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Home My WebLink AboutPermit Electrical 2005-9-2 i'~~~~ilS: ;.r= lit.iI~l. ...r 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ~N)l\-D\4~ €A,rtO&~&E~AT!f-':{iM'",~l1I~ I. .,.. _"",,,,,,,_" .~;,!,!:!t.!.~ ~'J,~~ \\I1Jl~nd-. \)\L LEGAL DESCRIPTION . \, D?{/2.Cn . ~ JOB DESCRIPTION , 1\0:9?\-\~ ' . . Permits are non-transferable and expireJfwork Is jo not started within ~80 days of Issuance or lfwork is Suspended for 180 days., S~~ 2. r;t; '".1-: ,tTQ . ". ,.... iJ. .@. " ' E!ectrical Contractor EC Comoanv A~ P;O. Box' 925 City, Albany, OR Phone 541/926-4266 . t", o --- Owners Name ~rf I;1o\H-h Address ]c ~ \L\..,~ City Wt'f\1' . , - Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent ' .Date 3, rl'eaMP.~;'---:i;'J;:e:;;:;'t;':;J;;'lI&iiE\BEt;oTAii~~.!.<tI;;~ ~dot:"~.;!;~.~,~~"<~M>u'_'''~~;oJ'--''''-',,,-,,,,~ A.~mr~~~.~~~~ ' ~,. - "iiJii,~~ . .;.....w. ServIce Included IOQOsq. ft. or less Each additional 500 sq. ft. ,or portion thereof' ' Each MaD.ufact'd Home or Modular Dwelling Service or Feeder SI06.00 S 19.00 S50.00 B..__ 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIV olts Reconnect Only 2.~q S 63.00 2.4.'1- S 75.00 . \ f SI25.00 \~ SI63.00 ~ S375.00 $ 50.00 \5.D51.00 ' ~;' ~;~.~ ~ E.~~~~~;;tt~~ S 50,00 S 50.00 S25.00 ~ S45.oo' ~eo ATTENTION: Oregon law r Supervisor License Number' 31\:l!1OW rules adonted by ffi, ~:gfg' Notification Center. Those rules ~ft_~et.fprth ' Expinltion Date 10/01/ fNOAR 952-001-001 0 throu~eJ!.'Il~~f~tion or Relocation 0090. You may obtain copi@lbt\ml!S~~~y S 50.00 Constr. Contr. Number 22eiIl5C1Q the center. (Note:2.~fl!9:1l99 Amps,S 69.00 , number for the Oregon UtilO!' J\!Q)liii~li\llhAmps S 100.00 Expiration Date, 10/01/06 Center is 1.800-33~tfJhAmps or 1000 Volis see ~B" above. D, ~RrGfr-t.I~~:~.l!}~~Jjg&~, ",.~ ~_:.~~~~~JP.!!,.~ft~~J~ New Alteration or Extension Per Panel One Circuit, S 43.00 Each Additional Circuit or with .., c.".:l.A ?~ J\JI:fJ. CO Service or Feeder Pennit ';~ S 3.00 . Pump or irrigation Sign/Outline Lighting Limited EnergylResidentiaI Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surcharges MfiY'CO:, ' , !r.'9'"''''-''''''''''''''''';;';-'''''''''''''''''''''''''''_''''' "...'1 Owners Signature: I ~. 4. ",SmrrO. ',PE.AB(J, ,,~... . ". ~.... THIS PERMIT SHALL EXPIRE IF THE wORlt""w~4ZJ!:_L_"'~, ' . .' ~\'!o. pO AUTHORIZED UNDER THIS PERMIT IS N017% State Surcharge "q~",~ .q\ COiViMENCED OR IS ABANDONED FOR EMO% Administrative Fee ' \ 0\,' 'Lot!tD ANY 180 DAY PERIOD. ~ t\. c::\V ' 1 L I ~ ~ 1 11 InspectionRequest: 726-3769 ~~ (\~ ~"'r~TIff....,^ OIl.~l4V{:z.~d) .' Ul,lO;J Sl . ~~ ~ YS~v~U'ldmgForms/EICCtricaIPermi'A~"n ,In ~ ~ - , , ,-cn.lA\.dl. . . CITY OF SPRINGFIELD Status Issued , 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax :; 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2004-01488 ISSUED: 09/0112005 APPLIED: 12106/2004 EXPIRES: 03/0112006 VALUE: $ 212,186,907.00 SITE ADDRESS: 3333 RiverBend Dr ASSESSOR'S PARCEL NO.: 1703220000902 Springfield TYPE OF WORK: Hospital TYPE OF USE: New Commercial PROJECT DESCRIPTION: Riverbend Hospital Owner: PEACEHEALTH 'Address: PO BOX 1479 EUGENE OR 97440 I, CONTRACTOR INFORMATION.I , Contractor Type Contractor License Expiration Date Phone Arcbitect ANSHEN & ALLEN 415-882-9500 ::, General TURNER CONSTRUCTION COMPANY 69988 11/09/2007 503 229-6000 ; Electrical E C COMPANY 49737 01/15/2008 503-224-3511 Plumbing TWIN RIVERS PLUMBING INC 17695 03/11/2007 541-688-1444 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I-I.I B IFR # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a 1 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: Handicapped: Compact: Notes: "C-,?'''''::. .