HomeMy WebLinkAboutPermit Miscellaneous 2013-7-19 SPRINGFIELD ' 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-SPR2013-01649
www.springfield-or.gov permitcenter @springfield-or.gay
PROJECT STATUS: Issued ISSUED: 07/19/2013 EXPIRES: 01/14/2014
STATUS DATE: 07/19/2013 APPLIED: 07/19/2013 •
SITE ADDRESS: 1863 LAURA ST,Springfield,OR 97477 SCOPE: Temporary Power Only
ASSESOR'S PARCEL NO: 1703271003900 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Temp Power
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OWNER: STAMBAUGH DANIEL L Phone Number:
ADDRESS: 1944 LAKEVIEW DR
EUGENE OR 97408 .
CONTRACTOR INFORMATION 6
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JB ELECTRIC INC CC/3 104929 03/14/2014 541-687-5770
L. INSPECTIONS REQUIRED
Inspections
4000 Temporary Power Service
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.ehsure that all required inspections are requested at the proper time,that each address is readable from the street,that the
permit-c\3T . located at the front of the property, and the approved set of plans will remain on the site at all times during
con ruction.
�) �'
7/f//3
Owner or/Contractor Signature Date
ATTENTION: Oregon law requires Util�y
NOTICE: follow rules adopted by g
Notification Center. Those rules are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
I;THORIZED UNDER THIS PERMIT IS NOT 0090. YOU may obtain copies of the rules by
"°"'1ENCED OR IS ABANDONED FOR • calling the center. (Note: the teleph:;:'c
number for the Oregon Utility Notification
AV PERIOD. Center is 1 800-332-2344).
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Springfield Building Permit 7/19/2013 3:12:37PM Page 1 of 1
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SPRINGFIELD"_ CITY OF SPRINGFIELD
225 Fifth St
LtE�oN TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SPR2013-01649
www.springfield-orgov 1863 LAURA ST permitcenter@spnngfield-or.gov
RECEIPT NO: 2013001585 RECORD NO:811SPR2013-01649 DATE:07/19/2013
,.ICL fl=AGCOUNT.CODE/TRANSiCODE ';i .4 AMOUNT OW !
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00
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
Temp services 200 amps or less 224-00000-426102 1003 69.00
TOTAL DUE: 93.60
Pri•MENSr1TTYP-E- P.AY,OR caSHIER:.7l isi :b'OMMENTS °• '-::...71-..aAMO,LINTRAIDIMMIDONI
Credit Card JB ELECTRIC INC 93.60
390928
TOTAL PAID: 93.60
Electrical Permit Application DEPARTMENT._USE ONLY
fv^a ^a x y r-r c` ,.94 , 4i' ve.4* " g:.2 SPING ^N wY
LCITY?,OF SPRINGNI�LD;OREGON
k . f . y
Permit no.:9tl7i9(3 o( 61
225 Fifth Slreet•5pringfield,OR 97477.PH(541)726-37534 FAX(541)726-3689 /
Date: 7// 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.
c +i tLOCAL,,GO.VERNMENT APPt2OVAL.at"h: ?s« -sa , °, x; ,FEE§SCHE IJEE7ataf` e ="
Zonis approval verified? Yes No °` ` ` 1- )`3i ti "Cost ITotalt .
Zoning PP ❑ ❑ Number of mspechon�s pei1,,-t(,)r rc Qty i lea `r" , cost;
'yy, , r� _',CATEGORY rOF,..;CONSTRUCTION,�� ea.rtc " '"
�'" '"°v Residential,per unit,service included:
❑ Residential ❑ Government (Commercial
051"`JOB SITE IN F.ORMATION-ANCALOCATION c,�„_ 1,000 sq.ft.or less(4) $147.50 $
�/3 / l — Each additional 500 sq.ft.or portion
Job site address: `!-/�j�(a `fT ��// thereof $ 27.50 $
City: trine/ / State: Q'e. ZIP: Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular
Mt g ;y,DESCRIPTION O F, E, c t a ;P ; <a;
> dwelling service or feeder(2)
$ 69.00 0 $
�
gaiety `�/'(A1L7� tc/ h y Services or feeders: installation, alteration,relocation
200 amps or less(2) $ 89.00 $
- _„= s�, -r, , �,a , -0 ++.t= . r°gl 201 to 400 amps(2) $ 104.50
r'c�,o� +., y..�,r, PRQPERTYI;OWNER ?.irr r .� .,.,3.�!akk.;+f $
Name: ,,�1./�. _c ut 401 to 600 amps(2) $174.00 $
Address: ( 9 4 it Ca ✓rc u Dr
601 to 1,000 amps(2) $225.50 $
City: G�,2{�, ,.. I State: 0-<, I ZIP:
Over 1,000 amps or volts(2) $516.00 $
Phone: - � - I 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) g 96.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
fiE, ” CONTRACTOR;INSTA�L�LATTII0N �t k ?�,?�, "y}r„i' Branch circuits:new alteration,extension per panel
Business name: C rZe-ea i r-e— a.Fee for branch circuits with purchase of a service or feeder fee:
Address: litezerirc„,a,k4,elt, Each branch circuit $ 6.50 $
City: tC ei-c f State: C9/C_—ZIP:9 7y,2 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone:S3f/-611.--_ -n Fax 7.7/2.-- 39 _gnt First branch circuit(2) $ 60.50 $
E-mail: 42440 0 4b 4e f a me-,47*- Each additional branch circuit $ 6.50 $
CCB license no.: �Qentacy I BCD license no.: 37-Ve., Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: g70/_S Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: p i Each sign or outline lighting(2) $ 69.00 $
Signature of signing supe ' o : - Signal circuit or alimited-energy panel, $ 80.00 $00 alteration,or extension(2)
Each additional inspection:(I) $80.00. $
x " 4s atia LICAIVT dSEi ,P, , I t
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) ' $
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $ 7? €a
440-2584-J(4/0112013/00M)