HomeMy WebLinkAboutPermit Building 2010-8-4
225 Fifth Street. Springfield, OR 97477.PH(54I)726-3753.FAX(541)726-3689
DEPARTMENT USE ONLY'
Electrical Permit Application
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CITY OF .SPRINGFIELD~ OREGON'
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Dale:
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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 AP.PROVAJ.:',';""" , :~.~ o;"):~!~; ;r;~\f~.~<~.t;~;i1K~'~:.'~-E.E~':-;':$CRE[j_OIJE-1;:'~': :,'.?!)~-i;i'~~t~:~7f:f~~~~~~5~}t;~'!
Zoning approval verified? DYes DNo ,N~m~er' o.f._~nspectio'ns per'it~-~' (.>." : .. . Cost Total
Qiy. i' "ea. cost
; . . C,6.TEGORY,OFCONSTRUCTION\,." .' '. . :.,', " . ',.,..... ".,:', :. ..
o Residential I 0 Government I 0 Commercial Residential, per unit, service included:
~,,~~lJOE3iiSITE "'INFQRM/IiTIONrANDn1o.CA1:10N',~i!\:t';YF 1,000 sq, ft. or less (4) $134.00 $
Job site address: , (')(V..., ~"/l..l (l'^""n'D"'~...)' ~-,j.. f,,~ch additional 500 sq. ft. or portion $ 25.00 $
ereof
City: ~\'l~'~'~() I State: bR... 0,-1'-171 7
ZIP: -, ,...,. I Limited energy (2) $ 32.00 $
Reference: I:l I Taxlot.: Each manufactured home or modular
:,'" .' dwelling service or feeder (2) $ 63.00 $
DESCRIPTION OF WORK 'i. .,,", .,
.J...\\1iA..- r il'l\\.J"-^ <-, tA1A.J'Z~ Services or feeders: installation, alteration, relocation
. 200 amps or less (2) $ 81.00 $
PROPERTY OWNER 20 I to 400 amps (2) $ 95.00 $
Name. V.-/A.. (' .(").~Q',="hA\) (lDllI",F( ~~ :101 to 600 amps (2) $158.00 $
Address: L()I)t) l.\) ~ .. I (';n I ) () fA '-/ 'io I to 1,000 amps (2) $205.00 $
City. r>...!"v.. . :'l ~i-:'t I State: .c--)R... ZlPY1477 Over 1,000 amps or volts (2) $469.00 $
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Phone:')t/l -tff; ~ loon Fax: Reconnect only (2) $ 63.00 $
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E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less (2) $ 63.00 $
owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 87.00 $
property is not intended for sale, exchange, lease, or rent. OAR 401 to 600 amps (2)
479.540(1) and 479.560(1). $126.00 $
Signature: Over 600 amps or 1,000 volts, see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: new, alteration, extension per panel
Business name: '-jRA1\ I C' -"" t:: ('--"f'l./.. ) a Fee for branch circuits with purchase of a service or feeder fee:
Address: 1')...C:;-J ~,) If ~(o I....... 1.0 Each branch circuit $ 6.00 $
City: L ). 1.1" A , .1 State: rn ZIP: EfTJ:JJI b. Fee for branch circuits without purchase of a service or feeder fee:
Phone'~('\?;L,",) <~:l:r:l. I Fax: - - First branch circuit (2) $ 55.00 $
E-mail: V.\.Iu.l ~(' l'1R...t.56 ~ ~R..A-II.l ~ . ( {JlAA Each additional branch circuit $ 6.00 $
CCB license no.: ~q4\)-2 I BCD license no.: Miscellaneous fees: service or feeder ~ot included
Signing supervisor's license no.: LI.<.~;:A Each pump or irrigation circle (2) $ 63.00 $
Print name of signing supervisor: k'. - (\..\ I? i e-,~ Each sign or outline lighting (2) $ 63.00 $
Signature of signing supervisor: a.~ Signal circuit or a limited-energy panel, $ 63.00 $
{{.../:::/ - alteration, or extension (2)
Each additional inspection: (I) $58.00 $
;#;t;;:~@.~~}11~'iJg~'t'"t.~YARF?)lfcAN*8us_E\i;tCi))~~;~;:??t::(":;r "
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(A) Enter subtotal of above fees 6Z
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [AD $ &> -7' ~
(C) Technology Fee (5% of [AD $ 2--' :.>,
TOTAL fees and surcharges (A through C): ~7-lr /10
{)C>
440-2584.J (9108/COM)
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-010S0
ISSUED: 08/04/2010
APPLIED: 08/04/2010
EXPIRES: 02/04/2011
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 1000 ROYAL CARIBBEAN WAY
ASSESSOR'S PARCEL NO.: 1703150001001 ..
