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Home My WebLink AboutPermit Electrical 2007-7-9 (2) .PRI~D. -:--J ZON c..c--- ~A~ -.,." INITIALS f'J "'^ "" " :" "'7-0'-7~;:D)AuTERCE 1 ~;':," _ _ 22S FIITH STREET' SPRINGFIELD, OR 97477 , PH:(541)716-3753 'FAX: (S41)716-3689 " IlliO' '- I , .".....V7_ ELECTRICAL PERMIT APPLICATION City Job Number (70;111'1 z.oo 7 -0 <:::::> '-16 r Date r- ",--- _u -- ,-- - --- -- --- -- ,-- -- 1. LOCATION OF INSTALLATION: 3. , COMPLETE FEE SCHEDULE BELOW 3i'~-~-~~-- J,.mAL DESC:RIl'TION: /703 Z2..0 0 oo9DZ, V A. :~ew_Resid!ntial- Single or Mu~ti-Family per d",elling nnit. Service Included JOB DESCRIPTION: \J01CLClL- ~ <..... 0~ 1000 sq, ft. or less Each additional 500 sq. ft. or portion thereof $iI7,OO $ 21.00 Permits are non-transferable and expire ifwork<1i Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 1_'___ - - ---- ---- --- - ."_. ,-- u_ - - -- 2 : CONTRACTOR INSTALLATION ONLY B. , Sef\ices or Feeders -Installation, Alterations or Relocation: . l_ _,_~ ___ _ __... _~_ _ -_._.- ~ -- - .- Electrical Contractor ---r-r-c........ CO LX\'\.~; c.~~mps or iess n l. 20 I Ampsto 400 Amps Address /J.?-::<, 1\ I\.) , t' [V\IYL. A V L 401 Amps to 600 Amps ~ _. 'I A\/j....,r . ~ 60i Amps to 1000 Amps City ~ Phone ,lJal"7..aQ.) U Over 1000 AmpsNolts v Reconnect Only $55,00 $ 70,00 $ 83.00 $138,00 $i80,OO $413,00 $ 55,00 Supervisor License Number 3.?St q ( (~ Cf:// / Iz; 0 - I/_/r.,-j~ I/U//(() Cansti'. Contr. Number 6*fl..... I I 1/7 IW" I LI/ !I/Dq I C. i Temporary Services or Feeders l. _ _ ~_ __ ." _ __. -- Expiration Date ~~~;Aiir&PIRiIF'i'H~ WWI{ 2o~ER tHI\) rtnrln~l~ 3&1 40~~m:OO IS ABAl\lDUNtU ~~,OO Orv<tJ6lfl_~~.~e '::B.':. ab~ve, _ _ _ _ __ _ _. - , D. ' Branch Circuits Expiration Date u"Z:ViW;;c/ U- New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48,00 $ 4.00 Owners Name Address ~O E.l_~i~ll~;e~;S(S~;~iCe/f~e~r notin~lui.,d)~~a~'; Ins~~lation~: . Pulllp or inigation $ 55,00 Sign/Outline Lighting $ 55,00 OWNER INST ALLA nON Limited EnergylResidential $ 28,00 The installation is being made on property I own which Limited Energy/Commercial I $ 50.00 ,0 is not intended for sale, ~\l1~~t:::::1~' aectric Permit Inspection Fee is 550.00 + Surcharges II1.1l a:~~~Gn 0 00 - ~- . Owners Signature: =caiI:~ ~liP , _ TALOF~9~ __~_ ' 5'0 !r:.,,~~..ftfl~..(!fiiQ~~~~S,,:charge '1 @GOO, ':ooiilOV~~~~.lidll1ll1lstratlve'Fee .5 @sl1lnl! ~~_ ~~~hnOIOgy Fee z...so lihJRlM1 Cor Qho orogon ~ ~ 0 / /' ~o Inspection Request: 7Z0-3n9-ecnwr 10 ~~~ TOTAL 'Ci . Shared Drive(f:)fBuilding FormslElectricaJ Permit Application 7-07.doc Phone City SCANNED -~~~ WIt, , . . CITY OF SPRINul'mLD Building/Combination Permit PERMIT NO: COM2007-00469 ISSUED: 06/29/2007 APPLIED: 03/30/2007 EXPIRES: 0110612008 VALUE: $ 29,769,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3355 RiverBend Dr ASSESSOR'S PARCEL NO.: 1703220000902 Springfield TYPE OF WORK: Medical Office TYPE OF USE: New Commercial PROJECT DESCRIPTION: Northwest Specialty Clinic Owner: PEACEHEALTH Address: PO BOX 1479 EUGENE OR 97440 I CONTRACTOR INFORMATION I Contractor Type Architect General Low Voltage Electrical Contractor ROLAND UDENZE THE HASKELL CO A FLORIDA CORP TTC COMMUNICATIONS INC License Expiration Date 147733 164114 05/11/2009 04/11/2009 Phone 904-791-4801 904-791-4674 541-689-2650 BUILDING INFORMATION I # of Units: Primary Occupancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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 GaragelCarport Sq Ft Other: Occupant Load: nla 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: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: speciallnw@1fU~~~ Notes: il'US ~R~Jlrr SHALl. EXPIRE IF THE WORK JUl'i'HORIm} ItJI\lDER THIS PERMIT IS NOT COMM~I\IC~D OR IS ABANDONED FOR AN'{ 180 DAV ~ERIOD_ Sidewalk Type: Downspoutsffirains: ATTENTION: Oregon law mqull'9Q you to roflow rulGO adopted by ths Orsgon Utility Notification Center. Those rulso are oat forth In OAR 952-001-0010 through OAR e52-OOi. 0090. You may obtaIn oopleo ~ tho Nloe blJ calling the center. (Nots: tho ~O!lllcn, 0 number for the Oregon l1iIlliy N\.il\~M Center 10 1-800-332-2344). Paee 1 of 4 -iiiF Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lipe Descriptiop Estimate Tvpe of Construction Estimate Fee Description Plan Review CommlInd/Public + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Deposit Plan Review Comm/lnd/Public Plan Review Fire & Life Safety Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Total Amonnt Paid Plan Review Comments . 