HomeMy WebLinkAboutPermit Electrical 2013-6-19 •
SPRINGFIELD - 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
koitg Phone: 541-726-3753
OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01322
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/19/2013 EXPIRES: 12/15/2013
STATUS DATE: 06/19/2013 APPLIED: 06/19/2013
SITE ADDRESS: 1650 GLENWOOD BLVD, Eugene,OR 97403 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703343300800 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Extend 100 amp •
OWNER: SANIPAC INC Phone Number:
ADDRESS: 10001 WOODLOCH FOREST DR STE 400
THE WOODLANDS TX 77380
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type - Lic No Lic Exp Phone
Electrical Contractor NORMS ELECTRIC INC CCB 55960 01/12/2015 541466-5328
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.
•
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
Avg follow rules adopted by the Oregon Utility
J'h- <r IF ZHj K Notification Center. Those rules are set forth
MOS�CE;�J �p�� p�R S of In OAR 952-001-0010 through OAR 952-001-
Re)i SHWA f`PI PERM OR 0090. You may obtain copies of the rules by
TN�W t OER �NED F calling the center. (Note: the teleph.sr:.
t�TH�nal) �R\S pgAN� number for the Oregon Utility Notification •
;r- 1‘ ROOD. Center is 1-800-332-2344). .
. s,u.nDAyPE
Springfield Building Permit 6/19/2013 10:26:29AM Page 1 of 1
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SPRINGFIELD"- CITY OF SPRINGFIELD
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Fifth St
5
TRANSACTION RECEIPT 22sp5 Fifthd,oRg7477
OREGON 541-726-3753
811-SPR2013-01322
www.springfield-or.gov 1650 GLENWOOD BLVD permitcenter @springfeld-or.gov
RECEIPT NO: 2013001267 RECORD NO:811-SPR2013-01322 DATE:06/19/2013
DESCRIPTION u°!SW 2` is liter. P WW:AGCOUNT:CODEI RANS CODE ALVS,PrAMOUNTs 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 19.50
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
PAWI ENTaTYi PE . - I AYOR caswERC�!.i d:. 3.:la60MME ifen AMOUNTiPAID ria a;o
Check NORMS ELECTRIC INC - 93.60
19856
TOTAL PAID: 93.60
. ,
Electrical Permit Application DEPARTMENT USE ONLY
• SPRINGFIELD
CITY OF SPRINGFIELD, OREGON ... Permit no.: IIla37 0I; L2.
225 Fifth Street•springfield,OR 97477•PR(541)726-3753•F4x(541)726-3689 OREGON
ci��//,
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- eat cost1 t
CATEGORY OF CONSTRUCTION
--
Residential,per unit,service included:
❑Residential ❑Government Q Commercial 1.000 sq.R.or less(4) $147.50 $ G
JOB SITE INFORMATION AND LOCATION
.Each additional 500 sq.ft.or portion
Job site address: I L SO GI le n-wood B 1 Jd thereof $ 27.50 $
City: Salene� State: OR ZIP: 974'{6 Limitedenergy(2) $ 35.00 $
Reference: 0 Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
Nd fH) 100 - Services or feeders: instillation,alteration,relocation
EX1z
6•n9 Crrcu,i is
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: S4n;M,." ---- 401 to 600 amps(2) $174.00 $
Address: t'so 41U'twooS- 131 NeI. 601 to 1,000-amps(2) $225.50 $
City: <et c. State: OP, ZIP: 914•{ts Over 1,000 amps or volts(2) $516.00 $
Phonesyl-130 Fax: Reconnect only(2) $ 69.00 $
130-3400 5-4 i --134- 341;0
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
Business name: Kip(11LS r tc C.6rie. EKG a.Fee for branch circuits with purchase of a service or feeder fee:
Address: P.0. 13o% as Each branch circuit $ 6.50 $
City: ear0v'n5Jt'l It State: 0Q ZIP: 91311 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: NM l-'¢4(r- 532.6 Fax: 5-24 t-'f44 -S35-o First branch circuit(2) 1 $ 60.50 $(r0 Sv
E-mail: rtar eltefri c. a e�._6.rt. (-et.etci- Each additional branch circuit 3 '$ 6.50 $ t9 5U
CCB license no,: aa-24C BCD license no.: Shy 60 Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 35/Ds Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: 'gob, y,/,l tom Each sign or outline lighting(2) $ 69.00 $
JJ Signal circuit or a limited-energy panel,
Signature of signing supervisor: -rP.e - alteration,or extension(2)
$ 80.00 $
lCok-'c 0 c e 4f rl'CC II.vvic Each additional inspection:(I) $80.00 $
I
V1 C("1 e APPLICANT USE .
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $ eoP°
(B)Enter 12%surcharge(.12 x[AI) $ 9,60
(C)Technology Fee(5%of[A]) $ '+00
440-2584-J(4/012013/COM) TOTAL fees and surcharges(A through C): $ 9 340