HomeMy WebLinkAboutPermit Electrical 2007-7-9
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COMPLETE FEE SCHED ULE BELOW
225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number 6.01V\2:00 7-oa L/br
1. LOCATION OF INSTALLATION:
LlI v--.' \ . .. ..
~~~~
LEGAL DESr.RTPTJON.~
1703 'Z2..D 0
JOB DESCRIPTION:
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I......
\J 01 tL~ ~ C.01eJAL<</
Permits are non-transferable and expire if work~
not started within 180 days of issuance or if work is
Suspended for 180 days.
A. New Residential- Single or Multi-Family per dwelling unit.
Service Included
1000 sq, ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$ 21.00
$55.00
2. CONTRACTOR INSTALLATION ONLY B. Services ,or Feeders - Installation, Alterations or Relocation:
Electrical Contractor--l I c.- l.1Jffi..~~ c..~~mps or less $ 70.00
201 Amps to 400 Amps $ 83,00
401 Amps to 600 Amps $138.00
601 Amps to 1000 Amps $180.00
Over 1000 AmpsNolts $413.00
Reconnect Only $ 55.00
Address Lb3 [)
City~
to. POvYlLAv L
Ph'one {d6q 2r.dSO
Supervisor License Number 3?fJL ct. ( (:K
If;/I' If) &;
i/",-/ (, , I ~'j /&l?l/ Y
Constr. Contr. Number /n6-:. J 1,7T-.
Lilli/oil
- j /
g;;;1~iw;~c/
Owners Name ?c7\ce-(~l.f-l
Address ---=:PO 6' 6 ~
City 6cG-6l/c'
Expiration Date
Expiration Date
f47 ')
l''''''~
C. !;Tempor-!lry S~r~fe~ or Feeders
~~=a;A[l~ IFTH W~/;lK
20~m WI::; ~tKiVI~I~~~T
40lClJaI~ IS,~~AN[l)(H\ltU-~j\.OO
ov~1tlHUr<ftl~8ee "B" above.
.' .,~ v _ _m .
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
E. Miscellaneous (Service/feeder not included) -Each Installation )
~"::' 4
. . ~'P~~p or irrigation $ 55.00
Sign/Outline Lighting $ 55.00
OWNER INSTALLATION Limited EnergylResidential $ 28.00
The installation is being made on property I own which Limited Energy/Commercial t $ 50.00 <::,0
is not intended for sale,~. . .~.. ....'.. ,..:0. ..~.5..."'." ~.' ~...... "'~' lee<ct.r. ic. Pe. rm.......it Ins.p. ec..tio.O Foo is $50.00 + Sonh.<'g"
Owners Si ature: f@iji~ [f@OOO ~~@)d ~ ~~:"~TALOpA]OYE; ,. S-0
gn ~~~~=~:~1~~OM' 0 ~S~;ch~;~~-H~_~_._~m... - l{
@ijOO. ~m~@~~TH~@~~of~~nistratiVe^Fee ,', 5.
~mQ'ij~ h @Q~. ~GI:!.ht~~chnology Fee VSo
mw~\l@Il'~@<<)f@@~~~~~ / /'';-0
Inspection Request: 7tb-3109-tOO~~8' l@ 1~~). TOTAL "C;f----
Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07,doc
Phone
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-00469
ISSUED: 06/29/2007
APPLIED: 03/3012007
EXPIRES: 01106/2008
VALUE: $ 29,769,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3355 RiverBend Dr
ASSESSOR'S PARCEL NO.: 1703220000902
Springfield
TYPE OF WORK: Medical Office
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Northwest Specialty Clinic
Owner: PEACEHEAL TH
Address: PO BOX 1479
EUGENE OR 97440
I CONTRACTOR INFORMATION I
Contractor Type
Architect
General
Low Voltage Electrical
Contractor
ROLAND UDENZE
THE HASKELL CO A FLORIDA CORP
TTC COMMUNICATIONS INC
License
Expiration Date
147733
164114
05/11/2009
04/11/2009
Phone
904- 791-4801
904-791-4674
541-689-2650
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
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 1st 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
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction: '
NOnCE:
Notes: THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Sidewalk Type:
Downspouts/Drains:
ATTENTION: Oregon law requIres you to
fof/ow rules adopted by the Oregon Utility
Notlfloatlon Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001.