\ - : ~ ,-'.... I PUDLIl.. IMPROVEMENTS' ATTEN~J~PI"'raw requires you to tol.low ~u'6~_liWibi'a\\ls:Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090,. You may obtain copies ot the rules by callIng the center, lNote: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Street Improvements: Storm Sewer Available: Special Instruction: THIS PERi\1IT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COiVilViENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Paee I of4 . " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Estimate :. Estimate Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety + I % Seismic Fee + 10% Administrative Fee + 7% State Surcharge Building Permit + 10% Administrative Fee + 7% State Surcharge Fixture Sanitary Sewer - 1st 50 Feet :_ Special Waste Connection Deposit + 10% Administrative Fee + 7% State Surcharge Plan Review Plumbing (30%) Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addt11 00' Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each Addt1100' + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus Perm ServlFdr 1000 amps/volts Perm ServlFdr 200 amps or less Perm ServlFdr 201 to 400 amps Perm ServlFdr 401 to 600 amps .. Perm ServlFdr 601 to 999 amps Plan Review Electrical (25%) Total Amount Paid . I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 212,186,907.00 248,000,00 Total Value of Project Fpp< tailIJ Amount Paid $443,476.63 $272,908.69 $5,518.79 $55,187.86 $38,631.51 $551,878.72 $21.60 $15.12 $14.00 $90.00 $112.00 $10,000.00 $293.20 $205.24 $1,029,)3 $45.00 $560,00 $1,162.00 $45.00 $1,120.00 $14,201.30 $9,940.91 $22,602.00 $63,585.00 $19,125.00 $15,057.00 $18,150.00 $1,375.00 $2,119.00 $41,538.81 $1,590,008.51 Date Paid 12/6/04 12/6/04 7/1105 7/1105 7/1105 7/1105 7/6/05 7/6/05 7/6/05 7/6/05 7/6/05 7/8/05 8/22/05 8122/05 8/22105 8/22/05 8/22/05 8/22/05 8122/05 8/22/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 9/2/05 Paee 2 of4 . CITY OF SPKll~\"1<l~LD' Building/Combination Permit PERMIT NO: COM2004-01488 ISSUED: 09/0112005 APPLIED: 12/06/2004 EXPIRES: 03/0112006 VALUE: $ 212,186,907.00 Value Date Calculated $212,186,907.00 $248,000.00 $212,434,907.00 07/0112005 06/08/2005 Receipt Number 2200400000000001481 2200400000000001481 2200500000000000873 2200500000000000873 2200500000000000873 2200500000000000873 1200500000000000955 1200500000000000955 1200500000000000955 1200500000000000955 1200500000000000955 2200500000000000902 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 . . CITY OF ~rKlNGFIELD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit. PERMIT NO: COM2004-01488 ISSUED: 09/0112005 APPLIED: 12/06/2004 EXPIRES: 03/0112006 VALUE: $ 212,186,907.00 Structural Review 06/0212005 I Plan Reviews I 06/03/2005 10 LLH Forwarded revised structural fill drawings to Clair Approved for Structural fill Only Approved for foundation, shell and core only. See attached documents for plan review comments and or conditions Structural Review Structural Review 06/03/2005 06/30/2005 06/08/2005 APP 06/30/2005 APP AC AC To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. L..Rplnlli~,:Iortinn{', I Water Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Backf10w Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Special: See Plan Review and/or Inspector Notes. