: rrm.lIT ~ fI,")T
,MM~~I("~n nd'~Ii'ilet'womll:n IDR
Supervi.ing Ele....iei.n'. lie. n'8B'.DAyj~Riob.
I Supervising Electrician's N~m'e:. HERMAN OLLAR
Emall:
ATTENTION: Oregon taw requires 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-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number lor the Oregon Utility Notification
. . ~ Center Is 1-800-332-2344).
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..' ;: : Inspections Phone: 541-726-3769 ~
/ . . .
This Authorization To Begin Work must be posted at the job site until replaced byaPermit
Metro lie. no.:
Number of Inspections included in paid services:'-
Residenti.al Service: 4; ... .~_
Reconnect Only: 1 ..t;::. 1"
All Other Services: 2.
Upon review and approval by your local Jurisdiction, your ,permIt will be e.malled or faxed
within one busIness day, with Instructlona on how. t~~ch.~ule your Inspection.
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NOTE: This Authorlzatlon,To Begin Work expires within 180 days If II perinlt Is not obtaIned.
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The local building dep~rtment' may d~ermlne that an Authorization To Begin Work Is null and
void If It does not meet applicable land use laws and local ordinances.
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CITY OF SPRINGFIELD
Building/Combination Permit
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. Status .:, Peqding j" ,
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225 Fifth Street;:Sj,,;ingfleld,'OR,{,'L
541-726-3753 Phone' .'.' '..'" :\.<;;.
541-726-3676 Fax'
541-726-37691nspection Line.
PERMIT NO: COM2009-01368
ISSUED:
APPLIED:
EXPIRES:
VALUE:
09/16/2009
04/28/2010
$ 9,975.00
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SITE ADDRESS;:;)':;;.'ii12MAll',i'sf ,'. Springfield TYPE OF WORK: Heating System
. ASSESSOR'S PARCEL NO.: 1703353108800
. . . :\.:,.;~(;.;.\/i '.' ',,' TYPE OF USE: New Commercial
PROJECT DES'CRiPtioN,'C;1nstalI 'gas fnrnace, piping and .c. Electrical to wire gas furnace with air conditioning,
. 'receptacle, and condensate pump.
Owner:
Address:
MOLON~Y DONA~~l & MARY J
922 B ST. .. ;':'::'::,.,
SPRINGFIELD OR 97477
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Contractor Type' .r Contractor
Electrical OREGON ELECTRIC SERVICE
Mechanical ASSOCIATED HEATING & AIR CONDITIO
!
I CONTRACTOR INFORMATION'
License
181997
106275
Expiration Date
05/0912010
08/31/2010
Phone
541-343-1681
541-683-2590
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I, BUILDING INFORMATION ~
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# of Units: , :.
, .
Primary O~cuPll,ncy ,Gr~up:
Secondary Occupancy Group:" '
Primary Const;ucii~nType '.:~ ::~::.c
Secondary Construction Type: " !
# of Bedrooms:
.'
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
. Sq Ft Other:
Occupant Load:
, r;SJw[:. "" ,10 -
i THIS i'ERMITSHAll ~FORMATION ,
; AUTHORIZED UNDER T~f .
Frontyard Setb~c.\'iOMMENCED OR IS ABANDONl!{)flQRn(st("
S~de 1 Setback::~L ANY i 80 DAY PERIOD. # Street T:ees Rqd:
SIde 2 Sethack: ", ., Paved DrIve Rqd:
Rearyard Sethack: % .of Lot Coverage:
Solar Setbacks: ,...,....0.. ',.
# of Storifs:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path: ,
~pri~~Ied Building:
"' ."', -,";\:f:",;,..;.h~.~:,.,'J'
n/a
u
REQUIRED PARKING
Total:
Handicapped:
Compact:
u
ATTENTION: Oregon taw requires you to
fnl'pll' rules adoDted bv Iha CreDon UIII~
I PUBLIC IMPROVEMENTJ'4Dlificatlon Center. Those rules are set forth
.. ".OAR 952.()O1.()O10 through OAR 952~01.
0090. 'WlWmdj< 5blaln copies of the rules by
call1rw tt!!t~nt!lrnLl'1ol!l: the telephone
numbe'Pfb't"th'lfl:l~~b'R\1tility Notification
. Center is 1-a00-332-2344).
