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Home My WebLink AboutPermit Electrical 2005-5-18 , !, CITYbF ~ ).INGFIELD~ OREGON' " SPRINGFIELD l^~ ~~~ 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number COM 2.o0S - CO 17 L/ Date S - I~ - D f:.. , ~ -"<5> . --~, 3.!' COMftE.l"EF~E sc~o --"~-B-":fOW -:t-~ ", '--_ - --c:L.. ~ ~/Ql.,o-"~ "'9.....(5) . Q,::..o,.. -'~:: --=",=-----r"- ~,"0:--..... -:r"~'= ..~-o -9:-- .--,<-c-', . ~~- -0':,"'- ~ .+' ~--'-'..- 0010 l A. !:New Residen~iaF!,~i~ e_o9:>.MUltf~IY per'ilwelli..'.!gunit, . ""0' ....tJ-',........ ~ ServIce Included~, "Q "6..... ~., ~;, ..~. 1000 sq, ft. or less "~, " \106,00 Each additional 500 sq, ft. or "~' . "C),:~"'" portion thereof . f'1(~ o "0' 04< . Permits are non-transferable and expire if work is Each Manufact'd Home or Go",o"", .. not started within 180 days of issuance or if work is Modular Dwelling Service or . 000" ~ Suspended for 180 days. Feeder'" . 2. f CV..zvTit4.CTOR INSTALIATIOf'l ONLY I Vlllh~a~~~e~,lter~on Electrical Contractor /-1. .ELc!dnc.. fNL..pollotlfl~cae.r&.~ bv thG ,Oregon Utl1itv. $ 63,00 /2.1. .DD -:- Ii\! . sa IU es are s". ;&u. /nOAR ~~~ 8&hOAR952--;;Cl- $75.00 Address f.1). 8o'i.. 73(,5" 0090. \'6~~ c'diWls olthe ruJc~ I.>y $125.00 caflin~l!f1~rlO(l<lM.Plhe teleph~M $163.00 City B{ND . OL Phone '~~D~-451-1~b~1009~~lityNotificati~.. $375,00 , ~-llP\1IEOO-332.2344). $ 50.00 , _7~. ~ .~.~. ....".,., -"'f'-.". 1. 1:.!i0CATION OF1NST_4 r L4.T10N, Z6S"f:, O(oyw1.l'. L ~ -\- 17 01 z. '5'( I LEGAL DESCRIPTION ~!,~" O\"....oi~ sf. JOB DESCRIPTION SOlll...118~ ." q7477 /IE "J /~ J4"1P St!fU,~ ~ C/,4t(#O~.(. Supetvisor License Number 418 4 S . Expiration Date Je. b I - b 7 . Constr. Contr. Number /4 5 41!lCjll. Expiration Date &, . 3() - (J(, li[o,,;t:~.. Owners Name vi )-\2-Q.CnV w, ('('Bt:-fLL'f Address 1t(C6~-\ Sf:: 8'Z......L ~A.. City cJA-c..~~ S Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 " \ , c. l temporary Services 9r,Feeders Installation, Alteration or Relocation 200 Amps or less $ 50,00 201 Amps to 400 Amps $ 69.00 40 I Amps to 600 Amps $ 100.00 ~veti~~~~S or 1000 Volts se..e '::'B" abov.",__ __ D. L!~~'!'<l' Pii.~~!!L~' !)J:!8LLEXElBEJE...tHE...WQl1J< New4AiW~ml\l\ifJi~~'rt~ignTp~i3PlliflMIT IS NOT On&ilMit1ENCED OR IS ABANDONED F$I!I3.00 Each~a&itiBBareitdti18Jl M[th Setvice or Feeder Permit , I J $ 3,00 E. : "Miscellaneous (Ser.Yi~e/feeder not illcl~ded) ..,E.ch.}nstallatio~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is 545.00 + Surcharges 4. f Sv:B'1'OTAf. OF:ABOvE _ .I. \ 'l..l. _I!lO 887 12bD /1.{7 t{~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:YBuilding FonnslElectrical Permit Application 1"()3.doc . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2656 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1703254100102 . \...11 r OF ~rK11'ilj1<lJ!.LD Building/Combination Permit PERMIT NO: COM2005-00I74 ISSUED: 04/19/2005 APPLIED: 02/14/2005 EXPIRES: 11/16/2005 VALUE: $ 13,057.00 Springfield TYPE OF WORK: Cell Tower - Communication Tower TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Antenna collocation. Contractor PACIFIC TELECOM SERVICES WIRELESS ALLIANCE INC 146700 Oll10/2007 K T ELECTRIC INCATTENTJON: OrAnnl'll",J~~R.M' _.. A. 06/30/2006 l:iilJiiritN('; 'fNF6RM'Alfw.tt.fegO'; UtilitY I, .!!,'.I!IH.f..lIfJf. mU"lHUles are setforth In OAfjj gpgcCilMJOl 0 through OAR 952-ochQt Size: 0090. ~efglll1oUS!l:daiD~pies of the rules ,$.\I Ft 1st Floor: call~flni:r. (Note: the telephoneS'q Ft 2nd Floor: num!wlrtbtT~~regon Utility Notificatio,..sq Ft Basement: Ra6'ge~~ 1-80Q-332-2344). 'Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: Owner: WARREN WIMBERLY M Address: 14855 SE 82ND DR CLACKAMAS OR 97015 Contractor Type Applicant General Electrical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I CONTRACTOR INFORMATION I License Expiration Date Phone 206-464-4412 503-582-9938 5413890660 U VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS J I\U"V". S'd IkT THIS PERMIT SHALL EXPIRE I~ ~'Mat w~~<<R AUTHORIZED UNDER THIS p!