HomeMy WebLinkAboutPermit Electrical 2009-11-6
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Sity Of Springfield
.225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Email: pennitcenb;r@ci..sPringfield.or.us
Commercial Electr~cal Authorization To Begin Work
69600-BEL-09-00234
Approval Code: 01868C 11/6/2009 3:32 pill
E-mailedTo:keliasen@att.net
11ll~E\iF~ilr~~1;'(I1E!OFJWORK~~~'.~~A?~;l'i
I D New Construction' '\'~,.1Xl Addition/alteration/replacement
Il'lL~~CATEG6RYAOF.li5:QNS'f~u.ciiOiE';,ii;~&rj~~~:r,~~
10 1 or 2 family dwe'iii.~9; : 0 Multi-family (&] Commercial 0 Accessory
1~~~Ii~~OB1sltE\iNF.ORMAffON'AND:I[6cATKfN~-'fi~it;:\i':; .i
I Job Address: 2750 GATEWAy'.ST' '. .":.~
I City/State/ZIP: SPRINGFIELD, OR 974~7
I SuitelbldgJapLno.:
Project Name: Target.:,
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Cross Streetldlrectlo.~s to J~b site: Gateway SI & Harlow Rd
Tax map/parcel no.:
1703220002307
1"',,"'''-'''"''' .,~.~----"---'-iNl.-". ._,- -_,,"--4""~~" . ,. "-"'-~-,
r.~,-,,"\!'(~__DESCRIp"TION.QIiiWORK'ilii~.:ii&:<t" "if,;;-Jl.;'t,
Replace ballasts over sales floor.
Name: Diana Ketts ;
Phone: 541-461-0291..
Fax: 541-461-2340
Emall:
r1E:\'~~1!;~~(;:ONt"ijAc;toB~~~f.~f~;.;"-".i
Elec lic. no.: 20-53C
CCB lic. no.: ~.38497
Business Name: BEACON ELECTRIC
Contact:
Address~i05 RO~~EVElT BLVD
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City/Statftlf"E~~ENE. O~ i!.402~5?0 ~_
.. 1'~r.r.lI, udALL C^,'"u- I~ IH"WORK
Phon., .....'02!l....'7>=O AI>O"5'"''''''''''
. nU, .."IK U~JDm T11:t: r:::n:v'l1T IS NOT
EmOl" ~eJ;~~!1~ffl![J>t'~ ARMIDONED Fg,
Metro ,;S()bY 180 DAY PERIOD. City lie. no.:
I Supervising Electrician's lie. no.:-"
I Supervising Electrician's Name:
3485S ~
GARY E JOHNSEN
Number of Inspections included In paid services:
Residential Service: 4
Reconnect Only: 1
All Other Services: 2
Upon review and approval by your local Jurtadlctlon, your' permit will be e-malled or faxed
within one busine.. day, wlth Instructions on howlo achedule your Inspection.
NOTE: This Authorization To Begin Wortt expires within 180 days If a pennn I. not obtained.
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The local building department may determine that an Authorization To Begin Work Is null and
void If It does not meet applicable land use la_ and local ordlnam:ea.
tq. / II 8 r;
1~~f~~~~;.,~~~f,)c:.'t,l:;.pG\NrREVIEW!lq~,,~~~if,.t~ ~:&:t~~iL-~~j
Please check all that apply: 0 Hazardous locations
D A service or feeder beginning 0 A service or feeder rated at
at 400 Amps where the 600 amps or more
available fault current exceeds 0
Buildings more than three stor
10,000 Amps at 150 Volts or
less 10 ground exceeds 0 Marinas and boal yards
14,000 Amps for all other 0 Floating buildings
o Commercial-use agricultural
buildings
o Installation of a 150 KVAor
larger seperately derived sys
o ~A", "E", or "1-2" or "1-3"
. 0 Recreational Vehicle Parks
D Supply voltage for more than
600 supply volts nominal
If~;-~~~:~' .J);~~'~""~rft:*f,fl;;E;:'~"GttED~l!E~~tr"~}~~;~:._~&d~~> .t~
I Description I Qty. I Ea. Total
IBr~.rl:CtiTC!i'~uits(:I.;;~"-;,~~~~;~',~:~"!?ir:~;o,"~.-iW,{[~~~~1:,f,,:? !.. ';.;;~1'{'!f:~~ \~;i'
I Branch circuits without service or $55.00 $55.00
feeder
I Branch circuits each additional
circUltwithoutservice
IElectric'~J Permitf.~~~'-;'\:..~".~ ;q~~~:o~.~.!.
I Subtotal
I State surcharge (12% of permit
total)
I Technology fee (5% of pennit total)
I TOTAL PERMIT FEE
o Fire pu~ps
o Emergency systems
o Addition of a new motor load
of 100 HP or more
o Six or more residential unils jn
one structure
o Health care facilities
7
$6.00
$42.00
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$97.00
$11.64
$4.65
$113.49
CC) -\l.o35 ~ 11/9 [0'1
ATTENTION: Oregon law 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-oot.
0090. You may obtafn copies of the rules bJ
calling the center. (Note: the telephone
lUmber for the Oregon Utility NCltlfloaIIDn
Genter II t-'llVl.3i2....).
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, Inspections Phone: 541 -726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
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Status, Issued. . ",." .;'.
225 Fifth' Street, Sp~ngfield;6Ri\:;~r ,:
541-726-3753 Phone".' . \.
