HomeMy WebLinkAboutPermit Electrical 2013-10-9 SPRINGFIELD 225 Fifth St
'`t -emu_— CITY OF SPRINGFIELD Springfield,OR 97477
l Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02261
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued • ISSUED: 10/09/2013 EXPIRES: 04/07/2014
STATUS DATE: 10/09/2013 APPLIED: 10/09/2013
SITE ADDRESS: 705 FLAMINGO AVE,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703223109200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Install feeder for shed sub panel
•
OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number:
ADDRESS: 525 MILL ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JK GUCKENBERGER ELECTRIC INC CCB 45129 04/24/2014 541-746-4656
_ INSPECTIONS REQUIRED `
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
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
construction.
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to NOTICE- • `':'I `` •
•follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IFTHEWORK
Notification Center. Those rules are set forth
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 telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 10/9/2013 8:15:51AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
_i_ti:ti
tc 225 Fifth St
"C00.EGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2013-02261
www.springfield-or.gov 705 FLAMINGO AVE permitcenter@springfield-or.gov
RECEIPT NO: 2013002244 RECORD NO:811-SPR2013-02261 DATE: 10/09/2013•!DESCRIPTION" _LACCOUNT CODE/TRANS CODE_,_ _, =,AMOUNT DUE_i
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.02
Technology fee(5%of permit total) 100-00000-425605 2099 5.43
TOTAL DUE: 126.95
L PAYMENT TYPE . .. PAYOR CASHIER:duRSON =- .... - , COMMENTS ;' • . i AMOUNT PAID A aj• _w
Credit Card JK GUCKENBERGER ELECTRIC INC _ v 126.95
015809
TOTAL PAID: 126.95
Electrical Permit Application DEPARTMENT USE ONLY
r. is y*t.ko pony meg zt x ., ° •. m : o SPRINGFIELD
CITY F SPR'INGFIIE'L"D;OREC'®N , - :,,. , , ;y, 3 (\ z'C3 on G(
a x Yennit no.:
225 Fifth Street•Spriigliield.OR 97477,PII(541)726-3753.1 \N(5411726-3689 LOREGON
Date: /J 7c/ / I-3
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 1
days of issuance or if work is suspended for 180 days. (
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No NUM her or inspections per item O Qty. Cost Total ,
ea. cost
CATEGORY OF CONSTRUCTION
Residential,per unit,service included: I❑ Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1:000sq.O.orless(4) $147.50 $ }}
Each additional 500 sq.li.or portion 3
Job site address: 705 F/ez4.14„y o thereof $ 27.50 $ 1
City: 66](1&. State: oft ZIP: fly 7.7 Limited energy(2) 5 35.00 $ 1
Reference: Taxlot.: Each manufactured home or modular
dwelling service or feeder(2)
LL DESCRIPTION OF WORK 66.96
;cid 1 f/ feeder ,-L_eaacA Services or feeders:installatimt nl(ernlian.relocation
200 amps or less(2) 1 $ 89.00 $ 1
I
PROPERTY OWNER 201 400 amps(2) $ 104.50 $ I
t 1
Name: 4cc!L , �ol X ;c, . 401 In 600 amps(2) $174.00 $
Address: SZ_c }4A.v\ S 601 to 1,000 mops(2) $225.50 $
City: 2(C/J State: o C ZIP: Over 1.000 amps or volts(2) $516.00 $
Phone: - - Fax: - - Reconnect only(2) S 69.00 $
E-mail: Temporary services or feeders:installation.ahemtion,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 S
Signature: Over 61)0 amps or 1.000 volts,see services or feeders section above
CONTRACTOR��INSTALLATION Branch circuits:urn( alteration,extension per panel
Business name: 3 K t_l.Q(hN cc) an a.Fcc for branch circuits with purchase ofa service orfeeder fee:
Address: a I el ,( b}- Each branch circuit ' 3 $ 6.50 $
City: y-I �[I State: 0)/ ZIPcril 4.77 b. Fee for branch circuits without purchase of a service or feeder lee:
Phone:Sq-( -//� -Lig�Sk F ax:5$� -`j 442-3g.ss First branch circuit(2) S 60.50 $
E-mail: yb l'"13Kcr,e I��(j) fl Each additional branch circuit S 6.50 S f
CCB license no.: 4s I Zf BCD license no.: to-In C us fees:service or feeder not included
Signing supervisor's license no.: 4 1$15 S Each pump or irrigation circle(2) $ 69.00 S ,
Print name of signing supervisor:0 CenbF YYZ/Ir Each sign or outline lighting(2) $ 69.00 $
Signature of lignin supervisor: '- Signal circuit or a limited-cncrgv panel. $ $0,00 $
o P alteration,or extension(2) r1
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal or above lees $
(Minimum Permit Fee S80.00)
(B)Enter 12%surcharge(.12 x(AI) $ 4
(C)Technology Fcc(5%of(A)) S
TOTAL fees and surcharges(A through C): $ 7 2.C..
1
440-2584,1(4/01/20 13/COM) g g ) I
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