HomeMy WebLinkAboutPermit Electrical 2013-5-3 •
SPRINGFIELD 225 Fifth St
Lax
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00885
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05103/2013 EXPIRES: 10/30/2013
STATUS DATE: 05/03/2013 APPLIED: 05/03/2013
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SITE ADDRESS: 1919 LAURA ST, Springfield, OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703271003200 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Storage Areas
OWNER: OLSSON INVESTMENTS LLC Phone Number:
ADDRESS: PO BOX 70413
SPRINGFIELD OR 97475
L CONTRACTOR INFORMATION `
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OLSSON INDUSTRIAL ELECTRIC INC CCB 63473 01/26/2015 541-747-6460
INSPECTIONS REQUIRED II
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
4999 Final Electrical Final Electric: When all electrical work is complete.
4225 Service or Feeder
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.
Owner or Contractor Signature Date
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT In OAR 952-001-0010 through OAR 952-001-
`)MMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
20 PAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 5/3/2013 1:27:56PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
't- 225 Fifth St
-'�`o EGOH TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2013-00885
www.springfield-or.gov 1919 LAURA ST permitcenter @lspringfield-or.gov
RECEIPT NO: 2013000870 RECORD NO: 811-SPR2013.00885 DATE:05/03/2013
(DESCRIPTION - _ __ i. __s ,-.., ACCOUNT CODE/TRANS_CODE ;.__ ,AMOUNT DUE_ -
Branch circuits with service or feeder each circuit 224-00000-426102 1004 390.00
Services 200 amps or less 224-00000-426102 1004 267.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 78.84
Technology fee(5%of permit total) 100-00000-425605 2099 32.85
-- ----- — TOTAL DUE: 768.69
LPAYMENTTYPE:_ __ PAYOR-. .,CASHIER:JLARSON } -'COMMENTS-";.' _ .. .`. + ,-p-AMOUNT-PAID . . ; ;5 ,I'r
Credit Card Olson Industries 768.69
513082
TOTAL PAID: 768.69
Electrical Permit Application DEPARTMENT USE ONLY
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Permit no.:
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225 Filth Stree t•S I in feld,OR 97.77.PH 54 1)726 3753+F 1X(541)726 3689 :: 1OR EGON
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Date:
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.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Number of inspections per item() Qty. Cost Total
CATEGORY OF CONSTRUCTION ea. cost
Residential, per unit,service included:
❑ Residential ❑Government ®Commercial
JOB SITE INFORMATION AND LOCATION 1 000 sq. R or less(4) $147.50 $
Each additional 500 sq. 0.or portion $ 27.50 $
Job site address: 1919 LAURA STREET thereof
City: SPRINGFIELD State: OR ZIP:97477 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
STORAGE AREAS Services or feeders:installation,alteration.relocation
200 amps or less(2) 3 $ 89.00 $267
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name:OLSSON INVESTMENTS 401 to 600 amps(2) $174.00 $ 1
Address: 1919 LAURA STREET 601 m 1,000 amps(2) $225.50
City: SPRINGFIELD State: OR ZIP: 97477 Over 1,000 amps or volts(2) $516.00 $
Phone:541 7478460 Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders: installation, alteration. relocation
This installation is being made on residential or farm property 200 amps or less(2) $ 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
479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: new, alteration,extension per panel i
Business name:OLSSON INDUSTRIAL ELECTRIC, INC a.Pee for branch circuits with purchase of a service or feeder fee:
Address:PO BOX 70413 Each branch circuit 60 $ 6.50 $390
City:SPRINGFIELD State: OR ZIP: 97475 b. Fee for branch circuits without purchase of a service or feeder fee:
Phone:541-747-8460 'Fax: - - First branch circuit(2) $ 60.50 $
E-mail: Each additional brunch circuit $ 6.50 $
CCB license no.:63473 BCD license no.:20-241C Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 33345 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor:DO I AS HEER Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel,
Signature of signing supervisor: �/ $ 80.00 S
']' /l 7G alteration.or extension(2)
Each additional inspection:(I) $80.00 S .
APPLICANT USE
t
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $657.00
(B)Enter 12%surcharge(.12 x[A]) $ 78.84
(C)Technology Fee(5%of[AI) $ 32.85
440-2584-J(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ 768.69