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Home My WebLink AboutPermit Electrical 2010-7-12 C/() ,QZ3 Commercial Electrical Authori~ation To Begin Work 69600-BEL-10-00322 Approval Code: 663034 7/12/2010 2:09 pm E-mailedTo:deborah.perdew@christenson.com ~,- ptAi,FREVH:wFC City Of Springfield 225 Fifth 5t Springfield, OR 97477 Phone: 541-726-3753 Email: permitcenter@ci.springfield.or.us D New Construction [Xl Addition/alteration/replacement r _ _' _'~:-;_~_~-;1:{~S:;AT:EG:ORy7qF.1::c5~STR~Qf!2~~;~~ . D 1 or 2 family dwelling D Multi-family [Z] Commercial D';ACcessory . ,'0. -n 'UOB;SITE'INI'ORMATI0'wAND'L20'CA TION Job Address: 1007 HARLOW RD City/State/ZIP: SPRINGFIELD, OR 97477 Suite/bldg.lapt.no.: Project Name: GATEWAY MEDICAL Cross Street/directions to job site: Tax map/parcel no.: 1703223300400 REPLA.CE EXHAUS FAN IN FIRST FLOOR PHONE ROOM Name: Vv'ES RITTER Phone: 541-726-0100 Fax: Email: .,,'.... .._;"~ r ',~ CQNTR)l;CTOR: ~ Elec lie. no.: 26-34C ceB lie. no.: 458 Business Name: CHRISTENSON ELECTRIC INC Contact: Address: 1631 NWTHURMAN 5T STE 200 City/StatefZIP: PORTLAND, OR 97209 ',.. "''1 Phone: 503-419-3600 Fax: 503-419-3695 ~:t;~r . ',,;.H ""~ ..!"~ '. Email: INFO@CHRISTENSON.COM i,.'i' :;" Metro lie. no.: City lie. no.: Supervising Electrician's lie. no.: 4079$ Supervising Electrician's Name: PAUL E HORVATH Number of inspections included In paid services: Residential Service: 4 Reconnect Only: 1 All Other Services: 2 Upon review and approval by your local jurisdietion, your permit will be e-mailed within ona business day, with instructions on how to schedule you', inspection. :..!}:".t..: NOTE: This Authorization To Begin Work expires within 180 days if a permit is i;ot,'ob~~ined. ~,,, ,- or f~,x,e~, The local building department may determine that an Authorization To Begin Work void if it does not meet applicable land use laws and local ordinances. CorJ-vzu/o - OOc?d-.3 is null and Please check all that apply: o A service or feeder beginning at 400 Amps where the available fault current exceeds 10,000 Amps at 150 Volts or less to ground exceeds 14,000 Amps for all other o Fire pumps o Emergen?y systems o Addition ~f a new molor load of 100 HP or more o Six or more residential units in one structure o Health care facilities ~t'. :~,. ".' Description Brcmch Branch circuits without service or feeder Misc~lhlneolJsy;,>,,:4: 'Balance of permit fees Electrical:per'nti(f~9S:, !fj",,> ,Subtotal Stale surcharge (12% of permit total Technology fee (5% of permit total) TOTAL PERMIT FEE #<~ ~ f\~ ,\ ~ fa': t- " l, /? ,r>"--" o Hazardous locations o A service or feeder rated at 600 amps or more o Buildings more than three star o Marinas and boat yards o Floating buildings o Commercial-use agricultural buildings o Installation of a 150 KVA or larger seperately derived sys o "A", "E", or "1.2" or "1-3" o Recreational Vehicle Parks o Supply voltage for more than 600 supply volts nominal $58,00 $6.96 $2.90 $67,86 G.D fl.VO.\D v.S~~ \}.. .-\ 7-/,,). ~ /CJ Inspections Phone: 541-726-3769 This Authorization To Begin Work must be posted at the job site until replaced by a Permit 'I,J ...... ,~ , "I,~",',..: CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20IO-00923 ISSUED: 07/12/2010 APPLIED: 07/12/2010 EXPIRES: 01112/2011 VALUE: ,.'. ,/,. .