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HomeMy WebLinkAboutPermit Electrical 2013-6-3 SPRINGFIELD i 225 Fifth St ' 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-SPR2013-01138 www.springfield-or.gov permitcenter @springfield-ocgov PROJECT STATUS: Issued ISSUED: 06/03/2013 EXPIRES: 11/29/2013 STATUS DATE: 06/03/2013 APPLIED: 06/03/2013 SITE ADDRESS: 1290 W CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703273402919 TYPE OF STRUCTURE: Commercial • PROJECT DESCRIPTION: Electrical for remodel work OWNER: CENTENNIAL DENTAL BUILDING LLC • Phone Number: ADDRESS: 2245 CHARNELTON ST EUGENE OR 97405 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JB ELECTRIC INC CCB 104929 03/14/2014 541-687-5770 • INSPECTIONS REQUIRED 1 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. • • Owner or Contractor Signature Date • NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK . ATTENTION: Oregon law requires you to AUTHORIZED UNDER THIS PERMIT IS NOT follow rules adopted by the Oregon Utility • COMMENCED OR IS ABANDONED FOR , Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- ANY 180 DAY PERIOD. 0090. You may obtain copies of the rules by calling the center. (Note: the telephc: 3 number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 6/3/2013 11:49:39AM • Page 1 of 1 SPRINGFIELD --- CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfeld,oR 97477 OREGON 541-726-3753 811-SPR2013-01138 www.springfiem-or.gov 1290 W CENTENNIAL BLVD permitcenter©springfield-or.gov RECEIPT NO: 2013001087 RECORD NO:811-SPR2013.01138 DATE:06/03/2013 1aI e1:Ji bilol`t °a ,r -t '`-O Y .`3 > . J.. r•ACCOUNTeCODEITRANS CODE-1 ?II. 'AMOUNT DUE:`,?, Branch circuits without service or feeder-1st circuit 224-00000-426102 1004 60.50. Branch circuits without service or feeder-each additional 224-00000-426102 1004- 45.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 12.72 Technology fee(5%of permit total) 100-00000-425605 2099 5.30 TOTAL DUE: 124.02 PAYMENTSTYP_E P.AYOR• CASHIER:CCARPENTER' . -.COMMENTS ' r- •- : 'r -AAMOUNTPAID Check JB ELECTRIC INC 124.02 123625 TOTAL PAID: 124.02 • Electrical Permit Application .' DEPARTMENT USE ONLY snwirvcrte�c --, - - - •CITY OF SPRINGFIELD,1OREGON.� 7 S permit no.: S) 7— 151 225 Fifth Street•Springfield,OR 97477*PH(541)726-3753.FAX(541)726-3689 / I `� Date: 67 3/ J 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 "` ?` ° `q r,FEE;SCHEDULE , '.. . '7,€ ,M Cost Total Zoning approval verified? gYes ❑No :Number of inspections per.item O . Qty .ea:- "cost: .. CATEGORY OF CONSTRUCTION,.'3 Residential, per unit,service included: ❑Residential ❑Government I7:8 Commercial 1,000 sq. ft. or less(4) $134.00 $ `JOKI,SITE 1INFQRM�7ATIIO�N>'AND LOCATiION+ Ku f 9v G!l! ' Each additional 500 sq. R.or portion $ 25.00 $ Job site address: ,J 07 L.Lit,I/LPitlia—C thereof City: Jv/Lyfj!(GJ L`�r� I State: Qjc_ I ZIP: Limited energy(2) $ 32.00 $ Reference: ( 7 3 273y I Taxlot.:O 2''( `f Each manufactured home or modular $ 6100 $ 'DESCRIPTION' OF WORK .. dwelling service or feeder(2) . met ir yie e. /J Services or feeders: installation, alteration, relocation (['�/X 200 amps or less(2) $ 81.00 $ PROPERTY OWNER / 201 to 400 amps(2) $ 95.00 $ Name: , .Q-�.�ti` t. ._t 401 to 600 amps(2) $158.00 $ Address:21-4(5.--- / -7 77/7----- 601 to 1,000 amps(2) $205.00 $ City: 41 Cj I State:cri_. I ZIP: y,c7A) Over 1,000 amps or volts(2) $469.00 $ Phone: - - I Fax: - - Reconnect only(2) $ 63.00 $ Temporary services or feeders: installation, alteration,relocation E-mail: This installation is being made on residential or farm property 200 amps or less(2) $ 63.00 $ owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale,exchange, lease,or rent. OAR 479.540(1)and 479.560(1). 401 to 600 amps(2) $126.00 $ 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:/_Q R7� lCee,- rc-C� �fric a. Fee for branch circuits with purchase of a service or feeder fee: Address: L{4 9c / L2 1z .7 Each branch circuit I $ 6.00 I $ City: Q.G._.Q_- State: C 7�- ZIP:C 7qa2_ b. Fee for branch circuits without purchase of a service or feeder fee: Phone 6?7;j-f7D Fax:S3'7--3cje2—jo29.6 First branch circuit(2) / $ r $5Y E-mail: A Each additional branch circuit 7 cad) $ L�•> CCB license no.: /,&QO/ BCD license no is�'7G Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 3k/7:P S Each pump or irrigation circle(2) $ 63.00 $ � K fuf�✓x� Each sign or outline lighting(2) $ 63.00 $ Print name of signing supervisor. o`j Signal circuit or a limited-energy panel, $ 63.00 $ Signature of signing supervise . ___---,_---- alteration,or extension(2) Each additional inspection: (I) $58.00 $ -74 °, .,. r' _ AP.P_.LICANMUSE. (A) Enter subtotal of above fees $ 0;32%(Minimum Permit Fee$58.00) --77 (B)Enter 12%surcharge(.12 x[Al) $ I G 2 (C)Technology Fee(5%of[A]) $ S 3i TOTAL fees and surcharges(A through C): $ 1ZYi 440-2584-1(9/ )