The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2007-2-28 ~ o o ~i ~i rrI11 rr.~ ~~ ' O'~ , ~ r . f? ~ fJ~~ J I r-1 j \ o ~~ fi,.A/':.-z.n'Cf'A 1--1';'; PHONE: .:;~:S. ZA/7 P120fJrz. e.r/ PI../JAJAJJII,f;. it j'UUe.IA#/J?p.n-l. /23 t::N1't/2j/1/fT/~n/l/" WIfY ./ ZIP: Q'7l,l71 ;'\t.~: . . , .' : '. CITY OF,S]'lUNGFIELD, OREGON,' .' . 1 ~ _ .' " , . ,. . 225 FIrrH STREET . SPRINGFIELD, OR 97477. PH:(541)726.3753 . FAX: (541)726.3689 City Job Number (17 - vasa'? LOCATION or PROPOSED WORK: .' ~. 5.33 ,lQ t/~RA6J(//J ,0..e ASSESORS MAP: 17-03- 2-2. TAX LOT: OWNEK: ADDRF.sS: CITY: /;;::>.e//f/c; p/ t-i-O STATE: J?12- SCANNED /(');:0,100 II1Y7 , . , DESCRlITION OF WORK: t/,{J~126#n/.J1/.Jf) PNetf/I'Jtl/I1)v -7vk. ".rJk.e. nl/c.,f i'/!61bIMm NEW: L REMODEL: _ ADDITON: _ DEMOLISH: _ OTHER: _ VALUE: CONTRAcrOR'S NAME CONST. CONTRACfOR # EXPIRES ADDRESS GENERAL: T/-S.o "7P;, n PLUMBING: MECHANICAL: ELECfRlCAL: 1'".P;L> MECHANICAL PERMIT .' PHONE PEE PLUMBING PERMIT ITEM ITEM. Furnace Exhaust Hoed Vent Fan No, Wood Stove/Insert/Fireplace Unit Fixtures Residential Bath(s! No. Sanitary Sewer IT. Water IT. Stonn Sewer IT. Mechanical Pennit Subtotal "Minimum of $45.00 Slate Surcharge 8% Administrative Fee 10% Issuance Fee Technology Fee %5 Plumbing Pennit Subtotal "Minimum of $45.00 Slate Surcharge 8% Administrative Fee 1096 Technology Fee %5 TOTAL MECHANICAL TOTAL PLUMBING PEE Md~m~ · Phlmbmg · Miah/IDJIllOOlWS Shared Drivc{T;)lBuilding FonnsIPelllli( WOfhheetOB..o6.doC' . . . ,. ," 'CITY OF SPRINGFJFLD OREGON' ; . ,_ '". ,..J,.. ZON rNlTlALS DATE SOURCE l2S FlITH STREET. SPRINGFIELD, OR 97477 . PH:(S41)726.37S3 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION LEGAL DESCRIPTION: /7'o~,2.z... /t.../~. /00. 1;00 , ,. JOB DESCRIPTION: i!Jel" 1. 1000 sq. ft. or less .:rtV.srlll__'''.i~f';O# C!f"" F .' l.__~f~TS; . Each additional 500 sq. ft. or ;?-S >>~/.2T /J'p p;f/emll7'ltC- ~,ft:: ~'d').Jmortlon thereof City Job Number 1. ~WDI{;)l$~~~""wI@lV:~,,",Ji>:\j!J,' t:'1:!~ ltt.t~. '. _,J.,~~~~ "537 3~ R;UZlZkff.!,tJ,e.. Permits are nuo-transferable Bud expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~"",i!JNli~,''f:l. ~~i\i~1'~~,~.,' 2. ~.:=t..i~~~j~1i~~t:.~ Electrical Contractor 713D Address City Phone Supervisor License Number Expiration Date Constr.C ontr. Number Expiration Date Signature of Supervising Electrician Owners Name Address City Phone OWNER INSTALLATION The installation is being made on property [ own which is not intended for sale, lease or rent Owners Signature: Inspection Request: 726.3769 Dale 3. ~j!~'iilmi!i!i{jl~I'&J~"~~ ~~' .B'\I'. "';J!!:;;t0"~~''''''-'l!WF''-'W 7"'~~" .~" A'.'.,,'.,' ',',t"', '1'''','S','I'',''' ""'I<''jj:'l\iiii1lii1i\\~",',,1 ~i~"',"d,"',ll fig ,.' , '.: ., \'.~J~ ,,)11; ~~. .ug~~~J. jll~:r~. w~e I .~ I" . '. Service Included $106.00 $19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B.ll~I!i~~'ltllt't\\1fil~1i~ !