The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2010-3-2 SPRINGfIELO- ~b"';;;'~'" t.. 1~.' ' i't.;F:; .( ~:>4; < :"~ ':.? .. ........ t',.:u/",.. OREGON City Of Springfield 225 Fifth 8t Springfield, OR 97477 Phone: 541-726-3753 EmaiJ: permjtcenter@ci.springfield.or.us .. ;Y''.',,< D New Construction '. ",1YPEOF'WORIf ',,,: IRl Addition/alteration/replacement I D , CATEGORY OF CONSTRUCTION, D Multi-family [Xl Commercial o Accessory 1 or 2 family dwelling I, I JOB SITE INFORMA'nON'AND LOCATION.- Job Address: 1007 HARLOW RD City/State/ZIP: SPRINGFIELD, OR 97477 Suitelbldg.lapt,no.: Project Name: Cascade Endoscopy Cross Street/directions to job site: Tax map/parcel no.: 1703223300400 ',' "S" ~~7;";e:l", 'r;;;:' DEScglpTloNOF,WORK' ASC Fire Evac Work . SITE,C_ONJACT"';; .... Fax: . ;CONTRP,.~TOR;' Elec lie. no.: 20~552CLE CCB lie. no.: 165599 ,", Business Name: INTEGRATED ELECTRONIC SYSTEMS INC Contact: Address: PO BOX 708 City/State/ZIP: EUGENE, OR 97440 Phone: 5414854456 Fax: Email: acrowle ". ';';c, \':~<I~;; ~t:t~.~:.?!,~:,o,. m:. Metm Hc, no, THIS PERMIT SHAlt ~IRiJ Supe",','n9 EIAI~ ,1;\ Number of inspections included in paid services: Residential Service: 4 Reconnect Only: 1 All Other Services: 2 Upon review and approval by your local Jurisdiction, your permit will be e-malled or faxed within one bUSiness clay, wtth Inslructlons on howto sChedule your In specllon. NOTE: This Authorization To Begin Work expires within 180 days If a permit Is not obtained. The local building department may determine that an Authorization To Begin Work Is null and void lflt does not meetilppllcable lancl use laws and local ordinances. 6 IV. 248 Commercial Electrical Authorization To Begin Work 69600-BEL-10-00095 Approval Code: 066767 3/2/2010 11:52 am E-mailedTo:jen@iesyst.net .f '1."";" . ",':;:" PLAN.REVIEW' . ." . ').,', Please check all that apply: D Hazardous locations o A service or feeder beginning D A service or feeder rated at at 400 Amps where the 600 amps or more available fault current exceeds D Buildings more than three stor 10,000 Amps at 150 Volts or less 10 ground exceeds o Marinas and boal yards 14,000 Amps for all other o Floating buildings o Fire pumps D Commercial-use agricultural buildings o Emergency systems D Installation of a 150 KVA or o Addition of a new motor load larger seperately derived sys of 100 HP or more o "A". "E", or "1-2" or "1-3" o Six or more residential units in o Recreational Vehicle Parks one structure o Health care facilities D Supply voltage lor more lI1an 600 supply volts nominal ;,~t.":v!4, ,""; SCHEDUI!EI? '~: ." 1 Description I Qty, E.. I Total l;Imiteq Energy' . ~ "J. :~ , .;;: " , Stand-alone limited energy, 1 $58,00 $58,00 commercial Ejectriccll,J:!ermif F..ee~ ; ,.4",', ,,; '..'" .-.. -"'.':, Subtolal $58.00 State surcharge (12% of permit $6.96 total) Technology fee (5% of permit total) $2.90 TOTAL PERMIT FEE $67.86 ~\O- 2J1J5 ~ 3/21/10 ATTENTlON: Oregon law requlrGO you io iollOW rule9 adopted by the Oregon UtI~'%. Notl1lcatlon Center. Those NI'c;.=' =-001- In OAR 952-001-0010 through of th rules.... 0090 You may obtain copies e WN calilng the center. (Note: the telephonQ BlUmber for the Oregon UtIlity NotIficlatiOn Center 10 1-800-332-2344). ~ ~~Ily\\ '0- Cd. 1:)':-.0 ~~~ ~ Inspecfions Phone: 541,726-3769 This Authorization To Begin Work must be posted at the jo~ site until replaced by a Permit Status Issued ( CI-'FY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00265 ISSUED: 03/02/2010 APPLIED: 03/02/2010 EXPIRES: 09/02/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54 J -726-3769 Inspection Line SITE ADDRESS: 1007 HARLOW RD ASSESSOR'S PARCEL NO.: 1703223300400 Springtield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: ASC Fire Evac Work Owner: WILLAMETTE MEDICAL CENTER LLC Address: 541 WILLAMETTE ST #106 EUGENE OR 97401 Contractor Type "ow Voltage Electrical I CONTRACTOR INFORMATION . Contractor License INTEGRATED ELECTRONIC SYSTEMS 165599 BUILDING INFORMATION ~ Expiration Date 07/13/2011 Phone 541-485-4456 # of Units: Primary Occnpancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: AnENnoN: Oreg8W~ttequn. YVUIo ~OW rutes acIopted by the Oregon UtI""" otIficatIon Center. Those nllee are let ".T ao:; You may ObtaIn copies otthe rur:::; .I:Ithe.~. (Note: the telephone VlW ff/i' Oregon UtIlity NOI/fIclat/cM Down~OOibeOO-332'2344). ~;:en:y;;~h~YiC!: <3",,,,;:;;;;{ii;~.~verlay ~:::~ Rqd: Side 2 Setba'EMlS PERMIT SMALL EXPIRE ~~~~rive Rqd: Rearyard Sill<<<lItORIZED UNDER THIS PEnm.. o(Coverage: Solar SetbaOO:MMENCEO OR IS ABANDONED ....Ar.f:: . I P'UBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Tvpe of Construction $ Per Sq Ft or multiplier . Square Footage or Bid Amount Value Date Calcnlated Pa2e I of2 .,It \" ' ~',J~' '\ :1,' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00265 ISSUED: 03/02/2010 APPLIED: 03/0212010 EXPIRES: 09/0212010 VALUE: ',,' , , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Low Voltage - Commercial Indus Amount Paid Date Paid Receipt Number $6.96 $2.90 $58.00 3/2/10 3/2/10 3/2/1 0 1201000000000000191 1201000000000000191 1201000000000000191 Total Amount Paid $67.86 PHin Reviews' ~ ",.' 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 work day. LReouired Inspections I 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 will be made of any strnctnre withont permission of the Commnnity Services Division, Bnilding Safety. I fnrther 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 will remain on the site at all times during construc,tion. '.;f;; ."., "~.". , "I'; " . ,," Owner or Contractors Signature Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone iF., City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000191' Date: 03/02/2010 1 :06:35PM Job/Journal Number COM20 I 0-00265 COM20 I 0-00265 COM20 I 0-00265 Payments: Type of Payment ONLINE CHGS cReceintl Description Low Voltage - Commercial Indus + 12% State Surcharge + 5% Technology Fee Paid By ONLINE PERMIT CHGS Amount Due 58.00 6.96 2.90 $67.86 Item Total: Check Number Authorization Received By Batch Number Number How Received KR " ., ,i' . ;", Page lof I ~:""'; I Amount Paid ONLINE INTEGRA T Online ED ELECTRON ICS SYSTEMS Payment Total: $67.86 $67.86 3/2/20 I 0