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HomeMy WebLinkAboutPermit Electrical 2013-7-2 SPRINGFIELD 225 Fifth St hNI „ CITY OF SPRINGFIELD Springfield,OR 97477 C P hone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01520 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/02/2013 EXPIRES: 12/28/2013 STATUS DATE: 07/02/2013 APPLIED: 07/02/2013 SITE ADDRESS: 950 INTERNATIONAL WAY,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703153000201 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Data wiring OWNER: GOLDEN TEMPLE OF OREGON LLC Phone Number: ADDRESS: 950 INTERNATIONAL WAY SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Low Voltage Electric ASTRO TECH INC CCB 111175 03/04/2014 541-683-5719 L INSPECTIONS REQUIRED Inspections 4550 Limited Energy 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 tip eq\Sd °� e�\CP- p�\a. ,tre \O ate es -0 eo`o' `e9 a`o� et' 0. et' _. Q , O' Q ov ,r°c c0' es° \er:2,\ ��e, ,��c N\esGe�';e p10% 009\ .ire ov 0 P\�pve i01\ opVoeva,\° o�e.'31 aN): ��F'(d���gN N°\pop 3.20 R`a0e-\\epte9 00 ? 3 cf-Q�P oe QEO� \00c \\\�e toe`e.`s N$ �\Gi �\is S��POf�P\1;., : GS��m Cr 3©\SQ o9,1.. 0'3 c 0• Springfield Building Permit 7/2/2013 11:28:33AM Pay U Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD t= 225 Fifth St t�< EGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-01520 www.springfield-or.gov 950 INTERNATIONAL WAY permitcenter@springfietd-or.gov RECEIPT NO: 2013001425 RECORD NO: B11-SPR2013.01520 DATE:07/02/2013 DESCRIPTION - - . - _ _ ACCOUNT CODE/TRANS CODE'.. ..._-__AMOUNTDUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 Signal circuit(s)or limited-energy panel, alteration, or extension 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•j_p.AYMENT_TYPE:___PAYOR CP!SHIER oeoWLSey AMOUNT PAID ''-2 . _ .__.—._.._ COMMENTS._e__'�v.._..-_�__.. _ _ .w— _._.._..._-_. ..... ,�• Credit Card scoff wafters 93.60 002804 TOTAL PAID: 93.60 • Electfical Permit Application DEPARTMENT.USE ONLY '.'i SPPINGPIELO 5333 M... CI'P OE SPRINGFIEL �-e� �` hrgzi S/3 -0/::�...,«,.. �' _ +. '*2.�,,, . Peit no.:225 Fi fth StreetsSpringfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 / Date: 7/ / 7 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 ;-.:'? .'• . b, .• -; *FEE,,it:SCHEDULE , '_,,i _,, "; Zoning approval verified? ❑ Yes ❑ No Number of inspections perlitem e,7 Qty t Cost .,Total':, `` ,' a.;°iCATEGORY.r.OF'i:CONSTRUCTION ea, cost .'; Residential,per unit,service included: ❑Residential ❑ Government firnmmercial JOB .SITE.INFORMATION "AND LOCATION"?! 000 sq. ft. or less(4) $147.50 $ y—. Each additional 500 sq. ft.or portion Job site address: 6-0 crfri fttkig 7',`a he, / thereof - $ 27.50 $ City: 5/-P/ti Stateeft ZIP 4 ? 77 Limited energy(2) $ 35.00 $ Reference: )f t L—/76 3/s3 O Taxlot COZO t Each manufactured home or modular $ 69.00 $ M ,- ka, �, ;# dwelling service or feeder(2) ,: ;;DES IPTION° OFa_WORK:, • t ,r,.;r Jl �,1 ^fri y Services or feeders: installation, alteration, relocation ('� ✓ 200 amps or less(2) $ 89.00 $ - .,,.), ;'_ ..r'PROPERT,;,OWNER `•6_ „ , .,y4 201 to 400 amps(2) $ 104.50 $ Name: ;6 y^ to A 401 to 600 amps(2) $174.00 $ Address: 5--0 So IBrh 411;:0 lt°t/ ^� 601 to 1,000 amps(2) $225.50 $ City: S 1'p It/d State: 67 A.. ZIP: i 20 / Over 1,000 amps or volts(2) $516.00 $ Phone: - - Fax: - - Reconnect only(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 .l-1 i;:CONTRACTORONSTALILATION , , Branch circuits:new, alteration, extension per panel Business name: y4S f✓d•-/f eG L a. Fee for branch circuits with purchase of a service or feeder fee: Address: U/ o l{U li old t0rpe1 h a rel• Each branch circuit $ 6.50 $ City: F vg :e 1 C State: Oft_ ZIP: 9 7 ?O f b.Fee for branch circuits without purchase of a service or feeder fee: Phone:CV [83 5 7/,l Fax: -- - First branch circuit(2) $ 60.50 $ E-mail: 4_St Val e ci C o/h — r0 pM.q, I Each additional branch circuit $ 6.50 $ CCB license no.: Ili/ 7C BCD license no.: C 1, E Z/ Miscellaneous fees:service or feeder not included Signing supervisor's license no.: g a tt 7 L 1£`4 .0 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: c o T t A oI I I e�•j Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: l'[ w(� Signal circuit or a limit( - panel, t $ 80.00 $9 Q g g P alteration,or ext sion 2 l Each additional inspection:(1) $80.00 $ ;`j', +. c ten. ,.APPLICANT:?,USEx . ,'r . w0:01.i'c' (A) Enter subtotal.of.above fees �AMinim it Fee$800ee0 $ au- ._____ (B)Enter 12%surcharge(.12 x[A]) � $ 910 (C)Technology Fee(5%of[A]) $ V TOTAL fees and surcharges(A through C): $ 7(O 440-2584-1(4/01/2013/COM)