~~ 'IO~S~milr.. . . . 1#...." ,,--,'~'.r..! "-.~ .._e.~, ; 1"" '. ", '; _. 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C W~i'!l~jf~_I,.....;.,',i'''''~'&.'ei!;.'/;''<!i'~'''''l~t'o:(''''!i ""'i~, ' ,.; :.u . " s:Rll\-t~~S(Jt!~~ - ~~~~~~~~~~;'~.I~ Installation, Alleration or Relocation 200 Amps or less $ 50.00 '201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 D.OtW;~i;~_~;!~~(~.. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. ~~ll\lt'l~m!l\J"_. Pump or irrigation $ 50.00 SigolOutline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial C 5 $ 45.00 Minimum Electric Permit lospection Fee is $45.00 + Surcharges 4.~___~~ 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Shared Drive(T:)fBuilding FonnsIElectrical Permit Application 8.06.doc CITY OF SPRINGFIELD PLUMBING PERMIT FEES TABLE 5 Peace health Riverbend Pneumatic Tube Annex Hospital TABLE No. 3-G REFERENCE NO. DESCRIPTION . a One & Two Family Dwellings. Not Applicable b Single Plumbing Fixture c Sanitary Sewer (1) First 50 Ft. (2) Each additional 1 00 Ft. or portion d Water SelVice (1) First 50 Ft. (2) Each additional 100 Ft. or portion e Storm & Rain Drain (1) First 50 Ft. (2) Each additional 100 Ft. or portion f Sewage Ejector Pump 9 Special Waste Connection h Manufactured Homes. Not Applicable I Backflow Prevention Device j Relocated Structure. Not Applicable k Sanitary or Storm Sewer Cap I Any Trap or Waste not connected to Fixture m Any plumbing installation not listed in this schedule with sanitary waste or potable water supply n Minimum Inspection Fee - Not Applicable o Partial Inspection Fee (1) P Reinspection Fee (2) q Inspections Not Covered By Schedule r Inspections Outside Normal Business Hours s Investigation Fee. Not Applicable t Building Without Permit Penally - Not Applicable u Accessible Minor Plumbing Labels NO LONGER AVAILABLE. Not Applicable v Not Accessible Minor Plumbing Labels NO LONGER AVAILABLE. NOT APPLICABLE w Hourly Inspection Fee for Requests Not In Permit Table . I I I SUBTOTALI State Surchargel Administrative Feel Technology Feel Plan Review Feesl TOT ALl FEE QTY $14.00 $45.00 $14.00 $45.00 $14.00 $45.00 $14.00 $14.00 $14.00 $14.00 $45.00 $14.00 $14.00 $45.00 $45.00 $45.00 $45.00 $67.50 $45.00 I I I I $45.00 I I I (i:il 8% 191 10% @ 5% @ 30% AMOUNT 1 $45.00 I 35 $490.00 I I I I I I 10 $140.00 I I I I I I $m:ool $54.00 I $67.50 I $33.75 I - ~202.50 I $1,032.75 NOTE 1: Assessment of partial inspection fees TBD NOTE 2: Two (2) inspections allowed, additional inspections required to correct deficiencies at $45.00 each at the inspecto~s discretion For questions please call CLAIR at (800) 383-8855 Page: 1 of 1 CLAIR No.: 1141-025 ~ . . CITY OF SPRINGFIELD, OREGON 225 FIFTH STREET' SPRINGFIELD, OR 97477' PH:(541)726.3753' FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number