HomeMy WebLinkAboutPermit Electrical 2013-9-16 •
SPRINGFIELD — 225 Fifth St
br_Z- r `- -° CITY OF SPRINGFIELD Springfeld,OR 97477
' O OREGON Phone: 541-726-3753
Building I Commercial Permit Inspection Phone: 541-726-3769
• Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02071
www.springfeldor.gov permitcenter @springfeld-or.gov
PROJECT STATUS: Issued ISSUED: 09/16/2013 EXPIRES: 03/15/2014
STATUS DATE: 09/16/2013 APPLIED: 09/16/2013
SITE ADDRESS: 1920 OLYMPIC ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703254201601 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Data Cable
OWNER: WINCO FOODS LLC Phone Number:
ADDRESS: PO BOX 5756
BOISE ID 83705
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor TTC COMMUNICATIONS INC CCB 164114 04/11/2015 541-689-2650
INSPECTIONS REQUIRED
Inspections •
- 4550 Limited Energy
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 .
constructi
Ike—% 0614 qb 1g ik?
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
Notification l Cennter. the Oregon
re set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the ti O center. (rote.:I the Notification
COMMENCED OR IS ABANDONED FOR
n.m i;i:r fn ti Oregon I);i! r; hlotification
l.er h-. '-, ', ':t44). ANY 180 DAY PERIOD.
Springfield Building Permit 9/16/2013 9:04:13AM Page 1 of 1
SPRINGFIELD°", - CITY OF SPRINGFIELD
225 Fifth St
�{ __ TRANSACTION RECEIPT Spnngfield,OR 97477
}v 541-726-3753
:OREGON 811-SPR2013-02071
wwwspnngfield-cr.gm/ 1920 OLYMPIC ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2013002033 RECORD NO: 811SPR2013.02071 DATE:09/16/2013
p; ION '-t _'_S.,? 2t" _,M=" t-Wil 712ePf ACCOUNT,CODETtRANS CODE= : tom k S' AMOUNT DUE -
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) 100-00000425605 2099 4.00
TOTAL DUE: 93.60
' PAYMENT TYPE PAYOR casNiErigLaesox - - -•COMMENTB -----= �'e��AMOUNTpP-AID
Credit Card TTC COMMUNICATIONS INC 93.60
849716
TOTAL PAID: 93.60
•
: Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
` C Tl' OE SPRIINGFIE `D REGON ' y Permit no.: // Z 'i 0Zo7 '
225 Fifth Srrect•Sprin told,OR 97477•141(541)726-3753•FAX(541)726-3689 \,o EGON
Date: ?7 / 6// 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. •
LOCAL GOVERNMENT APPROVAL J _ FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No Number of inspections per item() Qty.1 Cost Total
I I ll ea. cost
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
❑ Residential ❑Government C6 Commercial
JOB SITE INFORMATION AND LOCATION 000 sq. ft.or less(4) $147.50 S
Each additional 500 sq. ft.or portion
S 27.50 S
Job site address: flq o ant-1C- thereof
City' i -///���}(I.{Q^f State. -S' ZIP: Limited energy(2) $ 35.00 S
Reference: W Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK - dwelling service or feeder(2)
„[ /� ^ Services or feeders: installation.alteration,relocation
( I \ I"/�p_ Q_� 200 amps or less(2) S 89.00 $
PROPERTY OWNER 201 to 400 amps 121 $ 104.50 S
401 to 600 amps(21 $174.00 $
Name: .n CO 9 —
Address: a Sc— 7 5-0 601 to 1.000 amps(2) 5225.50 S
City: ,tie„ State: / D ZIP: _ Over .000 amps or volts(2) $516.00
Phone: - Fax: - - Reconnect only(2) $ 69.00 $
E-mail: 'l'ent porary services or feeders: inslalltdot). alteralior6 relocation
•
200 amps or Tess(2) $ 69.00 $
This installation is being made on residential or farm property
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 6(10 amps(2) 5138.50 S
Signature: Over 600 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: rev, alteration.e.ster(Sinn per panel
Business name:-ITC cixn m u NA@J.-], -S a. Fee for branch circuits with purchase of a service or feeder fee:
Address:Co t iu l• Each branch circuit I I $ 6.50 $
City': _ ,1 y State:p ZIP: I -1 b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: -�4q—a(�U Fax:if� iay_j First branch circuit(2) $ 60.50 $
E-mail: a ;fi (0) - i1/4./a)1 Cati Each additional branch circuit $ 6.50 $
CCB license no.: /to Lf g(. I 130 license no.: Miscellaneous fees:service orkeder not included
Signing supervisor's license nu.: ?3qq ( Each pump or irrigation circle(2) $ 69.00 S
Print name of signing supervisor: oak__ 60�r� Each sign or outline lighting(2) $ 69.00 5
Signal circuit or a limited-energy panel. Qf1
Signature of signing supervisor: 0/42_60_ alto:I ion.or extension l2) $ 80.00 S a J
Each,addilional inspection:(I) $80.00 S
APPLICANT USE
(A) Enter subtotal of above fees $
(Mininnun Permit Fee S80.00)
(B) Enter 12%surcharge(.12 a[A]) $
(C.)Technology Fee(5%of[A]) $
73-140-258-1-1 la/OIl201J/COA.p TOTAL fees and surcharges(A through C): $ G