>.q",.'.'~p.<!JI!~lprains: COMMENCED OR IS ABANDONED FOR ANY 160 DAY PERIOD, Paee I of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Tvpe of Construction Estimate Fee Description Plan Review CommlIndlPublic + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 100/0 Administrative Fee + 7% State Surcharge Building Permit Plan Review CommlIndJPublic Plan Review Minor - Planning SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement + 10% Administrative Fee + 7% State Surcharge Perm ServlFdr 200 amps or less Total Amount Paid Fire Department Review 02115/2005 . . CITY VI' ~rKll'll."'~LD Building/Combination Permit: PERMIT NO: COM2005-00174 ISSUED: 04/19/2005 APPLIED: 02/14/2005 EXPIRES: 11/16/2005 VALUE: $ 13,057.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 13,057.00 Total Value of Project F pp('. tIiII.I Amount Paid Date Paid $69.81 $4.90 $3.43 $43.00 $6.00 $13.86 $9.70 $138.60 $20.28 $59.00 $0.21 $3.45 $0.78 $12.60 $8.82 $126.00 2/14/05 3128/05 3128/05 3128/05 3/28/05 4/19/05 4/19/05 4/19/05 4/19/05 4/19/05 4/19/05 4/19/05 4/19/05 5/16/05 5/16/05 5/16/05 $520.44 I Plan Reviews I 03/14/2005 OK GRG Initial Review 02/15/2005 02/15/2005 APP SKG Plan nine Review 02/15/2005 02/1 5/2005 APP EMM Public Works Review 02115/2005 02/2512005 APP SB Structural Review 02/15/2005 02124/2005 WE JMP Structural Review 03/18/2005 03/1812005 10 JMP Structural Review 04/08/2005 04/0812005 10 JMP Paee 2 of 3 Value Date Calculated $13,057.00 $13,057.00 04/08/2005 Receipt Number 2200500000000000t65 1200500000000000379 1200500000000000379 1200500000000000379 1200500000000000379 2200500000000000445 2200500000000000445 2200500000000000445 2200500000000000445 2200500000000000445 2200500000000000445 2200500000000000445 2200500000000000445 1200500000000000625 1200500000000000625 1200500000000000625 Plan Review: Addition of antennas to existing tower. Job #COM200S-00174. Plans appear to meet code requirements. SDCs added ($4.44) See 5 structural comments faxed to Sean Bell. WE. Received response from Curtis Holloway to Item 2 of comments. WE. Sean Bell emalled contractor and cost/value data. . . CITY OF ~rKll~ld'lELD Building/Combination Permit PERMIT NO: COM2005-00174 ISSUED: 04/19/2005 APPLIED: 02/14/2005 EXPIRES: 11/16/2005 VALUE: $ 13,057.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 04/13/2005 04/13/2005 APP JMP Received fax from Sean Bell addressing the 5 structural comments. 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 Renuired InSDf'ctions I Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Final Building: After all required inspections have heen requested and approved and the building Is complete. Rougb Electric: Prior to Cover Final Electric: When all electrical work Is complete. Electric Service: Approval required prior to utility company energizing service. 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 1 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 witbout 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, tbat 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. Owner or Contractors Signature Date Paee30f3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00174 COM2005-00174 COM2005-00174 I :Payments: Type of Payment CreditCard 5/16/2005 . RECEIPT #: "'~_GI'IllLQ " ~'.', ""~"'.'.'." ,.,.,..-"',.,".'. 1 ' , "I-'~ I .~~.~_ . ~f'- ; ...:.ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000625 Date: 05/16/2005 Description Perm ServlFdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Paid By KT ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 003358 In Person Payment Total: Page 1 of I 8:29:47AM Amount Due 126,00 8.82 12.60 $147.42 Amount Paid $147.42 $147.42