HomeMy WebLinkAboutPermit Electrical 2010-4-15
Elerirical Permit Application
DEPARTMENT USE ONLY
225 Fifth Street+Springficld, OR 97477+PH(541)726-3753+ FAX(S41)726.3689
Penrutno.: (10-00 '-( 57
CITY OF.S;Ir~'~NGFIELD, OREGON
Date:
t.f-I J- -10
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.
LOCAL GOVERNMENT. APPROVAL. ". .
Zoning approval verified? 0 Yes 0 No
; . . CA17EGORY: OF CONSTRUCTION
D Residential I D Government I ,a:Commercial
JOB SITE INFORMATION AND LOCATIOIll 1,000 sq. ft. or less (4)
../-- \, . 0 "h Each additional 500 sq. ft. or portion
Job site address: LlDD J..(lt'l rt1(',LTlOYltl IA' \f\ thereof
City: ~ni f f1 0. +lD .Cr,11 State: 0 Q ZIP: qllr-r Limited energy (2)
SubdivisioJ: JIO~ /S'{u I Lotno.:COSOC Each manufactured home or modular
~ , ". . "DES'CRIPTION 0F"WORK"""'''''"''''';',,,, ",:'j dwelling service or feeder (2) _
C / L 0 ,~-' r-,;-...... 1." ,.- 01 II"~ f\/""\ Services or feeders: lflstaflatlOn, alterallOll, relocatlOn
:f/O \XI "'l,y\()'L f-iY~ rt(",],y \
S~, stT vi/) I iA / .n-f ~fh () <1 200 amps or less (2) $ 81.00 $
,'c>. " ....,.. PROPERTY OWNER I ~{j&~(2) $ 95.00 $
Name J/Jk./n ,J'.;'{vt'l r ,MOVI1 Lb~o" la \~ :If%W~WA ) $158.00 $
Address rO ~O.x 7S~~:.~~sadopte~;o e UillSft<~, ~f2) $205.00 $
City: t::lA~E StatPr~I\~:~J.\KllI'f~fp\\, ~l ~( <l_~volts (2) $469.00 $ j
Phone: - - I Fax: I" Op..'j',.J!:'~~a'/ obtal"ll ~~ ~.Rt\<i~.~l1R~li... $ 63.00 $ --j
E-mail: OO'd~;Ii"Q the ce"';::;e9 " jromp.!>U6' services or feeders: installation. alteration, relocation;
This installation is being made on residenti"hlllrtlloll!1J\tlu>efl}s ~_B~O """" amps or less (2) . $ 63.00 $ -'
owned by me or a member of my immediate family. \Pllg' 201 to 400 amps (2) , $ 87.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). 401 to 600 amps (2) $126.00 $
. , 'FEE .SCHEDULE"
Nu,!,ber of inspections per item () Qty. ,
, .'j
Cost Total
ea;" cost
.
Residential, per unit, service included:
$134.00
$
$ .25.00
$
$ 32.00
$
.
$ 63.00
$
Signature:
Over 600 amps or 1,000 volts, see services or feeders section above
-.
CONTRACTOR INSTALLATION. Branch circuits: new, al/eratioll, ex/elision per panel
Business name: OrYl Li rI 11 Yl rI S, D l fl J 1~ a. Fce for branch circuits with purchase of a service or fceder fee:
Address: IS I S. l1 ,., ~-+-"--e {1 - 0 Each branch circuit $ 6.00 I $
City: ~(t' ()o..A i { ,..( State:()t2 ZIP: ::},Ll--r:l b. Fee for branch circuits without purchase ofa service or feeder fee:
gl!n~e::;::!)q.\-:-,tL\~-=l.JS:!,,~a$: <;=::JJ I ,:="']tJ\ - D-::J...l( First branch circuit (2) $ 55.00 $
E.mail: t-.i "'" (9)( I, v-.(j nln ,;rv{?'",)/ Yl ill ",)I ~CMach additional branch circuit $ 6.00 $
CCB license no.:Wi?D I BCD license no.: J Miscellaneous fees: service or feeder /lot ineluded
Signing supervisor's license no.: L\ l\ rfF, l btt- Each pump or irrigatio~,sl~~l~~'~t.);,i;JA~~:~?! ;;.~u $;63.00
Print name of signing supervisor: , J\ f tCl/\f1,J1 {fa. '~6<- ';-1 ,~E.!)ch'~~n or outline lighting Ok i\\'t. N'::, ,.$ '.'63.00
. .. . _ 'l L ^ Jn1 ~ /1 - .. 0 ~\'tr.iaTciITu8. ~~..a :.:'
SIgnature of slgnmg supemsor'-'\T,.1" /'1, .I 1.. \~ l ;Jf"ll!WI'iXoM!'He\u-~',:> ':::~~'~ Qr' $.63.00
~ I 'j \'rIh~~i I 1J $58.00 $
P. . ~ f>,\llr,~n>,\-\C't\l v' ~""'f>L1CANT USE .'" .,
- ~ ~'" ~.y' ....0 C. ~4\l\ ~tt1 !?h\t~t;jl of abovcfees. -
,,~ t'V.. .' V I'" '(Miuimum Permit Fee $58.00)
'V ",a -' '~~~ (B) Enter 12% surcharge (.12 x [A])
~ (C) Technology Fee (5% of[A])
,yo TOTAL fees and surcharges (A through C):
$
$
$u3 -
.