IlOCATION OF INSTALLATION lEGAL DESCRIPTION JOB DESCRIPTION Permits are non.transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2 ICONTRACTOR INSTALLATION ONLY Contractor Address City Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Eiectridan Owners Name Address City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726.3769 TOTAL Pneumatic Tube and Fiber Ducts 3. ICOMPlETE FEE SCHEDULE BELOW A. A. New Residential- Single or Multi.Family per dwelling unit. Service Included 1000 sq. ft. or less. Each additional 500 sq. ft. or portion thereof. $106.00 $19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. IServices or Feeders -Installation. Alterations or Relocation: 200 Amps or less. 201 Amps to 400 Amps. 401 Amps 10 600 Amps. 601 Amps to 1000 Amps. Over 1000 AmpsNolts. Reconnect Only. $63.00 $75.00 $125.00 $163.00 $375.00 $50.00 C. ITemoorarv Services or Feeders Installation, Alteration or Relocation 200 Amps or less. 201 Amps to 400 Amps. 401 Amps to 600 Amps. Over 600 Amps or 1000 Volts see 'B" above. $50.00 $69.00 $100.00 D. IBranch Circuits New Alteration or Extension Per Panel One Circuit. Each Additional Circuit or with Service or Feeder Permit. $43.00 $3.00 E. IMiscellaneous (Service/feeder not induded\ -Each Installation Pump or irrigation. $50.00 Sign/Outline Lighting. $50.00 Limited Energy/Residential. $25.00 Limited Energy/Commercial. 1 $45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ISUBTOTAl OF ABOVE 8% State Surcharge 10% Administrative Fee 5% Technology Fee 25% Plan Review fee TOTAL $45.00 $45.00 $3.60 $4.50 $2.25 $11.25 $66.60 . . " ';' . dTY OF SPRINGF1E~D', OREGON' . .'-' .,. . , City Job Number o 1 & 2 Family Dwelling or Accessory -gl New Construetion o Multi-Family 0 AddilionlAlterationlReplacement J<r CommerclallIndustrial 0 Tenant Improvement Job Address '33'5:;$;;?/ /lJUeE1eAJO DR' Bldg No. Suite No. Lot Block Subdivision Tax Mapfrax Lot /7 - /)") - 2 '2 Project Name .6//~te. P/4.W.D 7"- /Ot7t?) ,lOCI, //00 Description of Work/location on premises/speciai conditions I4tJ""/..;hJ,,"~k ~ p)h,.P,:l. dL/.t"" o ~J!iilll'IDfQ.~7f~i:"i9~~,;;~.~ ~$c';211,\itI111m~u,'~~~n1-!!::~~~:\i;'~,.~W:\:~ Name /?:>.-?Cl'Lfi e_", t,:r rl/ 1't./;,p. PIll,;, If)~ve /. . SQ Ft X $/SQ Ft = Value MailingAddress 123 "J;.~~/l.NA1"I/JJ4/U ~ NewDweilingArea City SP,,'IU/JPIe-~ State OAt. ZiP'f?'!71 Garage/Carport Area Phone '3:>; ~ ~7 Fax 68-/ 3n:S-=:> Other Structure Area Owner Representative ~/L:> A4'-'2(L/./115' Total Value Phone ':3>~ ~'l!Jrl Fax Q.,J .,,~ fiiZi1t~8.l!S.i1iiR'~~1i\W;J~~~\!~ SQ Ft X $/SQ Ft = Value 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 Date Z!?."gM I [] o Demolition Other ,..;"",,,,",,.