, Springfield TYPE OF WORK: Electrical Work Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Low voltage for HV AC control
Owner: RC SPRINGFIELD 2007 LLC
Address: 1050 CARIBBEAN WAY
MIAMI FL 33132
I CONTRACTOR INFORMATION I
. Contractor Type
Low Voltage Electrical
Contractor
TRANE OREGON
License
54452
BUILDING INFORMA TJON'
-,:.,
Expiration Date
Phone
1-800-20TRAN
# 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:
Ralige'Type:
'"Ener ."Path:" . . ,.
,\\lP".gy '".. , .
S'prinkled'Btiilding:
;
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
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:
Handicapped:
Compact:
ATTENTION: Oregon law reClpUB~ic;.;MPROVEMENTS I
follow rules adopled by tne C _ ,.,'
Street Improwment.s:. on Center. Those rules are set forth
NOIITlcall hOAR 952-001-
Storm Sewer iAvailalJle:2-001-001 0 throug '. b
S . II t ""t"~ You may obtain copies of tile rufes y
peC13 ns rUe .on: h
calling the center. (Note:the telep one
mber for the Oregon Utility Notification
nu Center is 1-800-332-2344).
Sidewalk Type: 'J'JO\'>\\
't'\CcDownspoutsJDr-ainf:.t'. \r :tl;,S ~O\
-10, {.. \-\1\\..\:\:.'" 't:\,>W,l\
r\-\\S I''t:RM~6 ~~\)'t:R \\-\'~60~'t:\) I'O\'>
\ n\-\ORI1 OR IS 1\\)1\
'",,^MEt-ICE?, C:P.IO\).
I rr'i '\3U VI'"
Valuation Description
,.... ,'.n ~ I.' J'.~ .
Notes:
Description
Type of Construction
$ Per'~Ft ~T ;il'I' "Sq'ua're Footage
. ~.. ",',' .. I
or multiplier. :'.'.; ! j 'or Bid Amount
Value
Date Calculated
. ,
Paee I on
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-01050
ISSUED: 08/04/2010
APPLIED: 08/04/20]0
EXPIRES: 02104120] 1
VALUE:
Status
Issued
Total Value of Project
L Fees ~
,.
n:\ltt: ".:;,~~,:t~.. \:
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Low Voltage - Commercial Indus
Amount Paiij:;;ifi '."f!~'. :r~",;;.' '
~x:,.:;',," ",' .
$6.96 !j~~itl;" I ;
$2.90:~ .
$58.00
- Date Paid
8/4/10
8/4/10
8/4/10
Receipt Number
1201000000000000864
1201000000000000864
1201000000000000864
Total Amount Paid
$67.86
Plan Reviews ~
To Request an inspection call the 24 hour recgrding 31'726-3769. 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 InsDect~
Low Voltage: Prior to cover.
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By signature, I state and agree, tbat I have carefuIlY.l.~'.~minedithe c'o"'pleted application and do hereby certify that all
information hereon is true and correct, and I furth~rl.~ertify titat any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the t;aws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANC~::,.wi~ be '~Of any structu'r" without permission of the Community Services Division, Building Safety.
1 further certify t~at'6nly ~Jnttactor and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree t6 ensure.that all re uired inspections are requested at the proper time, that each address is readable from the
street, tha'-.the permit'fard is located at the front of the property, and the approved set of plans will remain on the site at all
. d" p. /
hmes ,~nng construction.
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I..~Yn:.. or ~t(.~tors SIgnature ~:,.," ", .~~~::
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Date
/
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225 Fifth Street
Springfl-dd, Oregon 97477
541-726-3759 Phone
T~~C;~.lI.IlU).~.. '.
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000864
-, \
Date: 08/04/2010
12:52:49PM
Job/Journal Number
COM20] 0-0 I 050
COM20 I 0-0 I 050
COM20 I 0-0 1 050
Description . ,:.,.: "
Low Voltage - Commerciallndu~;"
+ 12% State Surcharge
+ 5% Technology Fee
',f\;
Amount Due
58.00
6.96
2.90
$67.86
Payments:
Type of Paymeot
CreditCard
Paid By
RYAN CHRlSS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 046600 In Person
Payment Total:
Amount Paid
$67.86
$67.86
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