HomeMy WebLinkAboutPermit Electrical 2013-5-17 SPRINGFIELD-' 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
•celLY Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00982
WNW.springfieldor.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/17/2013 EXPIRES: 11/12/2013
STATUS DATE: 05/17/2013 APPLIED: 05/17/2013
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SITE ADDRESS: 645 MAIN ST,Springfield,OR 97477 SCOPE: ,Electrical Only
•
ASSESOR'S PARCEL NO: 1703353110100 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: New Exit Signs
OWNER: SPRINGFIELD PUBLIC Phone Number:
ADDRESS: 525 MILL ST •
SPRINGFIELD OR 97477
OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number:
ADDRESS: 525 MILL ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION .1
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
JOHN H SARACENO (PS)Electrician,Li 1073PS 10/01/2013 541-689-6010
INSPECTIONS REQUIRED
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover •
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 the property, and the approved set of plans will remain on the site at all times during
construction. •
_ -5-7713
Owner or�>. racto s nature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001- •
0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telep! AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR
Center is 1-800-332-23,14). NY 180 DAY PERIOD.
Springfield Building Permit 5/17/2013 9:23:09AM • Page 1 of 1
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SPRINGFIELD— CITY OF SPRINGFIELD
AgyR 225 Fifth St
TRANSACTION RECEIPT SpnngfielSOR97477
OREGON 541-726-3753
811-SPR2013-00982
www springfield-or.gov 645 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2013000972 RECORD NO: 811 SPR2013-00982 DATE:05/17/2013
11 ,..ga1;41 r■_-"ACCOUNT.CODE/TRANS:CODE .".y"_i-:-AMOUNT DUE I:
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 . ..19.50
Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50
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
PAYMENTtTYFE+,�? �P.r¢
AYOR -cASHIER:JLARSON COMMENSS , - AMOUNTgFA1D's Credit Card Card SPRINGFIELD PUBLIC 93.60
122342
TOTAL PAID: 93.60
Electrical Permit Application DEPARTMENT USE ONLY
C-Ait' . i:N , a:e. .i nfa 4T^Si.' {` Y3 %"`ananvM' a*sa.r.as 1�'itg RI GFIELO C 0 ..
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CIRW,OF SP<RDTGFIEEDr GREG`O -`""zdf `-t' o
s 9-- ,t _:aq s ,t, C Permit no �(/ 7 13 i?
225 Fifth StreeNSpring£eld,OR 97477•PH(541)726-3753•FAX(541)726-3689
` ."ice
Date: 5-47 //3
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.
`•;t t' LOCAL; GOVERNMENT APPROVAL ::: : .f t FEE, SCHEDULE i ' g '
Zoning approval verified? ❑Yes ❑No Number of inspections per item O Qty;,;:4 east eottl, ':
" " -CATEGORY' OF'CONSTRUCTION .,..'?5 .
' Residential,per unit,service included:
❑ Residential ❑ Government ❑Commercial 1,000 sq.ft.or less(4) $147.50 $
;,Y JOBuSIT.E. I NFORMATIO N'=AND LOCATION':',5.%::-2,:e=:,
" Each additional 500 sq.ft.or portion
Job site address: 695 4')q/,t J sr thereof - $ 27.50 $
City: 5p4 l"I cc 1 State:. a.(- ZIP: coy 77 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
` DESCRIPTION'OF. WORK;.; dwelling service or feeder(2)
Services or feeders: installation, alteration, relocation
N(i.t) tsxir Sl y.0 s 200 amps or less(2) $ 89.00 $
_<, /, :f PROP„ERTYY QVIINER ,
_ ` , f zw_ 201 to 400 amps(2) $ 104.50 $ •
Name: (Sloe?../.rii ItL2 scd,eOL_Doi..'0/`I 401 to 600 amps(2) $174.00 $
47 Address: t 6,�S ,/y/ 601 to 1,000 amps(2) $225.50 $
City: / ) I State: Oc I ZIP: q 7 V 7) Over 1,000 amps or volts(2) $516.00 $
Phone:,rt/ -- 3 t09 I Fax:511( 7 L[: 1 Sy f' Reconnect only(2) $ 69.00 $
42(....,76_,,c44_,01_,0 Temporary services or feeders: installation, alteration, relocation
E-mail: a- S/,U"✓phc= ) r.k:/4-..oi rh 200 amps or less(2)
This installation is being made on resid€ntial 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
479.540(1)and 47'.560 1). 401 to 600 amps(2) $138.50 $
Signature i Over 600 amps or 1,000 volts,see services or feeders section above
'' Y ��e i ,o R:i;INSTALL'ATION: !_'? .i ."'; Branch circuits:new alteration, extension per panel
Business � - s*-n` R{ n 12 ,�„tf•--- a. Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 6.50 $
City: State: . ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) I $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 70 73p 5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: L j, ,4 O,vo Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: Signal circuit or a limited-energy panel, - $ 80.00 $
Ong P a, �� alteration,or extension(2)
_- Each additional inspection:(1) $80.00 $
:.•M ;4' =atFAPFLICANT,'USE , T ' _,<:: -`
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) S
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges (A through C): $ 73 -S2'--
440-2584-1(4/012013/C0M)