HomeMy WebLinkAboutPermit Electrical 2009-11-13
Electrical Permit Application
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225 Fifth SlrCtl.Springllcld.On. 97477 ~ 1'11(54] )726-375H Ft\X(S41 )726.3689
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I DEPART~ENT USE ONLY I
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I Date J~i/J /0 '1 I
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This permit is hsucd under OAR 91S-309-0UOO. Permits lire llontl'ansferllhlc. Permits expire ifwol'l{ is not started within ISO
dllYS ofissulluce or ifworl{ is suspended fur 180 days.
I LOCAL GOVERNMENT APPROVAL
f Zoning approv<ll verified? . .0 Yes 0 No
CATEGORY OF CONSTRUCTION
I D Residential r;O Government j !&I Commerciul
I JOB SITE INFORMATION AND LOCATION
I Jobsit]oddress ~,5 1.~, _ ,
I City~ I Stat()~ ~ZIIl.{]1J1
I Subdivisi~n 1102.3lr> 0'2. 'O~o:
I ' DESCRIPTION OF WORK
IBranch circuits to control panels
I
PROPERTY OWNER
I Name: Arclin USA
I Address: 475 28th Street
f City" Spr,i.n;=t~ield I Stow: OR I ZIP: 97477
Phom:541-746 6501 .1 FllX:
I E-mail: erik.brunso@arclin.com
This installation is being made all rt:sidcntinl or farm properly
owned by me or Cllllcmber of my imlllediate family. This
property is 1101 intended for sale, eXl.;hrlllgc, \case, or 1't::llt. OAR
479,540(1) and 479.560(1),
Sigllnture:
I
I Business name: Olsson Industrial Elec'
I Address: 1919 Laura Street
1 City: Springfield State: OR I ZIP: 97477
\ Phone 541 747 8460 Fax:541' 747 4846'
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I CCB licCl1s;: no.: 634.73 BCD license (ic : 20 - 241C
I S~gJling sllpCrvisol"s license no.: 3 3 3 4 S
,Print name of signing supervisor: DouQ'las Beer .'
I S'gnature olsigning sllPel~is~~/-1_ ~t"~
CONTRACTOR INSTALLATION
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I FEE SCHEDULE I
1 IQty,1 Cost Total I
NumbCI' of inspections pCI' itcm ()
I ClI, cost
1 I Rcsidcntial,pcr unit, service included: I
11,000 sq. ft. or less (4) $134.00 $ I
I ~lae~'~oatditional 500 sq. ft. or portion S 25.00 $ I
I limited energy (2) $ 32.00 $ I
I Each manufactured home or modular I
I dwdling service Qt. feeder (2) $ 63.00 $
I Services or fccdcr.~: illSwllmioll, alrcl"(uiol/. ndvcaliol/ I
I 200 amps or less (2) $ 81,00 S I
I 201 to 400 amps (2) $ 95.00 $ I.
I 40 I to 600 nmps (2) $158.00 $ I
I 60 I to 1,000 amps (2) $205.00 $ I
1 lOver 1,000 amps or VOIIS (2) .$4119.00 $ I
I I Reconnect only (2) I $ 63.00 $ I
I I Temporary scrvit.cs or fceders: ill.\"/{III(/(ioll. alwmficJII, reloc(lliclI/ I
1'200 limps or'less (2).___~h": -.:-- "1--:.-" '-'$'63'00'.' - $' .-1
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120Ito<l00n1l1t)s'(2):'---"~.--" -.--- _..:. ~5;-6'7'OO-''::$ -",_ --.~I'
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I <lOlIO'6()O-,iIl1pS-(2):--~ . --.-:- '-,~ .....~l-.. $126.00" --S' . ': -.1
lOver GUU limps or 1,090 volts, se~ services or feeders section ahove - I
I Branch circuits: IIcw,'alle}'(/lioll, e,\'lell.l'iOlJpaplll/el I
I I u. Fee for branch circuits with p'urchase of a service or feeder fee: I
I I Each branch circuit J 4 I $ 6.00 I ,$24.001
b. Fee lor branch circuils without purchase of n service or feeder fee: I
',First.bnlllciJ circuit (2).'. --1,-11 $ 55'001-$55.001
Each lldditional branch circuit ,I $ 6.00 S I
I
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Misn'lIalll'OtlS, fees: sel'1'ice orjef!der I/of ill,'llIded
EachpUlllp or irriglllion circle (2) $ 63.00 .$
Each s.ign~)I' OIillille_lig~l,tillg (2) .s 63.00 $
Signal circuit or a limited-encrgy pflllel, $ 63.00 $
ulleralion, or extcnsIon (2)
Each additional inspection: (I) $58.00 S
APPLICANT USE I
(A) Enter subtotal of above fees I
$ 79,00
(Minimum Permit Fce 558,00)
(8) ~J.lle.r 12Y" s~r~l.large (. 12 x' [A]) : l' $' 'q- 4 R' I
(C) Te-~I!!l~l?gy)-~cc (5%.of[A]) -,~- - -'-,-_. . ; S' ~-,~ ~1
.T~rr.~~ ~;" f.t't',~:.IU~ ~!,Sll J'C h 1lI'ges"(A-t h r~u gh q :;-- :.;,:;:"$,' 9 ,2 -; -4-3.1
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax ",~ .
