HomeMy WebLinkAboutPermit Electrical 2013-8-26 —.
' SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
[ (� Phone: 541-726-3753
c OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01904
www.springrield-or.gov permitcenteraspringfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/26/2013 EXPIRES: 02/21/2014
STATUS DATE: 08/26/2013 APPLIED: 08/26/2013
SITE ADDRESS: 530 HARLOW RD,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703220002606 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: 100A service for DSL
OWNER: LES SCHWAB TIRE CENTERS OF PORTLAND INC Phone Number:
ADDRESS: PO BOX 5350 •
BEND OR 97708
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
LITE ELECTRIC SERVICE (C)Electrical Cont 20-288C 07/01/2014 541-485-8669
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
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: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow
Notification adopted by
Those rules Oregon e s t for Utility
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephc o .
number for the Oregon Utility Notification
Center is 1-800-332-2344). r
•
Springfield Building Permit 8/26/2013 10:18:06AM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
ii
.re.. 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
,I,K eat 541-726-3753
OREGON 811-SPR2013-01904
•
www.springfield-or.gov 530 HARLOW RD permitcenter @springfield-or.gav
RECEIPT NO: 2013001865 RECORD NO: 811-SPR2013-01904 DATE:08/26/2013
IDESCRIPTION_; : .ACCOUNT CODE/TRANS CODE .. ',_._.=..__AMOUNT DUE_
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68
Technology fee(5%of permit total) 100-00000-425605 2099 4.45
TOTAL DUE: 104.13
L PAYMENT TYPE . PAYOR CASHIER:CCARPENTER COMMENTS_ AMOUNT PAID .
Check LITE ELECTRIC SERVICE 104.13
7553
TOTAL PAID: 104.13
•
•
■
•
•
•
•
Electrical Permit Application DEPARTMENTJUSE ONLY ',s`
L�i {� SPWINGPIELO 'awnrvrvy, .
"lit .P4g.J.qu.. ,�.y. 'ttiiq r,Y nt,a,4 .�4 ,5, ` }a Y+ "�'xaS
a,•I`TY,OFSPRINGl�'L�;LD;OREG�AN;,� t' $/3— /9o-/
' 1.r.' '� ' " 7d:Si�, .,.:a�. :._ . fi'�9r..c •s-� sk #a �r... .mss Permit n0.:
225 Fifth Street•Springfeld,OR 97477•PH(541)726-3753♦FAX(541)726-3689 'Y /
Date: Qfr,p 3
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.
.":rf4; ;;a COCALCGQNERNMENT APPROVAL -i +:; i x ' a'*Ogt"' ',„,t,WIE,EE•:;SCHEpULE', `",,, '„- '
Zonin approval verified. ❑ Yes No r` } 1 °n " 't' r '# ° Cost Total
g PP 9 ❑ Number of ihspechons pernterr () , Qty ,,;ea a, cost-',".
rR \ .e .r! .NA. ..i .
s?_ , `x:1 CATEGORYy5OF,;,CONSTRUCTION ," ,>
Residential,per unit,service included:
❑ Residential ❑Government [Commercial
,O JOBS;SITE„ INEORMATIOMr°AND,:LOCATION,. , , 4 1,000 sq. ft. or less(4) $147.50 $
Job site address: �O (f{gyt_ �d„vJ Each additional 500 sq. ft.or portion
� thereof $ 27.50 $
City: Se r{_-N State: d--- ZIP: 77e717 Limited energy(2) $ 35.00 $
Reference: a 7 77/.}1-1 Tax1ot Each manufactured home or modular
. M•.4ra r - / I I !,r`� ; ,.;_• dwelling service or feeder(2) . $ 69.00 $
xvr� �n atk;°xesES C RIP ON OF WORKS ; ,_, .,�, :
10 0 A 1,0 Ls)e-LL P C D rr L Services or feeders: installation, alteration,relocation
Fo 61- [” �5 200 amps or less(2) ' $ 89.00 $F`f
aK,"d'"v cA'1IMIN c.PROPERTVOWN R ; :_ g4., ;�; .l 201 to 400 amps(2) $ 104.50 $
Name: �E J ...2(.n.,/MJtf3 V2cl 401 to 600 amps(2) $174.00 $
Address: Lr5-0 601 to 1,000 amps(2) $225.50 $
City: re-1,d) State: . ZIP:q'?06- 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
479.5400)and 479.5600). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
'£ tfi HI'„' ntil.C.ONTRACT,OR ,INSTALL'ATION a, „ i4:: ;'t Branch circuits:new, alteration, extension per panel
Business name: f.-I[ rE iT1t1 L a. Fee for branch circuits with purchase of a service or feeder fee:
Address: r0 . ISo c (( 1 31 Each branch circuit $ 6.50 $
City: &Lae ere(-J State:012.. ZIP:97 We b.Fee for branch circuits without purchase of a service or feeder fee:
Phoni5y(-Z.Src-serf Z. Fax: - - First branch circuit(2) $ 60.50 $
E-mail: p Each additional branch circuit $ 6.50 $
p
CCB license no.: 5174 BCD license no.:Z.0 '�L% Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 3 553 5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: 72,N e 6LOTb-) Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel,
' — $ 80.00 $
Signature of signing supervisor:
� !' • /�`�-� alteration,or extension(2)
C Each additional inspection:(1) $80.00 .$
rs9W APPJLleAANJSE " kaW:
(A) Enter subtotal of above fees r�.
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[A]) $ (C
/ G1
. - (C)Technology Fee(5%of[A]) $ T(� 1-
TOTAL fees and surcharges(A through C): $ ■ 7
/)<C")440-2584-1(4/01/2013/C0M) -