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Home My WebLink AboutPermit Electrical 2010-3-19 CITY OF SPRINGFIELD Building/Combination Permit Status In Review PERMIT NO: COM2010-00298 ISSUED: APPLIED: EXPIRES: VALUE: 03/09/20 10 09/09/2010 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 110 INTERNATIONAL WAY ASSESSOR'S PARCEL NO.: 1703154000100 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition PROJECT DESCRIPTION: Electrical to back up generators in case of failure Commercial Owner: PACIFIC HOSPITAL ASSOCIATION Address: PO BOX 7068 EUGENE OR 97401 I CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor License BUILDERS ELECTRIC INC 4296 BUILDING INFORMATION ~ Expiration Date 12/1012011 Phone 541-485-0922 # of Units: Primary Occup.ncy Group: Secondllry Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrnoms: # of Stories: Height of Structure Type of Heat: Wllter Type: Rllnge Type: Energy Plllh: Sprinkled Bnilding: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Bllsement: Sq Ft Gllrage/Cllrport Sq Ft Other: OccUpllnt LUlld: Il/n . t"j.l'll'\t ENT INFORMATION l:tQ\\C~. ~II SI-\~\..\.. II-\ISI't: D fOI'\ Fronty.rd ~~tlf.8rl'\lltO \l~Otl'\ ~~~~OO~t: OverlllY Dis!: Side I Setb',c..'S:(I-\OI'\ CtO 01'\ IS # Street Trees Rqd: Side 2 Setb"c~~~t~ ({ \'t.I'\IOt). Pllved Drive Rqd: Rellry.rd Sell!~ff'\ '(\0 Dill % of Lot Cover.ge: Solar Setbllc~ . REQUIRED PARKING Tot.l: Handic.pped: Compllct: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Av.il.ble: Special Instruction: Description Tvpe of Construction Sidewlllk Type: ,1" ATTENTION: OregonD"'" '~~";-~",v"'.'D f " I . ownspoublUr....' o .ow ru es 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 COPi.es of the rules by I . '1.,ulIIb,,! _ ~r lnEjOregon Utility Notification . Valuation Desc~ 1-800-332-2344). $ Per Sq Ft Square Fuotllge or multiplier or Bid AmoLlnt Value D.te Clllculllted Notes: i;.. P.ee I of 3 Status In Review 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line do"~ ;:, ,le-,.' Total Value of Project ~ Fee Description + 12% State Surcharge + 12% State Surcharge + 5% Technology Fee + 5% Technology Fee Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Perm Serv/Fdr 401 to 600 amps Plan Review Electrical (25%) Amount Paid Date Paid $38.40 $45.84 . $16.00 $19.10 $192.00 $162.00 $190.00 $158.00 $80.00 3119/10 3/19/10 3/19/10 3/19/10 3/19/10 3/J9/10 3/19/10 3/19/10 3/19/10 Total Amount Paid $901.34 .. ., I Plan Reviews I Electrical Plan Review 03/0912010 Initial Review 03/09/20 I 0 03/09/20 I 0 APP LLH CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00298 ISSUED: APPLIED: EXPIRES: VALUE: 03/09/20 I 0 09/09/2010 Receipt Number 2201000000000000262 3201000000000000093 2201000000000000262 3201000000000000093 3201000000000000093 2201000000000000262 3201000000000000093 2201000000000000262 2201000000000000262 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. l....ReouiredJnsnections ~ Electric Service: Approval required prior to utility company energizing service. Rougb Electric: Prior to Cover Final Electric: When aU electrical work is complete. .'. ,_'. ".; .'