541-726-3769 Inspe~iio.i' i.ine
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01652
ISSUED: 11/1312009
APPLIED: 11113/2009
EXPIRES: 05/13/2010
VALUE:
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Issued
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; SITE ADDRESS:'?':'{.:475 2~TH ST:,
ASSESSOR'S PARCEL NO.:;': i70pl0002300
Springfield TYPE OF WORK: Ele,ctrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Brancb circuits to control panels
Owner:
Address:
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, ARCi.INtJSAiiilc",\+; "
5865 MCL'AUGHLIN RD UNIT 3
MISSISSAUGA L5R IB8'
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I CONTRACTOR INFORMATION I
Contractor Type
Electrical
, Contractor
OLSSON INDUSTRIAL ELECTRIC
License
63473
Expiration Date
01/26/2011
Phone
541-747-8460
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BUlL?ING INFORMATION'
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# of Units: :,
Primary Occupancy, Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
,
# of Stories:
Heightof 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:
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I DEVELOPMENT INFORMATION I
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Frontyard Setba'cI<:" . ,. , :~, ;.
Side 1 Setback: ' ,
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Strcet Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:_,_
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, . ~ ' I PUBLIC IMPROVEMENTS I
Street Improvements: . Sidewalk Type: uires you to
, ' . "i'", ~' "" 0 eqon law reC) Tt
Storm Sewer Available:!," , ;;;;:. '. ATTENTiC'm;'tII~~'ioutSbD~il.iJJ{;Iregon Uti I y
Special Instruction: ' , follow rules a (jP'cT~ h~se rules are set forth
, . , Notification Center, hOAR 952-001.
NOTICE' In OAR 952-001-0g;~~h;~~i~S ofthe rules by
THIS pnllJ4JI..$J.. '.; _. _ 0090:YO~k~~.,~tll~1 (Note:tt1e t~le~ho;.'~..
AtJFHQRIZED' " \~~': k^rln:t..':. I!!L WOn . "'",,,,,. the Oregon uu"'y :\~iHiQl1
COJ1AMtNCED UNDER THIS PI;.WIW!!~~escriDtio""tnber~~ter Ia 1-800-a32-2a44l.
"\'ki ' OR IS ABANDONFD F.m~ '
, . . 'J~';' {' 80 D"W PERinf'. $Per sq'Ft Square Footage
DescnptlOn ,r Type of ConstructIOn It' \. B'd A Value
, or mu Ip lef or J mount
Notes:
Date Calculated
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225 Fifth S~reet;Springfield,pR'';c''
541-726-3753 Phone" ',:' .: '~,,'!'\\ ii!., ,
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541-726-3676 Fax' ..
541-726-3769 Inspection Line
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... Amount Paid
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee "
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Add, Alter, Extend Circ ". .., ';'
Add, Alter, Extend brc Ea Add ' ...
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,Total:Am(JlintPaid ,
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$9.48
$3.95
$55.00
$24.00
$92.43
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01652
ISSUED: 11/1312009
APPLIED: 11/13i2009
EXPIRES: 05/13/2010
VALUE:
Total Value of Project
Fees P3id I
Date Paid
Receipt Number
11/13/09
11113/09
11113/09
11/13/09
3200900000000000758
3200900000000000758
3200900000000000758
3200900000000000758
I Plan Reviews I
To Request a!1 inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.in. will be made, th~ same working day, inspections requested after 7:00 a.m. will be made the following
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. work day';' . "i;:',-r."'-r.' ' "(: " '
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Rellllirerl Tnsne~tions I
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Rough Electric: Prior to Cover
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Final Ele,ctri~; When all electrical work is complete.
By signature, I si~te;and agree, that I have carefully examined the completed application and do hereby certify that all
information he...~on is trne,and corr~ct, and I furthcr 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 Orcgon pertllining to the work described herein, and
that NO OCCUPANCY will be made of any structure withont permission of the Community Services Division, Building Safety.
I further certify that only contractors and employecs who are in compliancc 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 propcrty, and the approved set of plans will remain on the site at all
times during co~structio.n. i.
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Owner or Contractor~ Signature- "
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225, Fifth Street;;i';>\i .,-\, ". ,\.;
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Springfield, Or~gon 97477':"'\)::;;
541-726-3759 Phone'
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City of Springfield Official Receipt
Development Services Department
Public Works Department
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('.'.,RECEIi>t;#:' ,.' 3200900000000000758
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2:10:36PM
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Job/Journal Numberr'\:!~ D,escription
C01vl2009-01652 ::;.,. :Add,Alter, Extend Circ
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COM2009-01652~-'!,:t::;rlj'Ad~;'A!t~r, Extend Circ Ea Add
COM2009-0 1652 ;',' ':'+- 5% TecIIDology Fee
COM2009-0 1652 " .'+ 12% State Sutcharge
PaYlDents:
Type of Payment
Check
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JOLSSON INDUSTRIAL
'ELECTRIC
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Received By
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Page I of 1
Date: 11/13/2009
Item Total:
Check Number Authorization
Batch Number Number How Received
Amount Due
55,00
24,00
3.95
9.48
$92.43
Amount Paid
54001
$92.43
In Person
Payment Total:
$92.43
11113/2009