0090. You may obta'n copies of the rules b
oaflfng the oenter. (Note: the telephone .,
number for the Oregon Utility Notification
Center is 1-80Q.332-2344).
Paee 1 of 4
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Estimate
Fee Description
Plan Review Comm/Ind/Public
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Building Permit
Deposit
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Low Voltage - Commercial Indus
Total Amount Paid
Plan Review Comments
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-00469
ISSUED: 06/29/2007
APPLIED: 03/30/2007
EXPIRES: 01106/2008
VALUE: $ 29,769,000.00
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
29,769,000.00
Value
Date Calculated
Total Value of Project
$29,769,000.00
$29,769,000.00
06/19/2007
~
Amount Paid Date Paid Receipt Number
$2,268.92 4/2/07 2200700000000000472
$9,698.99 6/29/07 1200700000000000842
$4,849.50 6/29/07 1200700000000000842
$7,759.19 6/29/07 1200700000000000842
$96,989.90 6/29/07 1200700000000000842
$25,715.32 6/29/07 1200700000000000842
$60,930.94 6/29/07 1200700000000000842
$38,795.96 6/29/07 1200700000000000842
$10,201.75 6/29/07 1200700000000000842
$13,418.47 6/29/07 1200700000000000842
$10.00 6/29/07 1200700000000000842
$122,046.85 6/29/07 1200700000000000842
$122,046.85 6/29/07 1200700000000000842
$1,812.30 6/29/07 1200700000000000842
$33,226.08 6/29/07 1200700000000000842
$353,019.54 6/29/07 1200700000000000842
$80,024.23 6/29/07 1200700000000000842
$5.00 7/9/07 2200700000000001095
$2.50 7/9/07 2200700000000001095
$4.00 7/9/07 2200700000000001095
$50.00 7/9/07 2200700000000001095
$982,876.29
I Plan Reviews I
06/29/2007
10
LLH
Check dated 6/26/2007 from Haskell
exceeded the current amount due on
the project. I have requested the
amount placed in the deposit
account today (6/29/07) $25,715.32
be returned to the payee as soon as
possible. Information forwarded to
Kaye Wilson. I1h
Paee 2 of 4
CITY OF SPRINGFIELD'
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-00469
ISSUED: 06/2912007
APPLIED: 03/30/2007
EXPIRES: 01106/2008
VALUE: $ 29,769,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Public Works Review
06/27/2007
06/14/2007
APP JLP
Entered SDC fees based on DFU
calcs in memo provided by CLAIR
dated 6/8/07 as direCted by Ken. JU
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.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Roofing: Prior to installing any roof covering.
Masonry:
Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to
City Building Inspector.
Roof Sheathing/Nailing: Before covering sheathing with finish material.
High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection
results to City Building Inspector.
Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Site Inspection: To be made after excavation but prior to setting forms.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are ins~alled.
Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector.
Provide results to City Buiding Inspector
Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector.
Final Fire Department. After all requirements of the Fire Department have been met.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Grading: After gravel is in place but prior to placing concrete.
Final Paving: After paving is complete.
Rough Plumbing: Prior to cover and including required testing.
Pae:e 3 of 4
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00469
ISSUED: 06129/2007
APPLIED: 03/30/2007
EXPIRES: 01/06/2008
VALUE: $ 29,769,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 structure without 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, 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 4 of 4
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00469
COM2007-00469
COM2007-00469
COM2007-00469
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001095
Date: 07/09/2007
Description
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
TTC COMMUNICA nON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 872015 In Person
Payment Total:
Page 1 of 1
8:23:36AM
Amount Due
50.00
2.50
4,00
5,00
$61.50
Amount Paid
$61,50
$61.50
7/9/2007