~, ~~' .,,, ''lln1i; m O I)\"''''~l''~'~ 't, ,,' ,1"':J>:tr~""~~" ',. w~.ll. l'!J .,....,,' ....',..,....,}l\".I....:. i~-d", . Name ....J::;v? m ~ Mailing Address City Phone Existing Building Area New Building Area State Zip Fax Total Value o ~\l:~Ri1~w~.B;mh'.il1F~ Name KPpr:=- Address f Ii 'S W ..c;1!J. /l//H.J 151'; ,';' ZSCO City"'P2>~{.A 1,00 State of. ' Zipf7204 Contact Person AItILUZ."',IA/ rll9/)buncYJ Phone'503.34Z.::z,l'307 Fax O i!'!l'(i><,"""w;..""''''''''aw"''''''''"'''''''~''~~''''''''i,''''''''i'\'''''''''~~''''-....,--~~,j\r"~oo;;~.,;~.....'.''''<'"".,..~A~:-l " ~\"'''J{u.\.lJ..\(''~~IT''~~E'!it~r.;}~'''lC~:!!!"...".Y,lt~~~~~~f.i " " -li...fl......;;, ',' -~~~~....\;;.,..,;,,{'4'ucl8 Contractor's Name /1-_ ~ A CCB# Expiration Date Phone # General 7UILAJltU2- W~Lc.o 6..9f8P3 /~@j/17 S-'o/'~..:9~ -n..'IZJ Plumbing ..... .... 1"\ Mechanical Electrical -r p., If") (7\ orm~"'="~""'.r""lu-~tll' "~..p,'-nlYJ't~..'1 0 l:!;""'I/"'''''''"''''lmfJr''''t''''''''''''''~~-~ .,,,,,<. 11"" """'"'""',,,...,..,., , ,A.,J r'~()nt!HcJiUuf.....~..( .l!l 'llu.~...,~O,/~ ~Uel!..'~U _ Jc",:SA':-~~:~~"h~~~$'l:''j'~:<q >,;....i~".,.,.:"....~ Has site review application been submitted? Heat Snurce: Primary Seccndary , ~ Yes 0 No 0 NIA Water Heater Range Energy Path Ifso, Name of Planner -I-11tI()ill1il~ Do you require any of the following for this project? Journal Number,D'2-G 2006 _ f)~1. Over-width or Second Driveway 0 Yes 0 No Temporary Power 0 Yes 0 No Notice: All contractors & subccntractors are required to be licensed with the Construction Contractors Bnard of the State of Oregon under p.rOYiSions. OfO. RS 701 and may be required to be licensed in the 'urisdictiop. where work is beiDa e.crformed. i~~~=:1'li1Ai1~411[~,r~, .1 RCPT# i I DATE" ",'.." ...: .. 'r;~-j ~~~.._~",..;"lm'fi'I 'lW~~ Existing New Occupancy Group(s) Const. TVDe(S) Number ofStaries BUILDING PERMIT APPLICATION Shared Drivt(r:)lBuilding' Forms/Building rermit Applicuion IO.02.doc - . . . Property Planning & Development 123 International Way, Springfield, OR 97477 Phone 541.868.3505 Fax 541-335-2595 . PeaceHealth Oregon Region I Letter of Transmittal I To: Clair Company, Inc. 3333 Game Farm Road Springfield, OR 97477 Allan Clair 2/28/2007 Job No: Re: RiverBend Sacred Heart Medical Center Underground Pneumatic Tube and Fiber Ducts Alln: Date: We Are Sending You: D Shop Drawings o Copy of Letter o Attached DSUbmlttal o Prints o Under Separate Cover Copies 1 1 1 3 Date No. Description Permit Worksheet Buildin~ permit Application Electrical Permit Application Sets of P-tube Plans These Are Transmitted as Checked Below: DFor approval DApproved as submitted DApproved as noted DRetumed for corrections DResubmit ~ copies for approval DFor your use DAs requested DSubmit _ copies for distribution DReturn _ corrected prints DFor your review and comment E]Other Remarks: For you review and a~Droval in issuin~ a Iimil~r1 energy and plumbing permit as we have discussed. Thanks, Copy To: Signed: Chip Moulds 3/112007