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Home My WebLink AboutPermit Electrical 2010-7-12 (jIO.Gf'Z.CS Commercial Electrical Authorization To Begin Work 69600-BEL-10-00321 Approval Code: 672759 7/12/2010 2:00 pm E-mailedTo:deborah.perdew@christenson.com '::d?'lrAN'REVIEW' . City Of Springfield 225 Fifth 5t Springfield, OR 97477 Phone: 541-726-3753 Email: permitcenter@ci.springfield.or.us D New Construction IX] AddjljOn/alteratlO~j!~a~;~~t:~~:'-~' CA TEGORY. OF!;~bIllSJRUCJION " " . D 1 or 2 family dwelling o Multi-family [Z) Commercial [l:Accessory . .,~. .::. 'J0BSITE 'INFORMA liON ANl:U:OCA TION Job Address: 304 Q ST City/State/ZIP: SPRINGFIELD, OR 97477 Suite/bldg./apt.no.: Project Name: FREN1US MEDICAL Cross Street/directions to Job site: Please check all that apply: D 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 Emergency systems .0 Addition of a new motor load of 100 HP or more o Six Dr more residential units in one structure o Health care facilities . ''': ~(:<,; ):'FEE'.sCHEDULE. .' Description Qty, '~f~nchdir~~itS!.' ~ Tax mapfparcel no.: 1703262401600 INSTALLED CIRCUITS FOR RCIT DESK AND DIALYSIS #39 Name: CANDACE JAN " ''''',--<:-" '''c,~ , ',":,;:>,1~ iJr:!cep: :~rJflJ~ !1.t,_ . Ph\?ne: 541-741~8005 Fax: Email: '7-<'CON:r~T9B~ Elec lie. no.: 26-34C 458 CCB fie. no.: Business Name: CHRISTENSON ELECTRIC INC Contact: Address: 1631 NWTHURMAN ST $TE 200 City/State/ZIP: PORTLAND" OR 97209 Phone: 503-419~3600 Fax: 503-419-3695 Email: INFO@CHRISTEN50N.COM Metro lie, no.: City lie. no.: Supervising Electrician's lie. no.: 40795 Supervising Electrician's Name: PAUL E HORVATH Number of inspections included in paid services: Residential Service: 4 Reconnect Only: 1 All Other Services: 2 ~,ir1l7~ '.':':~;':-':2:;'~. :'j;',l.':P ~_<r" '!L. Upon review and approval by your local jurisdiction, your pennit wili'l''b;-'';t-m';i1ed .~-; faxed within one business day, with instructions on how to schedule your inspection. ',~:. ~, ' NOTE: This Authoriz.ation To Begin Work expires within 180 days if a permit is not obtaIned. The local building department may determine that an AuthorizatIon \loid if it does nol meel applicable land use laws and local ordinances. Co'(Y\1P) 0 - a 09 05 To Begin Work is null and Branch circuits without service or feeder Branch circuits each additional circuit without'service El9ctrj~alPerfl1it Subtotal State surcharge {12% of permit lotal Technology fee (5% of permit total) TOTAL PERMIT FEE ( L .~ ~yR,.\\ ~. 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 $55,00 $55.00 $6,00 $6,00 . $61.00 $7.32 $3.05 $71.37 ~~.\~ ~~ lA. -\ Inspections Phone: 541-726.3769 This Authorization To Begin Work must be postedat:the job site until replaced by a Permit , (-I)-vO ()fV\ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00925 ISSUED: 07/12/2010 APPLIED: 07/12/2010 EXPIRES: 01/12/2011 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 304 Q ST ASSESSOR'S PARCEL NO.: 1703262401600 , ' ,ei', ,,:, Springfield TYPE OF WORK: Electrical Work Only ." .... . "-' ..: TYPE OF USE: New PROJECT DESCRIPTION: Installed circnits for RCIT desk and dialysis 39 Commercial Owner: SPRINGFIELD DIALYSIS LLC Address: 3355 RIVER BEND DR STE 200 SPRINGFIELD OR 97477 Contractor Type Electrical I CONTRACTOR I,NFORMATION ~ Contractor License CHRISTENSON ELECTgIC INC 458 BUILDING INFORMATION ~ Expiration Date 05/01/2011 Phone 541-688-6121 # 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: .. 