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Slab: To be made after all inslab building service equipment, conduit piping and other equipment Items are in place but prior to concrete. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. Special Inspection: Weld Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Special Inspection: Reinforcing Steel Mill Certificate Inspection: To he done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Special Inspection: Masonry, Mortar, Grout, and Reinforcing Steel Certificates Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Structural Welds: To be done during construction by State Certified Special Inspector. Provide Inspection test results to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. Page 3 of 4 . . Ul r OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2004-0I488 ISSUED: 09/0112005 APPLIED: 12/06/2004 EXPIRES: 03/0112006 VALUE: $ 212,186,907.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 tbe Laws of the State of Oregon pertaining to the work described berein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Dlvisiou, 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 I -. street, that the permit card is located at the front of the property, and the approved set of plans wllI remain ou the site at all ;.7~/ 2 -~-200'~ 'rrol2~;rssiZ;k'~-= Date Pal!e 4 of 4 225 Fifth Street . , . '. .Springfield, Oregon 97477 5.41-726-3759 Phone . ~~ ~ Job/Journal Number CbM2004-0 1488 COM2004-01488 COM2004-0 1488 C:bM2004-0I488 COM2004-0 I 488 COM2004-0I488 COM2004-0I488 COM2004-0 I 488 COM2004-0I488 COM2004-0 1488 P.ayments: T~pe of Payment Check !NT CHGS Jiib/Journal Number COM2004-0I488 , . CpM2004-0I488 CpM2004-0I488 COM2004-0I488 COM2004-0l488 COM2004-0 I 488 COM2004-0 1488 COM2004-0 1488 COM2004-0 1488 COM2004-0 1488 Payments: Type of Payment Check !NT CHGS ~ :! ;1 :i: 'f! ~I " 'I , 9/212005 " RECEIPT #: 2200500000000001211 Description Perm ServlFdr 200 amps or less Perm ServlFdr 20 I to 400 amps Perm ServlFdr 40 I to 600 amps Perm ServlFdr 60 I to 999 amps Perm ServlFdr 1000 amps/volts Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus + 7% State Surcharge + 10% Administrative Fee Plan Review Electrical (25%) Paid By PEACE HEALTH 821-00000-2 I 550 EC ELECT Received By IIh Description Perm ServlFdr 200 amps or less Perm ServlFdr 20 I to 400 amps Perm ServlFdr 40 I to 600 amps Perm ServlFdr 60 I to 999 amps Perm ServlFdr 1000 amps/volts Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus + 7% State Surcharge + 10% Administrative Fee Plan Review Electrical (25%) Paid By PEACE HEALTH 821-00000-21550 EC ELECT Received By IIh Page I of I (;heck Number Batcb Number 228673 !NT CHGS aity of Springfield Official Receipt Wbevelopment Services Department Public Works Department Date: 09/02/2005 Item Total: Authorization Number How Received In Person In Person Payment Total: Item Total: Check Number Authorization Batcb Number Number How Received 228673 !NT CHGS In Person In Person Payment Total: 10:53:16AM Amount Due 15,057.00 18,150.00 1,375.00 2,119.00 19,125.00 22,602.00 63,585.00 9,940.91 14,201.30 41,538.81 5207,694.02 Amount Paid $197,694.02 $10,000.00 5207,694.02 Amount Due 15,057.00 18,150.00 1,375.00 2,119.00 19,125.00 22,602.00 63,585.00 9,940.9 I 14,201.30 41,538.81 5207,694.02 Amount Paid $197,694.02 $ I 0,000,00 5207,694.02