HomeMy WebLinkAboutPermit Electrical 2013-5-13 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
-`� Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00934
www.spnngfield-or.gov permilcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/13/2013 EXPIRES: 11/08/2013
STATUS DATE: 05/13/2013 APPLIED: 05/13/2013
•
SITE ADDRESS: 925 HARLOW RD,Springfield,OR 97477 SCOPE: Electrical Only
. ASSESOR'S PARCEL NO: 1703223300100 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Low Voltage
OWNER: SELCO COMMUNITY CREDIT UNION Phone Number:
ADDRESS: PO BOX 7487
SPRINGFIELD OR 97475
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
RJO COMMUNICATIONS (CLE)Electncal Cc CLE185 07/01/2014 541-285-6345
INSPECTIONS REQUIRED
Inspections
4550 Limited Energy
4999 Final Electrical Final Electric: When all electrical work is complete.
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 th property,and the approved set of plans will remain on the site at all times during
construction.
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
In OAR 952-001-0010 through OAR 952-001• AUTHORIZED UNDER THIS PERMIT'S NOT
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
• calling the center. (Note: the telephone ANY 180 DAY PERIOD. •
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 5/13/2013 9:14:03AM Page 1 of 1
•
•
•
•
/ SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
�t+ TRANSACTION RECEIPT Spnngfiel oR97477
t';nril,�i 541-726-3753
OREGON
xeGoH 811-SPR2013-00934
•
www.spnngfield-or.gov 925 HARLOW RD permitcenter@spnngfield-or.gov
RECEIPT NO: 2013000929 RECORD NO: 811SPR2013-00934 - DATE:05/13/2013
fel*gta1Ji foY;1Q '"W ' ?"=4,♦AL,:.a-2 - 1`:x ="'....ACCOUNTCODE/TRANSCODE4 `ZS AMOUNT DUE'.a:
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00
Data/Telecommunications 224-00000-426102 1004 69.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
'ZPAYMENTTYPE 'PAYOA dASHIEi JLARSON d.,a" . ,sr' 'COMMEN
Credit Card RJD COMMUNICATIONS 93.60
H20852
TOTAL PAID: 93.60
•
•
•
•
Electrical Permit Application '(: .‘ 00ARTmENTJusEoNLt:::::•::
SPRINGFIELD
tICITYOFESPRINC-'FIEL=W-fOREG-ON:
i---ai-sft
emi,
* --cm Permit no g/(Za7(3 0093c7
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689
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.
•
-4.:i) :',1V*'40CAL;;GOVERNMENTIAPPRO.VAlafitaSt '.f, 'Z''.;.$1•aiga:116,W1jFEE(t:SOILIEDUEEiliViVgNiVyn3';'!E71
Zoning approval verified? El Yes El No 't, ti”RS'Sr=1:+rit5SiteslaYMIVACInW7,1r4:;:t::47,1ACIE&S; rxrdtify;
kNoiptierptinsp,ccsiqnsteriterficoy ply: ..",..eit;3;,,:.;is-j-v eogr's‘'
W‘..c .:CATEGORY..c0F.j:..C,ONSTRUCTION::•AIM;A::::,M.; " ''''''''''-''C'' 'IS4.2“:3';4'3*';"''al&lh- 1" 'ff: '1" .-''' 'If['•
Residential, per unit,service included:
0 Residential 0 Government D Commercial
1,000 sq.ft. or less(4) $147.50 $
I
:,:t.?.::.-:JOBc:SITEANFORMATIONx"AND ).TIONti;SVV;
Each additional 500 sq. ft.or portion
Job site address:\ t\ 9 \\%CI cOU \ thereof - $ 27.50 $
City: <4 X) State: c 3( ZIP: Ci\ii(-rn Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular
'-'7A1'1K:::= 1tt•k11V%D ESC RIPT101 Fi'WORK ':',:4i'::,it:Mrlasic dwelling service or feeder(2) $ 69.00 $
1,.0 kTei \)kl
' k(ASA\ W 7 .'0U Services or feeders: installation,alteration,relocation
200 amps or less(2) $ 89.00 $
54.,C7:1;:l12";;;11:117W9.:PROPERMOWNER1n.:.P.,iWPM11:414 201 to 400 amps(2) $ 104.50 $
Name: E)-,c0 401 to 600 amps(2) $174.00 $
Address: IN 4) HT 0 ft 5--1 601 to 1,000 amps(2) $225.50 $
,
City:. Iuci-VV\ I State: UR I ZIP: 01193) Over 1,000 amps or volts(2) $516.00 $
only Phone: SI - V\)5 13-)Lrla‘.Fax: - - Reconnect onl (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
W]t WtiCONIEOCT,ORINSTALIM111010714**140 Branch circuits:new alteration, extension per panel
Business name: pcs o ws.\\ us.\\\p„,\A(-\. • a. Fee for branch circuits with purchase of a service or feeder fee:
Address: Iriji\0. 1 )C kV, INIT3jcb Each branch circuit $ 6.50 $
City: 5 ■cinc'■c\G"\ \AC,) I State: %., I ZIP: crokill b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: tS4i 0\8- 6-21.00..., I Fax: - - First branch circuit(2) $ 60.50 $
E-mail: 'kttiA\. 60VN l\\)k_ C\CAIC\ -Cq\ Each additional branch circuit $ 6.50" $
CCB license no.: r g 53,31 1 BCD license no : TA $) Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: (15 gi is R. Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Lf) Alc Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: 1.6i
Signal circuit or a limited-energy panel, •
$ 80.00 $
1 t ] alteration,or extension(2)
Each additional inspection:(1) $80.00 $
r . ATIFFIBTOKSifkraSI.E1Wrarifan
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges (A through C):
$ 73 a:2----
440-2584-3(4/01/20 I 3/COM)