1 Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 29,769,000.00 Total Value of Project Fppo, PIi/iLI Amount Paid Date Paid $2,268.92 $9,698.99 $4,849.50 $7,759.19 $96,989.90 $25,715.32 $60,930.94 $38,795.96 $10,201.75 $13,418.47 $10.00 $122,046.85 $122,046.85 $1,812.30 $33,226.08 $353,019.54 $80,024.23 $5.00 $2.50 $4.00 $50.00 4/2/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 6129/07 6/29/07 6/29/07 6/29/07 6/29/07 6/29/07 7/9107 7/9/07 7/9/07 7/9/07 $982,876.29 I Plan Reviews I 06/29/2007 10 Paee 2 of 4 . CITY OF SPRI~ul' IJ1..LU Building/Combination Permit PERMIT NO: COM2007-00469 ISSUED: 06/29/2007 APPLIED: 03/30/2007 EXPIRES: 0110612008 VALUE: $ 29,769,000.00 Value Date Calculated $29,769,000.00 $29,769,000.00 06/19/2007 Receipt Number 2200700000000000472 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 1200700000000000842 2200700000000001095 2200700000000001095 2200700000000001095 2200700000000001095 LLH Check dated 6/26/2007 from Haskell exceeded the current amount due OD the project. I have requested the amount placed in the deposit account today (6/29/07) $25,715.32 be returned to the payee as soon as possible. Information forwarded to Kaye Wilson. llh . . CITY OF ~rKll~GFIELD Building/Combination Permit PERMIT NO: COM2007-00469 ISSUED: 06/29/2007 APPLIED: 03/30/2007 EXPIRES: 0110612008 VALUE: $ 29,769,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 06/27/2007 06/14/2007 APP JLP Entered SDC fees based on DFU cales in memo provided by CLAIR dated 6/8/07 as direCted by Ken. JLF 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. Ueollirerunsnections I Ufer Electrical Ground: Install ground rod at footing and call for inspectiop in conjupction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Masonry: Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Roof SheathinglNailing: Before covering sheathing with finish material. High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are ins~alled. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Epoxy Anchors: To be done by Certified Spciallnspector. Provide Inspection results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Rough Plumbing: Prior to cover and including required testing. Paee 3 of 4 . . CITY OF ~rKll~uNJ<..LD Status Issued Building/Combination Permit PERMIT NO: COM2007-00469 ISSUED: 06/29/2007 APPLIED: 03/30/2007 EXPIRES: 0110612008 VALUE: $ 29,769,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3~76 Fax 541-726-3769 Inspection Line Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Fipal Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Low Voltage: Prior to cover. 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 1 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 witbout 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 the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 4 of 4 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2007-00469 COM2007-00469 COM2007-00469 COM2007-00469 Payments: Type of Payment Cred itCard cReceinl1 RECEIPT #: ~ Ilk " . of Springfield Official Receipt ~~elopment Services Department Public Works Department 2200700000000001095 Date: 07/09/2007 Description Low Voltage - Commercial Indus + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By TTC COMMUNICATION Item Total: Check Number Authorization Received By Batch Number Number How Received djb 872015 In Person Payment Total: Page I of I 8:23:36AM Amount Due 50,00 2.50 4,00 5,00 $61.50 Amount Paid $61.50 $61.50 7/9/2007