$ (j3.< 0
$ /,e=::,/r,.
$ ~.\s;-
$1;:2.,./1
440.2584,J (9!08/COM)
CITY OF SPRINGFIELD
Building/Combination Permit
Status
In Review
PERMIT NO: COM201O-00437
ISSUED:
APPLIED:
EXPIRES:
VALUE:
04/07/2010
10/15/20 I 0
$ 100,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 400 INTERNATIONAL WAY
ASSESSOR'S PARCEL NO.: 1703154000500
Springfield TYPE OF WORK: Tenant Infill
TYPE OF USE: Addition
PROJECT DESCRIPTION: Tenant Improvement - snite #160: Meeting/ Banqnet Room
Commercial
Owner: HAWES INVESTMENTS LLC
Address: PO BOX 7548
EUGENE OR 9740]
I CONTRACTOR-INFORMATION ~
Contractor Type
Electrical
Fire Contractor
Contractor License
OM LID & SWINNEY FIRE SPRINKLER 62730
OMLID & SWINNEY FIRE PROTECTION 62730
I BUILDING INFORMATlON~
Expiration Date
12/]5/2011
12/15/20] I
Phone
541-741-1775
54]-741-]775
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
]
A2
B
IlB
# of Stories: I Lot Size:
t, r!"!:I~~~Af ~r~!mtaw requireS you.toSq Ft 1st Floor: 1,976
;',iir)J;y~m!!!1:!Il~ted bfOk1a.ID~cm.!)tiI~ Ft 2nd Floor:
1'lotijl~)j~i\5~ b'mler. Those rule~~,lI@tfo Ft Basement:
O~"Y.lll!-W~~<tl01 0 through OAR 952.00 ~ Ft Garage/Carport
~090!'.ro(g~bbtain copies of the rules ~ Ft Other:
call\l1gq,""d~~oidk!ote:.~he ~~ccupant Load: 109
..w",b8f~lhl ~
I DEVELOI'GtlMeI'@lN)~I~. ,
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot c,overage:
Total:
Handicapped:
Compact:
. "'it.;,
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Sidewalk Type:
, ~ ",<,:,;\:<,.'(,.~,;~t:-;,~;-ii~~:'~,::~,y' .
NOTICE: .' "m"';iisp6HEYl~Rk
THIS PERMIT SH~Di~ ~~~~J~~IT 'S NOT
AUTHORIZED UN NED fOR
; ;"COMMENCED OR IS ABANDO .' .,
. ';:i:ANYt;80 DAY PERIOD. .... .... .
i
Pa2e I on
CITY OF SPRINGFIELD
Building/Combination Permit
Status
In Review
PERMIT NO: COM2010-00437
ISSUED:
APPLIED:
EXPIRES:
VALUE:
04/07/20 to
10/15/2010
$ 100,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
I Valuation Description ~
$ Per Sq Ft Square Footage
or mult'~~,i:ier,.l~' or Bid Amount
Value
Date Calculated
..: Total Value of Project
~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Traffic Signal - Panel
Amount Paid
Date Paid
Receipt Number
$7.56
$3.15
$63.00
4/15/10
4/15/10
4/15/10
2201000000000000360
2201000000000000360
2201000000000000360
Total Amount Paid
$73.71
I Plan Reviews I
Fire Department Review
04/07/20 I 0
Initial Review
04/07/20 I 0
04/07/2010
APP LLH
Extend existing fire alarm system in
tenant space by Omlid and Swinney
Plan nine: Review
04/14/2010
04/14/20l0
APP EMM
To be used as in attached
description as a conference room for
the primary use. No expansion of
existing or proposed secondary uses
shall occur in this space
(SDC3.2-415(8)).
, ti.;{
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.
UenlliredJnsnections ~
Low Voltage: Prior to cover.
..
,.j:
l~\! .;
!. Pa2e 2 of 3
'.
~~I'
CITY OF SPRINGFIELD
Building/Combination Permit
Status
In Review
PERMIT NO: COM2010-00437
ISSUED:
APPLIED:
EXPIRES:
VALUE:
04/07/2010
10/15/2010
$ 100,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 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 occur ANCY will be made of any structure without permission of the Commnnity Services Division, Bnilding Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 further agree to ensure that all required inspections are requested at the proper time, that each address is readahle 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 construction.
.....).:
Owner or Contractors Signature
Date
'\
",.'..::,
Paee 3 01'3
225 Fifth Street
Springfi'eIO, Oregon 97477
541-726-3759 Phone
if'
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #: 2201000000000000360 Date: 04/15/2010 11:21 :54AM
Job/Journal Number Description Amount Due
COM20 I 0-00437 Traffic Signal - Panel 63.00
COM2010-00437 + 12% State Surcharge 7.56
COM2010-00437 + 5% Technology Fee 3.15
" Item Total: $73.71
Payments: , Check Number Authorization
Type of Payment Paid By Rece'ived By Batch Number Number How Received Amount Paid
Check OM LID AND SWINNEY djb 39801 In Person $73.71
Payment Total: $73.71
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cReceintl
Page I of I
4115/2010