HomeMy WebLinkAboutPermit Electrical 2013-8-5 SPRINGFIELD -- 225 Fifth St
' CITY OF SPRINGFIELD Springfield,OR 97477
hircLEaoN Phone: 541-726-3753
Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01746
www.springfield-or.gov pormitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/05/2013 EXPIRES: 01/31/2014
STATUS DATE: 08/05/2013 APPLIED: 08/05/2013
SITE ADDRESS: 1111 MOHAWK BLVD,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703253317000 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Canopy light retrofits
OWNER: THABET INVESTMENTS-1111 MOHAWK LLC Phone Number:
ADDRESS: 4105 FRANKLIN BLVD
EUGENE OR 97403
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor LAIRD LIGHTING LTD CCB 109029 0926/2014 541-686-2166
LAIRD LIGHTING LTD (LMS)Electrical C 804LMS 07/01/2014 541-729-1216
INSPECTIONS REQUIRED
Inspections
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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 C ntractor Signature Date
ATTENTION: Oregon law requires you to NOTICE:
- follow 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 rules by COMMENCED OR IS ABANDONED FOR .
calling the center. (Note: the telepl-,:.;rt-..
• number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
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Springfield Building Permit 8/5/2013 10:18:42AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
'_A4, -(`A. '
_______si
TRANSACTION RECEIPT 225 Frfth St
`tNEGON Springfield,OR 97477
541-726-3753
O
811-S P R2013-01746
www.springtield-or.gov 1111 MOHAWK BLVD pennitcenter @springtield-or.gov
RECEIPT NO: 2013001697 RECORD NO: 611-SPR2013-01746 DATE:08/05/2013
?.DESCRIPTIONM._�e ` , _ACCOUNT CODEITRANS_CODE AMOUNT_DUE',,;
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00
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 6.50
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
;PAYMENT TYPE_.- PAYOR• CASHIER:CCARPENTER a COMMENTS AMOUNT.PAID -
Check LAIRD LIGHTING LTD 93.60 .
10078 .
TOTAL PAID: 93.60
•
' Electrical Permit Application DEPARTMENT USE ONLY
-� 3 y, = w SPRINGFIELD
CITY- OF SP;RINGF�IEL:0 OREGON " ,-: . 7 CI
A :. m�>as 'axe�ks- 's--' Peranit no.: �� �� 1
C.0
225 fifth ShreeNSpungfield,OR 97477♦PII(541)726-37a3*I 1A(+41)72G 3G8') OKEGON
Date: Cl/ 5
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
clays of issuance or if work is suspended for 180 clays.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No Number of inspections per item() Qty. Cost Total
CATEGORY OF CONSTRUCTION ea. cost
Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial
1.000 sq. ft.or less(4) $147.50 $
JOB SITE INFORMATION AND LOCATION
hy Each additional 500 sq. Ii or portion
Job site address: ,J/ /NO/74 IA/V thereof $ 27.50 $
City: *yin cid State: Q/2 ZIP:97y?- Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or(zcder(2)
e 0l/} /'y U' J /� / Services or feeders:installation,alteration,relocation
(� ( '/ esz ,'(/�/- fZ 200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: : p / r 401 to 600 amps(2)/?7C./r'w((a✓i'L:I` A • P ( ) $174.00 $
Address: gip:5- `rnvr/Zinan f WW1/ 601 to 1,000 amps(2) $225.50 $
City: M rr.L State:v' SZ ZIP:97C/07 Over 1,000 amps or volts(2) 5516.00 $
Phone:$ ,IVY%- 5b"3 Fax5YJ-91(5-7—7399 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 100 amps(2) $ 96.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.5400)and 479.5600). 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: near,alteration,extension per panel
Business name: jai red try Ai.k,44// a. Fee for branch circuits with purchase of a service or feeder fee:
Address:2510 wrd.5T7Alt- #-J Each branch circuit $ 6.50 $
City: eivek,c_.. State:0e ZIP: 97902 h.Fee for branch circuits without purchase of a service or feeder fee:
PhoneSII'4$6,•-0/4& Fax591-395,--,s/SZ First branch circuit(2) / $ 60.50 541
E-mail: .an O ' Z'a✓W1- J.1Py, zoi-- Each additional branch circuit / $ 6.50 $ /_
CCB license no.:/090 Z9 BCD license no.: Miscellaneous fees:service or feeder not included ((/
Signing supervisor's license no.: p07 Lo'+iS • Each pump or irrigation circle(2) $ 69.00 $
7
Print name of signing supervisor: �wC.,J f Lora Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel,
Signature of signing supervisor: Ard��i alteration.or extension(2) g. P� $ 80.00 $
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $pO
(13)Enter 12%surcharge(.12 x[Al) $9 e
(C)Technology Fee(5%of[A]) $ ypai
440-2584-1(4/01/2013/COtip TOTAL fees and s -chmges(A through C): $ �(9
m