'E~'ergY:I'~IJj':; ;,': :a,,'1 "1 Sprinkled Building: ." ..no' (. Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVEi:OPMENT INFORMATION ~ REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: , Compact: % of Lot Cover}\lJ'TENTlON: Oregon law requires you 1.0 , ,followrules adopted by the Oregon Utility . _. _ ~..t .. nT' ,,.,,r)rlI...Jl;::IIlt;:. IIIU"....'...''"'...................~.- PUBLIC IMPROV ,!\W~ 2.001.0010 through OAR 952-001- 0090. You ma'srd~Wlflk-Tyte'! of the rules by . , calling the cel1t~r, (NO,,,: l~: .t~~~~hone , number for tIDownspoutslDrams:,[,flcat,on Center i3 l-c.v0...):'~-,-J..,4). < ~'r-, I ,~ 1..-. ' .r"I';';I" Street Improvements: Storm S~~q~2~!able: Special Instruction: ",,;) n:hl\J1IT SHALL EXPIRE IF THE WORK Notes: ~UTHORIZED UNDER THIS PERMIT IS NOT "OMMENCED OR IS f\8ANDONED FOR T I""'" '.:.. ,-, "--, Description Type of Construction I Valua~ion Description ~ $ Per S-q:'i1f;:,':::iT< 'S~~~re Footage or multip!!er"\"r/' or'Bid Amount Value Date Calculated .I7r' Page I of2 Status Issued " , " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00925 ISSUED: 07/12/2010 APPLIED: 07/12/2010 EXPIRES: 0111212011 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line ,~~:, : .' , ~- ,- , Total Value of Project Fees Paid ~.. Fee Description + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add ., ~~:~Tir' '" -,'. "),t":. Amount Paid';J~~I; .;. .': r ,; Date Paid Receipt Number $7.32i:; ; $3.05'" $55.00 $6.00 7/12/10 7/12/10 7/12/10 7/12/10 3201000000000000427 3201000000000000427 3201000000000000427 3201000000000000427 Total Amount Paid $71.37 Plan Reviews, I. ., ,'j, ..: 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. ReQuired InsDections ~ Rough Electric: Prior to Cover ~_~ ~'"f .' ':'. <,'.<1" .-' ,., " i~" Ii ~( :';i" Final Electric: When all electrical work is complete. "'f' i~,': ,1;><1:', , ..,.,,,,~-_.... ri:._ 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 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 tbe property, and the approved set of plans will remain on the site at all times during construction. .' "'~':. ,>, ~ Owner or Contractors Signature ..,,,.,,~>..., Date "j"f ";:~?~!; 'e,~~~H; " 'r,lPaee 2 Of 2 Ie. f' ., 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone' City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3201000000000000427 Date: 07/12/2010 , 3:IO:52PM Job/Journal Number COM2010-00925 COM20 I 0-00925 COM20 I 0-00925 COM20 1 0-00925 Payments: Type of Payment ONLINE CHGS cRcceintl Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee Paid By ONLINE PERMIT CHGS ~'.'.j"'" .""f,-,;" Check Number Rcc"eived By Batch Number .'." . Item Total: Authorization Number How Received Amount Due 55.00 6.00 7.32 3.05 $71.37 Amount Paid . nJ':' ONLINE christenson Online Payment Total: $71.37 $71.37 "";, i : ;,'.'" ~I' : ! " t" ..-.. ...~ ......".",,~ '."-" ..: ~., -, i, - J'. i ' . ,. t .i:r.+,,', in., . n.1:n "'", ~ ; i', . f r . ';~J;;'" .~ "" - ; " ... 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