\1' "'-'r: .. , . Page 2 of 3 CITY OF SPRINGFIELD . Building/Combination Perm~t Status In Review PERMIT NO: COM20IO-00298 ISSUED: APPLIED: EXPIRES: VALUE: 03/09/2010 09/09/2010 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and [ further certi(y tilat 'any and all work performed shall be done in accordance with the Ordinances of the City of Springtield 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 emlJloyees who are in compliance with ORS 701.005 will be used on tbis project. I further agree to ensure that all required inspections are requested at the propel' 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"construction. . ~tJ?-- 3-1'f-!V Owner or Contractors Signature Date ;!".: I.. "~'I_": ,r. . \ .,ii ,,' 'n; , . ":\" " . . Page 3 of 3 Electrical Permit Application ctfy OF'SPRINGFIEtii~ OREGON _:~; ~ y ':' - -" ... "'- .. -"};, . .. 225 Fifth Street. Springfield, OR 97477+PI-I(S41)726-3753+ FAX(541)726-3689 SPRINGFIELD ~ ~t~~. ~." '. DEPARTMENT USE ONLY p,' . . . Permit no.C A!) - 002'i(j Date; 3--//--- /0 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. .; .' ;[bCAVGOVERNMENT"AF1I"ROVA~~,,":\";;' :\1\: Zoning approval verified? 0 Yes 0 No y:~,.; ;..>~:,CATEGORY::'OF,:CONSTRUCTION\,'" . .,'. L. o Residential 0 Government ~mmercial ~,\i@~J()Bf;;SrfE~INF()RMATIONrANDmL:OC'AT<ION::,1g;<;;;g;P yo City; Phone; E-mail; This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479,560(1). Signature; . CONTRACTOR INSTALLATION CCB license no.; Signing supervisor's license no.: Print name of signing supervisor; Signature of signing supervisor: C-- 440-2584-) (9/08/COM) (I,'~ i"~7..r.tZ:#!\~:~\;;~<I~~1l1~~~*~;I:EE2d:S-GH ED.Q l5E~;~;~~~'!;&1i\~t~~it1\~\\~rJ:RJi'h;~~ . _', " ""'<',,-, 'T' '. ,', ,'., ..Cost 'I Total ,Number of inspeciio'ns per item (),.:, Q'iy. . . ': ~ ,-,",', . ".-' ,~;;"'" ..".t ';0', '- ,__',-t,._ " I -ea., c9st. Residential, per unit, service included: 1,000 sq, ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation. alteration, relocation 200 amps or less (2) '/ $ 81.00 $ /0-:0 20 I to 400 amps (2) $ 95.00 $ ~ 40 I to 600 amps (2) / $158.00 $/ <; 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: instal/alion, alteration, relocation 200 amps or less (2) $ 63.00 $ 20 I to 400 amps (2) $ 87.00 $ 40 I to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration. extension per panel a. Fee for branch circuits with purchase of a se'rvice or feeder fee: Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 55,00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder I}0I included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (1) $58.00 $ """'~~.y,.z'~'Wi'-f,t';"""~ARF'LItANt'{JSe';;-""""";":',,,", "'. ;'. ~\,Vci.'o"""'-':!S'_;f.. ~J ,~':i.4.'~'~~ _ ".' _ - -:{ ~i';:-.;.\: .l~.:,;':X~~:':f..'t'_ (A) Enter subtotal of above fees $J2C (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of [A]) $ TOTAL fees and surcharges (A through C): $.37" ~. oil ~o Electrical Permit Application -CITY OF SP'RINGFlEtn,:OREGON"<. '. " '" ~ '. . or . ~ -: 225 Fifth Street. Springfield, OR 97477+ PH(541)726-375H FAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nont days of issuance or if work is suspended for 180 days. '.' . . "I!.()C~VGOVERNMENT' P;~PROVAl?