~', " .:-! ~ " .;. , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1007 HARLOW RD ASSESSOR'S PARCEL NO.: 1703223300400 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: Replace exhaust fan in,first floor phone room c.",. Commercial Owner: WILLAMETTE MEDICAL CENTER LLC Address: 541 WILLAMETTE ST #106 EUGENE OR 97401 I CONTRACTOR-INFORMATION . Contractor Type Electrical Contractor CHRISTENSON ELECTR,IC INC License 458 Expiration Date 05/01/2011 Phone 541-688-6121 BUILDING INFORMATION. , # 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 Typ'e: Energy Path:," , Sprinkled B'~iiding:' 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 ~ Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Hanilicapp'eif:'" Compact: Street Improvements: . ". . . . ,~;!ENT.ION: Oregon law requires you to . :' ~. : . -.-......... V~~vU uy tile uiegon tlfty I rUBriC IMPROVEMEN~SJ,;jCat'on Center. Those rules are set forth , " :'\R 9~Id~({'1,-I~Of9 t~:rough OAR 952-001- 'j, i: . 0090.. Yo.u may obt&'Pr copies of the rules by ," calling DowhspoutsApxai!lSihe telephone number for the. Oregon Utility Notification Center IS 1-800-332-2344).. Storm Sewer Available: Speciallnstructi~~~T1CE: Notes: THIS PERMIT SHALL EXPIRE IF THE WORK I\UTHORiZED UNDER THIS PERMIT IS NOT tI~ Jlf.!1 ,......,............... __ 1'~'~~'.'.,Il..l_' un Iv K.O,.u,I\'~':"":';:"'.... ,:.;:~ , . '1 I"ftV pcr~lnf). Valuation Descri Description Type Of Construction $ Per Sq Ft ' or multiplier" I . . .' ;Square Footage ." "1 j ,\ or' Bid Amount Value Date Calculated c .,'..-, .V . ,"'l! Paee 1 of 2 :~i~~lJl;(~:, :/.:;7,', ~..; . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00923 ISSUED: 07/12/2010 APPLIED: 07/12/2010 EXPIRES: 01112/2011 VALUE: Status Issued T"'fC:r' "i;~if1(f~;:i~'~' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,.;. -, Total Value of Project , Fees Paid ~' Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical 1> Amount Paid :. :(', 'Daie Paid Receipt Number $6.96' $2.90 $55.00 $3.00 7/12/10 7/12/10 7/12/10 7/12/10 3201000000000000423 3201000000000000423 3201000000000000423 3201000000000000423 Total Amount Paid $67.86 e).J!II.R~i~ws., I:i; , ,:\; ': ~ .',. i,. I:., n",,~!.';t I~ .~! /~ ; ", , ;.~ " 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. Reouired InsDections ~ " Rougb Electric: Prior to Cover Final Electric: When all electrical work is c~!"plete. . " \,~ '. 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. yL~~ ',' ;::1 ~'...;,:i" ~,-, i.' "~.^;'"F,'~'i:fJt'~:,It"""i\';-:':;', ,.,"";:,",!,7 . ",;,f" .~ , Owner or Contractors Signature .;~~~", , Date Palie 2 of 2 ""'j'; , 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3201000000000000423 2:56:12PM Date: 07/12/2010 JobtJournal Number COM20 1 0-00923 COM20 I 0-00923 COM20 I 0-00923 COM20 I 0-00923 Payments: Type of Payment ONLINE CHGS cReceiot 1 OescripHnn ,", < Actdl Alter, Extend Cire 0' ",-- " "h'; Minimum/Adjustment Electrical.;'/'.. + 12% State Surcharge + 5% Technology Fee ;.; ~~ Amount Due 55.00 3.00 6.96 2.90 $67.86 .-'1. ',.-':, -" Paid By ONLINE PERMIT CHGS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid NJM ONLINE CHRISTEN Online .. SON $67.86 Payment Total: $67.86 ...,.:..... ,.'.d',-1 ",; . 1 ."~"""~::::-"'~~.":' ~- ...;. . ",; - -', .~ "",,:"'"-. , .'~. ....., . . 'b:i '",:, .. ( ~'. 1 n."~b;' ,".-. '.;,'i:\.".. " '~r' ," ,. f.,..J '..,.,..... ~., ~:.':7, ..>.\.; .,,', j'" i' Page I of 1 7/12/20.10