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Home My WebLink AboutPermit Electrical 2011-2-15 .. Electrical Permit Application . 225 Fifth Street. Springfield, OR 97477tPH(541)726-3753tFAX(541)726-3689 " DEP,ARTMENTUSE ONLY', Permit no,: .511- 2 7 Date: 2- I) I f 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. ",,' ",' 'L()CAL'~OVERNMENT,6;P.F\~O\iAC":? f, " Zoning approval verified? D Ves D No I:;,," ':,>'C.,6.TEGORY,iOI'CONSTRlJCIIOf\l;" "',';',' " " o Residential 0 Government I EX'Commercial ~lTItjf:';~,QI3;;;$Jl'l:: INI'QRMAtloNi;ANr;jt:IlQc'A"'I()N~~t;iti'.~:' Job site address: &'lSDl (.v,L --.. "tSI- City: S '1Y1('L~lrA I State: nIL I zn,: Q'141' Reference: \, l~ y.....1l1.fY\ I Taxlot.{'V'-'" . ~ I'. .:. , DESCRIPTIOJif OF WORK"','.:";,:".,:,,,,,;, n luM ,'Lri ~p' /I, t\n. \'r\ b-, ,(J~ 0 c\ (11\ ,-nf I, 14 PROPI:RTY OWNER . . · Name: C; Al~-..J"t'"i4 /VII'\L...L...- Pfl-()'-l~J Address: ~() In../1'" to \"l q-..,c-~ City: (\ ~ .... -if) I State::o... I ZIP:(qr){ornl Phone: - - ~ Fax: - - E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: ,CONTRACtOR INSTALLATION Business name: -n-c...... (1.. '...'/fl'J:.'''''....:t:nr Address: P.o (3,w H,p City:~."'~l '/,4 State: 11R... I ZIP:ot7l{'j) Phone: Sui ~pq':::v ~ I Fax:{:;lIJ (J1 fCJ /;;)47 E-mail: \.JlJri. i ~ 77C... AJW. A IHA CCB license no.: . / ; /111./ I BCD license no.: 3"3C;Q L.EiP-.. Print 'name of signing supervisor: "JOdi L W6'-t!) d Signature of signing supervi'&: hAIl Ii "0_ _If U '1 Signing supervisor's license no.: t~ d\~ 440-2584-J (9108ICOM) {)'/(J;H~~~5r(:";\}?~'7:~~~~~1~~?{~:E~E-~~S'G8EJjJ)eE;~:J[l;(.S~:;\,:;j~l~'W~\\~~'?~~~H . ,',-' "{, ,'.:-. '- .... ,N urn ~er ofinspedionswit~~.' ( ) ,.'(1)'. ,__ '",.;'" ..,.,.- -.,-."',-,'J'. ". .''- ,',' -;""",_ "'.',." ',Cost ';, Total 'ea.":, "cost $134.00 $ $ 25.00 $ $~.oo $ $ 63.00 $ Residential1 per unit, service included: ],000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) 2- Each manufactured home or modular dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 40] to 600 amps (2) $158.00 $ 60] to 1,000 amps (2) $205.00 $ Over ],000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 '$' -. b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) Each additional branch circuit $ 55,00 $ $ 6.00 $ Miscellaneous fees: service" or feeder ~ot included Each pump or irrigation circle (2) $ $ $ 63.00 $ 63.00 Each sign or outline lighting (2) Signal.circuit or a limited-energy panel, r) $ 63.00 $ alteration, or extension (2) ~ Each additional inspection: (]) $58.00 $ :-};:~~::{f~0~~fil~li~!2;~~~lAReri1iGp/NT~)1J'S~1;;;J:t!/\:~tL~f)i&t{~1.t:~i1;ri: (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [AD (C) Technology Fee (5% of [AD TOTAL fees and surcharges (A through C): $lq1D~ $ /S/:3:. $ C, 10 $ Jl1744.- SP~.~~~_FIE~D lm\~ H_..:~';( _. ..,~cf"'~''-'OREGON CITY OF S,PRINGFIELD Building ICommercial Permit PERMIT NO: 811-SPR2011-00237 IVR Number: 811180933979 www.cLspringfield.or.us 225 Fifth Sf Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfield,or,us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 02/15/2011 02/15/2011 Issued 02/15/2011 EXPIRES: VALUE: 08/14/2011 $0.00 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477.7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Low voltage for Cabela's ~atacom and tetv Phone Number: OWNER: ADDRESS: GATEWAY MAll PARTNERS PO BOX 617905 CHICAGO Il 60661.7905 , CONTRACTOR INFORMATION ~ Contractor Type Electrical Contractor Contractor Name TIC COMMUNICATIONS INC # of Units: o Lic Type CCB BUilDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Site Information Engineered Fill: Fill Volume: Flood Hazard Area: . Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 2115f2011 11:16:57AM Lic No 164114 Lic Exp 04/11/2011 Phone 541-689.2650 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 2008 ATTENTION' Ore follow rules ~do t~on law requires you to .NotlflCation Cent~ ~ by the Oregon Utility In OAR 952-001-0010 those rules are settorth 0090. You may obtai rough OAR 952-001_ calling the center rJoPles of the rules by number for the Or' ote:, the telephone e 800n 'It.I,fll P'-""', ~ "",er IS 1-800 332 ' 'v""~""un I . -2344). NOTICE: T~~SH6ERMIT SHALL EXPIRE IF TH'~'~ORK GMM RIZED UNDER THIS PERMIT IS NOT ! ,ENeED OR IS ABANDONED FOR Y 180 DAY PERIOD. Page 1 of 3 . ",.) s[:.~~.:-. FI.E:i1.. . .~~ /"'F'~~ OREGON WWN ,ci.springfield.or.u5 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00237 IVR Number: 811180933979 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 02/15/2011 02/15/2011 EXPIRES: VALUE: 08/14/2011 $0.00 02/15/2011 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Low voltage for Cabala's datacom and cetv DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) CCTV Data I Telecommunications Amount Paid $15.12 $6.30 $63.00 $63.00 $147.42 Date Paid 02/15/2011 02/15/2011 .____M_,_._"'''______,._.~ 02/15/2011 02/15/2011 Reciot # 2011000288 2011000288 "'~.._--- 2011000288 2011000288 Total Amount Paid Springfield Building Permit 2/15/2011 11:16:57AM Page 2 of3 .. SPI'U,NG.,FIEL ~ .""',....., ,'.' r!:$ "\OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00237 IVR Number: 811180933979 wWN.ci.springfield.or.us 225 Fifth 51 Springfield,OR 97477 Phone, 541-726-3753 Inspection Phone: 541-726-3769 Fa" 541-726-3676 perm ilcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/15/2011 ISSUED: APPLIED: 02/15/2011 02/15/2011 EXPIRES: VALUE: ' 08/14/2011 $0.00 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Electrical Only WORK INVOLVED: Remodel TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Low voltage for Cabela's datacom and cctv Plan Review ~ Department Permit Issuance Received Due Date Comoleted Result 02/15/2011 02/15/2011 02/15/2011 Issued Initial Review 02/15/2011 02/15/2011 02/15/2011 Over the Counter Comments: Over the counter permit fAi)"plicati6li~AcceptanceC.?i ~'",,':_::;02/151:201~1~;_-_Q~r~5/2o'11_ :.:"D"2/15!2b1~1: ~, ';Over;the Co Linter,;? L;: -~ f;:~~; ':. ; ~ >, ~~~.Z~,~:t~~""l;~~~(';.;::~:~?;~':~~"i:~t:: )-, <. .~<'~ '\~:: ~ "':~ ?~J;~- '~:l ,~ ::-"~:~i Reviewer Chris Carpenter Chris Carpenter '0 Ch'ris:cEirpenferlJ ".:.. ~.':~~ ." ','2 ''fl:' . V -~..: . . ..\'{,,",:,:?!:r_~1f,;;..." '''t , ,., ."'" ,'>~. c_'1._----' """"!f'1""'-~~~~ , ,.,' ",,,- -",; ','-, "'j .",,;~~~(;,~.:';, , ;1 .~~' .----,-.- '," j INSPECTIONS REQUIRED ~ Inspections 4550 Limited Energy 4999 Final Electrical Final Electric: When all electrical work is complete. 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 or 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 aU 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 Contractor Signature Date Springfield Building Permit 2f1Sf2011 11:16:57AM Page3of3 " TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield, OR 97477 541-726-3753 www.ci.springfield.or.us 811-5PR2011-00237 2800 GA TEWA Y 5T permitcenler@cLspringfield.or.us RECEIPT NO: 2011000288 rDE5CRIR:TI0N:' 'f'':~' CCTV RECORD NO: 811-SPR2011-00237 DATE: 02/15/2011 \, " ",~"'"" ~'~f!~:"ii+"V'-:, ~ACC0.UN:[t6DE"", ii' ~'~-'';-:':;i;-j:~:AIVIOUNTll)lJE':;:::'::':':' ::',.j 224-00000-426102 63.00 224-00000-426102 63.00 821-00000-215004 15.12 100-00000-425605 6.30 TOTAL DUE: 147.42 t:EA YMENT1lY:i1I-;;.i';.::;:e,6,'y-'9Bit'CASHIER:1CARPENTER;':"':':;s;: ;([Q~~t[T.si,:-::~;;;l;-,,:r:,rr:l:i:~!!1(jUN:r;P~1!!.:::;C '''IT-:;,';:l Credit Card TIC COMMUNICATIONS INC 147.42 Data I Telecommunications State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) 706747 TOTAL PAID: 147.42