~,;\.::t'lj'i"i;~', Zoning approval verified? DYes DNo ", ::j'!:': ,,;~CATEGORY;~()F::CONSTRUCTION::)"'" , <fA' o Residential I 0 Government I 0 Commercial ~1t4riJ'&;jOB;;.SITE\,INF,bRI\II~TION:;AN[jr1I!.O_cAri()N~8i;j;ii Job site address: City: I State: I ZIP: Reference: I Taxlot: DESCRIPTION OF WORK':". ,,":',.,'.+:::' ,'. '~ 'PROPERTY OWNER . Name: Address: City: I State: I ZIP: Phone: - - I Fax: - - E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, This property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479,560(1). Signature: CONTRACTOR' INSTALLATION Business name: Address: City: I State: I ZIP: Phone: - - I Fax: - - E-mail: CCB license no.: I BCD license no,: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: (2IQ-- 2 <tf: 440-2584-J (9108/COM) t'2/!Q/ Date: 0 ransferable. Permits expire ifwo~t {rt(W~n rW ~;: '~P~{>-',;,;,;~~;:.~.;j!!'i~l';~~:;il,'!.:.:f%lFEE' ~dS'C(jefllll~E~:'iJ!:\)iiA"""j,:r.,q~I"'f:;;-';,\li\tl'~'~ ~'. " A~:_.~, . (~'\J,,'tilP,~i'l\'" .:}:,l;. 'i _ r.U:L1U L:.: ~';;.,i" r\";(f;f',\~!\',!."'" .'$)'t"f'\:-:. >~ . "" . ',',' ,.. ',~ Number of i;,;pectio'ris:peritem()..:. Qty. . 'n" ~" ,..,." .". ...."',..... ,~'" ....j...- ,". ~~_ '. ....-' Residential, per unit, service included: Cost .I"'ea.:~ Total cost 1,000 sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 40 I to 600 amps (2) $158.00 $ 60 I to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocqr,19n. 200 amps or less (2) II $ 63.00 $~ 201 to 400 amps (2) II , $ 87.00 ~ 401 to 600 amps (2) I $126.00 1%' ) fl1 Over 600 amps or 1,000 volts, see services or feeders sectio~ Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a se'rvice or feeder fee; Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee; First branch circuit (2) Each additional branch circuit $ 55,00 $ 6.00 $ ~- .- ~ Miscellaneous fees: service or feeder ~ot included Each pump or irrigation circle (2) Each sign or outline lighting (2) $ 63.00 $ $ 63.00 $ Signal circuit or a limited-energy panel, alteration, or extension (2) Each additional inspection: (I) $58,00 '$ J:{&!~iJ;.~~{Mf~Nf~~~'~f~A'R'~i1IC~Nt?1US"Et~~:f)"::':A~f:i;~3:::gI:.:6;~;~'t', ..:. , $ 63.00 $ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A]) (C) Technology Fee (5% of [AD TOTAL fees and surcharges (A through C): $ $ $ $ Ot' b(t9b'"JffOVtI I - tl/t:.."J p_~( UJ/~ tlo Of#t'f :-'~~;~'PM~/;' ;;,':,'; I - ;: dJ "^' ><: hv,p.. fo WI ct;. Jl.., "'-L"fI' '"........ (tOOIf~ S /-r"- ~'pM~/2-.,b t.-j7.} / - XFU1/l- 1<> /5"'01'/-""7 ;1MJ. . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone O;1:QF;~ Wit City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000262 Date: 03/19/2010 2:04:43PM Job/Journal Number COM20 I 0-00298 COM20 I 0-00298 COM20 I 0-00298 COM20 I 0-00298 COM20 1 0-00298 Payments: Type of Payment CreditCard cReceintl Description Penn Serv/Fdr 200 amps or less Penn Serv/Fdr 40 I to 600 amps + 12% State Surcharge + 5% Technology Fee Plan Review Electrical (25%) Paid By BUILDER'S ELECTRlC Received By NJM Check Number Batch Number . "jd: .ni. II . '\11 ,..; . ",' . Page I of I Item Total: Authorization Number How Received Amount Due 162.00 158.00 38.40 16.00 80.00 $454.40 Amount Paid 024162 In Person Payment Total: $454.40 $454.40 3119/20 I 0