HomeMy WebLinkAboutPermit Electrical 2013-5-24 •
SPRINGFIELD--° 225 Fifth St
jti 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-SPR2013-01063
www.springfield-or.gov permitcenter @springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 05/24/2013 EXPIRES: 11/19/2013
STATUS DATE: 05/24/2013 APPLIED: 05/24/2013
SITE ADDRESS: 2770 GATEWAY ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703220002300 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Thermostat wiring
OWNER: GATEWAY MALL PARTNERS Phone Number:
ADDRESS: 1114 AVENUE OF THE AMERICAS •
NEW YORK NY 10036
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor SALEM HEATING&SHEET METAL INC CCB 1505 05/19/2014 503-581-1536
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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 the property, and the approved set of plans will remain on the site at all times during
construction.
Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to NOTICE:
Tallow rules adopted by the Oregon Utility •
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 IS NOT
0090. You may obtain copies of the rule—, by COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telep . . ., /1 NY 180 DAY PERIOD.
number for the Oregon Utility Notiiict,-..,n
Center is 1-800-332-2344).
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Springfield Building Permit 5/24/2013 12:57:30PM Page 1 of 1
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SPRINGFIELD--- CITY OF SPRINGFIELD
Fifth St
TRANSACTION RECEIPT SFifthlSOR 97477
°IEGON z2s
541-726-3753
811-SPR2013-01063
www.springfield-or.gov 2770 GATEWAY ST - permitcenter @springfield-cr.gov
RECEIPT NO: 2013001037 RECORD NO: 811SPR2013-01063 DATE:05/24/2013
ligithilabltl-` a gaZire ��. ..rSaACCOUNT;CODE/TRAN&CODE.r r /AMOUNT:DU -
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00
Other Limited Energy 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
PAYMENTt PE. ._ .'..PAYOR cns`rgit RSO'N!- . C IMMENTS raMITAMOUNTyPAIp, ,,-
Check SALEM HEATING&SHEET METAL Its 93.60
60634
TOTAL PAID: 93.60
r Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD '#
gCITY!O SPRINGFIELD, OREGON 1 Permit no.:el(Zvl3 D1063 tts
225 Fifth Street•Springfield,OR 97477+PR(541)726-3753+1 A%(541)1263689 s' OREGON'
A-4/3 6
Date: 4
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This permit is issued under OAR 918'309-0000. Permits are nontransferable. Permits expire if work is not started within 180. i(
days,of issuance or if work is(suspended for 180 days.
LOCAL GOVERN ENT APPROVAL FEE SCHEDULE
Zoning approval verified? Yes ❑No Number of inspections per item O Qty. Cost cos l
CATEGORY OF CONSTRUCTION -
Residential,pet unit,service included: I❑Residential ❑Government Commercial - '
JOB SITE INFORMATION AND L C TION t:000sq.ft.or less(4) $147.50 $
( G l - - - Each additional 500 sq.ft:or portion
Job site address: d�-7-0 Gthti-e%GJ .�f thereof ,$ 27.50 $
City: f 1 •cit l di State: ( ' 1rJ—7
y: p u Q1` ZIP; �1 11-1 / muted energy (2) $ 35.00 $3S
Reference: �f Taxlot.: ' Each manufactured home or modular ;I
�'l DESCRIPTION OF WORK d+e'1i to service or feeder(2) $ 69.eo $ 'I(
11"!(flgo$k� Ol t1(1t{ Services or feeders: installation alterationq relocation +S
J200 amps or less(2) $ 89.00 $ 333
PROPERTY OWNER 20t to 400 amps(2) $ 104.50 $
Name:: (9,,ki el mai ktk-inu 401 to 600 amps(2) $174.00 $
Address: ///y Ave, or 7t-(,e 4,44.en" '601 to 1,000 amps(2) $225.50 $
City: /v X State:4/7 ZIP:/003,4 Over 1,000 ampsoivolts(2) $516.00 $ i
Phone: - - Fax - - Reconnect only(2) $ 69.00 $ I
E-mail: Temporary services or feeders: installation, alteration,relocation.
This installation is,being made on residential or farm 200 200 amps of=less(2) '$ 69.00 . $ t
. owned by me or a member of my immediate faniily.This 201 to 400 anips(2) $ 96.00 $ I
property is.not intended for sale;.exchange, (case,or rent.OAR !
479.540(I)and 479.560(I). 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
Business,name: 50%1P.A,. Ile�,Vintt a. Fee:for branch circuits with purchase of a service or feeder fcc:
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Address:' Po 3 os 1 z 0< l Each branch circuit $ 6.50 $ '
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City: j 0 e r ( State: 0g. ZIP: (I-nog b w
Fee for branch circuits ithout purchase of a service or feeder fee:
Phone: 503- SO) )5361_ _ Fax: 6.1).3--1 -37'a-3790 First branch circuit(2) $ 60.50 $
E-mail: �p IG(�o1.J® ��,Ier•,Lcc41AvGJ 5hef#Mefrnl- („n, Each a 'itional branch circuit ' $ 6.50 $
CCB license no.: J 2S "BCD,license no.: Miscellaneous fees:service or feeder not included
Signing supervisor s license no 251 L✓rg ,.� J/ Each pump or inigatmn circle(2) $69:00 $ ;I
Print name of signing supervisor: ,[J G A,.trf ' 77.9, ((JK Each sign or outline lighting(2) $ 69:00 $ �'
Signature"of si nun supervisor: �/[/`,I//"
Signal tion,or or"alimited-energy panel, $..80.00 $
signing P a/'r✓V w0' I alteration,or cstcnsion'(2)
�wJoj (? eW he-'k•^„ O,.)()IAeej-weSts` Each additional inspection:(I) $80.00 $
ed „ Lowe ' - ' APPLICANT USE - '-hf
(A) Enter subtotal of above fees Q
(Minimum Permit Fee$8000) o O ,j
(B)Enter 12%surcharge(.12x[A]) $. 9. 60
(C)Technology Fee(5%of[A]) $ 1
440-2581-3(4i01rz013/COM) TOTAL fees.and-surcharges-(A through C): $ IS €...2- 0
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