HomeMy WebLinkAboutPermit Electrical 2013-10-4 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
C catif Phone: 541-726-3753
:\OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02233
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/04/2013 EXPIRES: 04/02/2014
STATUS DATE: 10/04/2013 APPLIED: '10/04/2013
SITE ADDRESS: 919 INTERNATIONAL WAY,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703153000700 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Limited energy cabling
OWNER: MCKENZIE-GATEWAY BUSINESS PARK LLC Phone Number:
ADDRESS: 388 PEARL ST
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Low Voltage Electric NATIONAL NETWORK SERVICES OF OREGON INC CCB 154300 02!10/2015 541-726-9209
INSPECTIONS REQUIRED
- Inspections •
4550 Limited Energy
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.
l
Owner or Contractor Signature Date
requires You tO • :r
Oregon la the Oregon set tfli,y P`RE 1F H�S NO
followrr„les adopleTlbp$e rules are set 001 P`�EX
952-001 ZH S,PE M1( �Np\S PBAN��N FOR
001,0010 through OAP rules by `!�
Notifcatton 001-00, of the �OSNOR�ZED
in 0/kB 95 may obtain 0°P the telephone
0090., the center. .(No Utility Notification MENCEO p��1)p•
calling Oregon 44). CCM ppY
number for Center
A..800-332-23 P14V 18�
Springfield Building Permit 10/4/2013 2:48:59PM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
51
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OREGON TRANSACTION RECEIPT 225 Fifth Springfield,OR 97477
541-726-3753
811-S P R2013-02233
www.springfleld-or.gov 919 INTERNATIONAL WAY permitcenter @springfield-or.gov
RECEIPT NO: 2013002218 RECORD NO:811-SPR2013-02233 DATE: 10/04/2013
DESCRIPTION - ACCOUNT CODE/TRANS CODE- ;, ,,,AMOUNT DUE-
Signal circuit(s)or limited-energy panel, alteration, or extension 224-00000-426102 1004 80.00
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
TOTAL DUE: 93.60
LPAYMENT TYPE: • PAYOR .casHIER:DBOWLSBY COMMENTS_. '_-'AMOUNT PAID • I
Credit Card timothy huser 93.60
055502
TOTAL PAID: 93.60
Electrical Permit Application DEPARTMENT USE ONLY
tap- , r � �,#+ s .Y"""s"":7a%r em n SPRINGFIELD
4 Sr, `S -. ' ' ,I ' i.-ORE�c . x (->.. _::' Permit no.: 5/3 —0 Z Z 3 3
225 Fifth Street*S iin field,OR 97477•P11(541726-3753•rA\(54172( 3689 ",'\Og
p y' ) ) OREGON I
Date: /9 /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 FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Number of inspections per item () Qty. Cost Tal
ea. cotost
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
❑ Residential ❑Government IN Commercial !
1.000 sq.ft.or less(4) $147.50 $
JOB SITE INFORMATION AND LOCATION
Each additional 500 sq. ft.or portion
Job site address: 919 International Way thereof $ 27.50 $
City: Springfield State: OR ZIP: 97477 Limited energy(2) $ 35.00 $
Reference:PPO 3 /S3 d Taxlot.:O C.:70a Each manufactured home or modular $ 69.00 $
dwelling service or feeder(2)
DESCRIPTION OF WORK
Limited Energy Cabling Services or feeders:installation,alteration,relocation
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
J, / e 401 to 600 amps(2) $174.00 $
Name:G'F' ftCiS+�c� J'�f�(✓/�y LSC LLB--
Address: o (
3 c O G �LL t Sr- 601 to 1.000 amps(2) $225.50 $
� ,/
City: LFL.L- ' State:C-!1.-- ZIP: 7 71(al 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) g 96.00 $
property is not intended for sale,exchange; lease, or rent.OAR
479.540(I)and 479.560(1). 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: net, alteration.extension per panel
Business name:National Network Services of Oregon,Inc. a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 302 Shelley St.#6 Each branch circuit $ 6.50 $
City: Springfield State: OR ZIP: 97477 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone:541 726.9209 Fax:541 726.8929 First branch circuit(2) $ 60.50 $
E-mail: timhuser @nnsoregon.com Each additional branch circuit $ 6.50 $
CCB license no.: 154300 BCD license no.:20-361CLE Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 988LEA Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Tim Huser Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor:-� • NL. _ Signal circuit or alimited-energy panel, ( $ 80.00 59 b
/,r -- alteration,or extension(2)
Each Each nrlditiomd inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees l�
(Minim nn Permit Fee$80.00) $ (
(B)Enter 12%surcharge(.12 x[A]) $ fr'0
• (C)Technology Fee(5%of[A]) $
440-2584.1(4/012013/COht) TOTAL fees and surcharges(A through C): $ rya 6L