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Home My WebLink AboutPermit Electrical 2005-1-5 1. <2-? S 5' Yo LAt~"\) ~ f....-J ~ , . LEGAL DESCRIPTION t\.O '-:s 'i..-l\- ~ ~ 6 '2 ?-66 JOB DESCRIPTION \N. \, \2-€- ~\ L E \2..-. Permits are non-transferable and expire If work Is not started within 180 days of Issuance or If work is Suspended for 180 days. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modu]ar Dwelling Service or Feeder $106.00 $ 19.00 $50.00 2. Electrical Contractor 01~b, B. 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps 14~-4~S~ \)~'*' Over 1000 AmpsNolts S:- ~ ~\)'\Reconnect Only ~ ,\y:: ~ \S Supervisor License Number 4 <615 .~x.._c."'~\ <.,,\)~. \,.1'-' c... '( v ....\\..v ,\- -<..0'-;) <\\)\" Expiration Date (0 . l ,.,.l,'&<;;;;~ " _ ~~v ~.,~~~' ~'f::-' v\~~\)\S ~'Q\ Constr. Contr. N~Tb~[ Q<[~'\~\I ~f\~ <>,C\\)' " \0-~ ,<Fi$'-\~\j~~ \ ~\,.~' ExpIration Date ~\J\ ~Sh.~.;h~f; '$\'<' ~'\J S. f S . . \J .E1'l \. . Ignature 0 upervlsmg~~ eetnclan C~ Owners Name ~cl.. )'4u...u.t~= Address lor 0 /V- ell.. p-tO $ 63.00 $ 75.00 $125.00 $]63.00 $375.00 $ 50.00 Ci ty ? t; tV 1 nl..(:z.v OWNER INSTALLATION Phone $ 50.00 $ 69.00 $ 43.00 $ 3.00 '('3 ~ ol. '1- The installation is being made on property I own which is not intended for sale, lease or rent. $ 50.00 $ 50.00 $ 25.00 $ 45.00 Owners Signature: ".,;1 () A@ 1..1 \ 4. 7% State Surcharge 10% Administrative Fee 4-<'0,00 '3 \ ?. 'Z-. 4: " (p<:::> .s~,e"C- TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-03,doc Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01490 ISSUED: 01/05/2005 APPLIED: 12/06/2004 EXPIRES: 07/05/2005 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2355 YOLANDA AVE ASSESSOR'S PARCEL NO.: 1703244402200 Springfield TYPE OF WORK: School TYPE OF USE: Alteration Public PROJECT DESCRIPTION: Boiler replacement. Owner: SCHOOL DISTRICT #19 Address: 525 MILL ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Architect General Electrical Contractor SOLARC LEBANON SERVCO INC J K GUCKENBERGER ELECTRIC INC License Expiration Date 40395 45129 10/22/2006 04/24/2006 Phone 541-349-0966 541-451-5090 541-746-4656 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # 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: E-l n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pafe 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2004-01490 ISSUED: 01105/2005 APPLIED: 12/06/2004 EXPIRES: 07/0512005 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation DescriDtion I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 50,000.00 Value Date Calculated Description Total Value of Project $50,000,00 $50,000.00 12/06/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlInd/Public $240.92 12/6/04 1200400000000001698 Plan Review Fire & Life Safety $148.26 12/6/04 1200400000000001698 -Mechanical Issuance Fee- $10.00 12/17/04 1200400000000001758 + 10% Administrative Fee $45.17 12/17/04 1200400000000001758 + 7% State Surcharge $31.62 12/17/04 1200400000000001758 Boiler/Comm Over 50 HP $75.00 12/17/04 1200400000000001758 Building Permit $370.65 12/17/04 . 1200400000000001758 Refund - F & L Plan Review $-148.26 12/17/04 VOUCHER # 84786 Vent Fan $6.00 12/17/04 1200400000000001758 + 10% Administrative Fee $4.60 1/5/05 2200500000000000014 + 7% State Surcharge $3.22 1/5/05 2200500000000000014 Add, Alter, Extend Circ $43.00 1/5/05 2200500000000000014 Add, Alter, Extend Circ Ea Add $3.00 1/5/05 2200500000000000014 Total Amount Paid $833.18 I Plan Reviews I Initial Review 12/07/2004 12/07/2004 APP SKG Structural Review 12/07/2004 12/10/2004 WE JMP Jack Yousey submitted 4 page addendum #1. Still waiting for contractor and cost/value data. Structural Review 12113/2004 12/13/2004 10 JMP WE. Received 3 pages of Addendum #2. Structural Review 12/15/2004 12/15/2004 APP JMP Received general contractor data and verification of cost/value. SUB Review 12/07/2004 12115/2004 APP JF 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Pafe 2 of 3 _sP..,...,"..'.."...,. iij, _.___-'... WiL. Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01490 ISSUED: 0110512005 APPLIED: 12/06/2004 EXPIRES: 07/05/2005 VALUE: $ 50,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any 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. _/ C< ~ tM.JOf. , _ 't1 ;'n~tors Signatnre \ /s.hs Date Pae:e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone .rob/Journal Number COM2004-0 1490 COM2004-0 1490 COM2004-0 1490 COM2004-0 1490 lPayments: Type of Payment Cash 1/5/2005 RECEIPT #: r:ty of Springfield Official Receipt lelopment Services Department Public Works Del!artment 2200500000000000014 11:10:13AM Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By JOHN SARACENO Date: 01105/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received Jrnp In Person Payment Total: Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82 '. 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