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Street Improve'Pent~:
. Storm Sewe~ Availahle:'..
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Speciallnstrnction: I ;,'.
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Notes:
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CITY OF SPRlr~t..nl',LD
BuildiIlg/Combination Permit
Status Pending"
225 Fifth Street, SpringfieId, OR,':';P" ':.' '.
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541-726-3769 I~sp~~ti~~.ii~~ "I,
.,. ;
PERMIT NO: COM2009-01368
ISSUED:
APPLIED:
EXPIRES:
VALUE:
09/16/2009
04/2812010
$ 9,975.00
'~'"" " ':jt."":'; >~.
'. ::.:>1 Valuation Descriotion ,
'.
.... $ Per Sq Ft
,';.,::or multiplier
"'. $1.00
Square Footage
or Bid Amount
9,975.00
Value
Date Calculated
Description ,TVpe of Constni.ciio,! '
, Bid Amount :i::::i,;tN~~:~iidM~~~il;} .
Total Value of Project
$9,975.00
$9,975.00
.09/16/2009
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JI~e. paidJ
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Fee Description
+ 12% State Surcharge
+ 50/0 Technolo~ .Fee ~~:' ..... .:~i6 ':~ :,
Add, Alter, Extend ~irc :;.;.; ,"" 'f
Add, Alter, Extend Circ Ea Add
Amount Paid
Date Paid,
Receipt Number'
" $8.04
$3.35
$55.00 ' .
, $12.00
10/28/09
10/28/09
10/28/09
10/28109
1200900000000001204
1200900000000001204
1200900000000001204
1200900000000001204
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TotaJ'Kmount Paid
$78.39
I Plan Reviews I
o
'10/08/2009 "
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10/12/2009
APP JF
No energy inspections required.
SUB Review
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To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. willbe ~r~y,t~~ same..w~rking day, inspecti~ns requested after 7:90 a.m. will be made the following
work day. .. ,i ". . .
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R,eollir,ed ~J,.n,~ct,jp~~ I
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Mechanical: Prior to Cover
; 1
Final Mechanical: When all mechanical work is complete.
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!lough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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CITY OF ~nul~ul<lJ<"LJJ
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Building/Combination Permit
,Status "<, Pe#.lIi~g '1'," "
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225 Fifth Street, Springfield, OR'" ,",
541-726-3753 Phone . ' . ,.:".'}'
541-726-3676 Fax
541-726-3769 Inspection Line
",
PERMIT NO: COM2009-01368
ISSUED:
APPLIED:
EXPIRES:
VALUE:
09/16/2009
04/28/2010
$ 9,975.00
..'
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, By signature, lStateand agree, that I have carefully examined the completed application and do hereby certify that all
, informatio,! ber~on Is tr.ue and correct, and 1 further certify that any and all work performed shall be done in accordance with
:,' the OrdinancesllCthe-c1tYo,fSpringfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCU~AN'CY:wiUbe'~a4~of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contracto'rs 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, that the permit card is loc~te" at the 'front of the property, and the approved set of plans will remain on the site at all
times during cOJ;lstructio.D. "~:;-':'\f;":"I1A'?i'~;' ;'h. '-' .
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Owner or Contractors Signature
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, Date
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Paee 3 of 3
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2'25 Fifth Street, ' ',,',
Springfield,Oregon,97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
,:/{':~:':9U;CEi~T,i#~" 1200900000000001204
Date: 10/28/2009
2:12:24PM'
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Job/Journal Number>.,- ,:, Description
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CO!\:l2009~01368 U;}:);j;AM,Alt~r)'.xtend Circ
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COM2009~01368i~'><\4d;'i\I!~r;~xt#.!'d Circ Ea Add
C0M2009-01368 ,: :'~5% T~chnOiogy'r::~e
COM2009-01368 . ..+ 12% State Surcharge
....,
Item Total:
Check Number Authorization
Received By Batch Nu"mber Number How Received
Amount Due
55.00
12.00
3.35
8.04
$78.39
~;::o~n~:~ment . :€;~id,W~\>:<g;;~IJ,[j}~h::' .
ONLINE CHGS .::.ONLINE PERMIT CHGS
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Amount Paid
KR
ONLINE OR Online
ELECTRIC
SERVICE
,
Payment Total:
$78.39
$78.39
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10128/2009