541-726-3676 F~x'
, 541-726-3769Inspe~tio~:Line
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CITY OF ~rKlj~GFIELD
Building/Combination Permit
PERMIT NO: COM2009-01635
ISSUED: 11/09/2009
APPLIED: 11/09/2009
EXPIRES: 05/09/2010
VALUE:
;!:
SITE ADDRESS: 2750 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 170~220002300
Springfield TYPE OF WORK: Electrical Work Only
. . '. .;," ,:;:'":,,,:: TYPE OF USE: New
PROJECT DES,CRlPTlON:'/ 8'"drf"lts to replace ballasts over sales Ooor in Target.
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Commercial
Owner: ; GATEWAY MALL. PARTNERS
Address: 1l0'NW ACKER'DR BSC 3-04 A TTN PROP TAX ADMIN
CHICAGO 1l'.60606 ;~',
G I CONTRACTOR INFORMATION I
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Contractor Trpe~,:r,~Contract!lr
Electrical ~, i" ., , BEACON ELECTRIC
License
38497
Expiration Date
01110/2010
Phone
541-461-0291
I.. .
~UILDING INFORMATION'
...
:H. l-.;
# of Units: ;
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type .
Secondary Constructio"::Type:"':'; ,~~: -
# of Bedrooms::' . 1;".": .. '.
~ . 1 .
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Fl 2nd Floor:
Sq Fl Basement:
Sq Ft GaragelCarport
Sq Fl Other:
Occupant Load:
nla
\.
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
.. -
Frontyard Setback: Overlay Dist: Total:
Side I Setback: . ", ... # Street Trees Rqd: Handicapped:
Side 2 Setback: ' . ,. ....:,.'~.,' Paved Drive Rqd: ATTENTION: OregolrT8.WPMjulres you to
Rearyard ~gJ;:I&~::'f:. ';. "'~;. ~ THE ~dRk't Coverage: follow rules adopted by the Oregon Utility
Solar Setbarl<llS PERMIT SHALL EXPIRE IF ..nT Notification Center. Those rules are set forth
. UTII'V"IZrS 'JPICCn TU1" DCDMIT 1~ __ .
n ... ..Fl: "",:.j .. . - - III ""no o..Jc.-vv I~UUIV tll'Vl.l~11 vrU-l vvc..-vv.-
COMMENCED. OR IS ABANOOIllf.DlJll,ffi IMPROVEMENTS I 0090. You may obtain copies of the rules by
Street Impr,l\Winlli6:DAY PERIOD; ca!li8~ liWr. (Note: the telephone
. nuiiiber'for" th'i{O'regon Utility Notification
Storm Sewer Available: DowCllulWlll'4U~0-332-2a44).
Special Instruction: "
Notes:
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I Valuation Description I
. "
Description
Type of Construction
$ Per Sq Ft
or multiplier
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Square Footage
or Bid Amount
Value
Date Calculated
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CITY OF ~r.Kll"l\.JJ'IELD
Building/Combination Permit
PERMIT NO: COM2009-01635
ISSUED: 11109/2009
APPLIED: I i/09/2009
EXPIRES: 05/09/2010
VALUE:
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. Status,Isst'ied'~, .~"' . ..
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225 Fifth Street;Springfield.;'OR'{:,.; .
541-726-3753 Phone .;., .'f
541-726-3676 Fax
541-726-3769 Inspection Line
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Total Value of Project
. I Fees Paid.
II I I ~ .
Fee Description
+ 12% State Surcharge.
+ 5% Technology Fee _
Add, Alter, Extend Cire
Add, Alter, Extend Circ Ea Add
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Total Amount Paid .'
. '.'
Amount Paid Date Paid Receipt Number
,c. $11.64 11/9/09 1200900000000001244
$4.85 11/9/09 1200900000000001244
$55.00 11/9/09 1200900000000001244
$42.00 11/9109 1200900000000001244
$113.49
I Plan Reviews I
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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
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workday. " , .... c. :' .
RI~"uil'ed lnsnections I
I11Qli1iiiii111 I
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Rough Electric: Prior to Cover
'l:,
Final Eleftric: When all electrical work is complete.
By signatu;e, 1 s'jate;~nd' agree, that 1 have carefully examined the completed application and do hereby certify that all
information bereon is trueand corr~ct, 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 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 locate~ at the front of the property, and the approved set of plans will remain on the site at all
times during construction.' .
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Owner or Contractors Signature
Date
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225 Fifth Street<ift::,1;ilt~l;::::;;in;~::,;,~;:~,i:..
Springfield, On\giin97477.. .
541" 726"375~rhlille,;:}" , .\. .,:.
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City of Springfield Official Receipt
Development Services Department
Public Works Department
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RECEIPT:#:i >'1200900000000001244
Date: 11/09/2009
9:]3:33AM
Job/Journal Number" D.esc.....iption;.:,~:-~;".:;.,., .0
C0M2009-01635 /,<.Add, Nt~r;J:;~t~~4Circ'.
COM2009-0 1635. :~,,:,:':;lAdd; AI;b~;;Eiitind Circ Ea Add
COM2009-0 1635 ,;:, i;}+5:%Techn~iogy Fee
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C0M2009-01635. ::i':",+ 12% State Surcharge
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Received By
KR
Item Total:
Check Number Authorization
Batch Number Number How Received
Amount Due
55.00
42,00
4,85
11.64
$113.49
Payments:
Type of Payment
ONLINE CHGS
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Paid By
ONLINE PERMIT CHGS
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Amount Paid
ONLINE BEACON Online
ELECTRIC
Payment Total:
$113.49
$] ]3.49
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11/9/2009