HomeMy WebLinkAboutPermit Electrical 2013-5- •
SPRINGFIELD 225 Fifth St
hI ° CITY OF SPRINGFIELD Springfield,OR 97477
tN Phone: 541-726-3753
' /OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00864
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/01/2013 EXPIRES: 10/28/2013
STATUS DATE: 05/01/2013 APPLIED: 05/01/2013
SITE ADDRESS: 326 CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703263406200 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Electrical for irrigation
OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number:
ADDRESS: 525 MILL ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
4500 Rough Electrical Rough Electric: Prior to Cover
4999 Final Electrical Final Electric: When all electrical work is complete.
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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 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.
_ Sil /I 3
Own- o Contrac .r Signature Date
ATTENTION: Oregon law requires you to
NOTICE: follow rules adopted by the ()ear egon Utility
Notification Center. Those rul are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through AR 952-001-
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
number for the Oregon Utility Notification
ANY 180 DAY PERIOD. Center is 1 800 332-2344).
Springfield Building Permit 5/1/2013 10:01:13AM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
°.\`OREGON
O TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-S PR2013-00864
www.springfield-or.gov 326 CENTENNIAL BLVD permitcentergspringfieid-or.gov
RECEIPT NO: 2013000849 RECORD NO:811.SPR2013-00864 DATE:05/01/2013
tDESCRIPTION_ - '- . _- w L,.�..__A000UNT.CODE/TRANS_CODE^ri:_AMOUNT.DUE __ ,
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.02
Technology fee(5%of permit total) 100-00000-425605 2099 5.43
TOTAL DUE: 126.95
i_,;PAYMENTTYPE PAYOR.. c nSRIER_ccA0E,NTER _ COMMENTS ^".- . r,:4AMOUNTPAID r' '
Credit Card SPRINGFIELD SCHOOL DISTRICT 1£ 126.95
125939
TOTAL PAID: 126.95
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Electrical Permit Application DEPARTMENT USE ONLY i
y -, l SPRINGFIELD 3 q/
CITY OE SP.RLNGEIELDtOREGOI�i Permitno.: S( J - K2"( .
(Lw t
225 Fifth Sireet•Springfield.OR 97477♦PB(541) '-6-3753♦FAX(541)726-3689
hr OREGON _ / J /
Date: r/ 1 1 t
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 wort: is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑Yes ❑No Number of inspections per item () Qty. Cost Total
ea. cost j
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
❑Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1,000 sq.R.or less(4) I $147.50 $
Each additional 500 sq. ft.orponion {
Job site address: 50'Ll, CZ.N j A114(-- r LAL-. thereof $ 27.50 $ 1
City:. SPAjvig�(-, State: 6c� ZIP: 97/77 Limited energy(2) $ 35.00 $
Reference: 7'7O $ 2.L.7Y Taxlot.:eZ 209 Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK
duelling service or feeder(2)
�. , Services or feeders:installation,alteration,relocation
LACCIC n.CAA. SiE R.vi C •/D riti q,6^) ,
200 amps or less(2) 1 $ 89.00 $ ger
Puny
f-PROPERTY OWNER 201.to 400 amps(2) I $ 104.50 S l
Name:Spa K��Q-Lab SC.1..t. nr.) dr..(G1 401 to 600 amps(2) $174.00 S
Address: y M� � - 607 to 1.000 amps(2) $225.50 $
Citya�0atuti `r..y� State: D Ct ZIP: 72 9 9'> Over 1.000 amps or volts(2) $516.00 S i
Phone: f Reconnect only(2) $ 69.00 $
SY 7,4, -3 L„/ Fax:311/- /tut 9SSS'
E-mail: �.- Temporary services or feeders: installation, alteration, relocation
L tf(.w.f'H U civ✓ i '2. ,-,-6b0 ��/Ld1- ,f.S 200 amps or less(2)
This installation is being made on residential or farm property $ 69.00 $ !
owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 $
property is not intended for sale,exchange,lease,or rent.OAR
479.5400)and 479.560(1). 401 to 600 amps(2) $138.50 , $ 1
Over 600 amps or 1,000 volts;see services or feeders section above
Signature 4Z+-2�
CO OR INSTALLATION Branch circuits: new,alteration,extension per panel
Business n LA_.) 1X_ a.Fee for branch circuits with purchase of a service or feeder fee:
t
Address: Each branch circuit 3 $ 6.50 $ft7,5 1
City: State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: i
Phone: - - Fax: - - First branch circuit(2) $ 60.50 $
E-mail:
Each additional branch circuit $ 6.50 $
i
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included .
I
Signing supervisor's license no.: O Each pump or irrigation circle(2) $ 69.00 $ i
Print name of signing supervisor:, Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel, $ 80.00 $
Signature of signing supervisor: alteration,or extension(2)
Each additional inspection:(I) $80.00 $ ,
APPLICANT;USE
(A) Enter subtotal of above fees I
$
(Minimum Permit Fee$80.00) /o)O ■
(B)Enter 12%surcharge(.12 x LA]) $ /702
(C)Technology Fee(5%of(Al) $ 9/=
440-2584-4(4101/2013/COM11) TOTAL fees and surcharges(A through C): $ /2/0c S i