HomeMy WebLinkAboutPermit Electrical 2013-10-24 •
SPRINGFIELD- 225 Fifth St
" -a,.�- CITY OF SPRINGFIELD Springfield,OR 97477
t Phone: 541-726-3753: .ONEGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02361
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/24/2013 EXPIRES: 04/22/2014
STATUS DATE: 10/24/2013 APPLIED: 10/24/2013
SITE ADDRESS: 4395 E 20TH AVE,Eugene,OR 97403 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1803031103001 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Service Install
OWNER: BIERSDORFF KEVIN RAND Phone Number:
ADDRESS: 60 W 22ND AVE
EUGENE OR 97405
CONTRACTOR INFORMATION
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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
L INSPECTIONS REQUIRED
Inspections •
4225 Service or Feeder
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
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone
number for 00-800 344)ification CAONYMM18E0NCDAEyD
PERIODBANDONED FOR
Springfield Building Permit 10/24/201 6:20:19AM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
lir 225 Fifth St
OREGON TRANSA CTION RECEIPT Springfieltl,OR 97477
541-726-3753
811-SPR2013-02361
wvnv.springfieltl-ar.gov 4395 E 20TH AVE permitcenter @springfiem-ar.gov
RECEIPT NO: 2013002333 RECORD NO: 811-SPR2013-02361 DATE: 10/24/2013
IDESCRIPTION _ - ...,,� - - _ . _.__-.' =ACCOUNTCODE/TRANSCODE_;' - „ ;, AMOUNT,DUEL,
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
----- — -----.r - -- -� TOTAL DUE: 104.13
L PAYMENT TYPE PAYOR.. CASHIER:JLARSON COMMENTS ,_ - . - .. -- AMOUNT PAID -1._ ']
Credit Card JK GUCKENBERGER ELECTRIC INC 104.13
025389
TOTAL PAID: 104.13
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Electrical Permit Application I DEPARTMENT USE ONLY
tires V '° 'rsty3' rr,+r =,tiyw' r*,d.piS- SPRINGFIELD
v ` 4%/e --
2251dth Sired*Sp,,o field.OR 974771 P6(_41)726-37534 I.t\(54 11726-3689 '" OREGON
Date: /07Z16
This permit is issued under OAR 918-309-0000. Permits are nontrnsferable. Permits expire if wort:is not started within 180
days of issuance or if wort;is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Cost TolaI
• __ Number of inspections per item( Qty. Ca. Cost
CATEGORY OF CONSTRUCTION ---.-_--___-
---- -- - Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial '
JOB SITE INFORMATION AND LOCATION moo q. IL or less(4) $147.50 $
------ Each additional 500 sq. IL or portion
Job site address: `45 qsL Zo ± !hereof $ 27.50 $
Ci.tyL4FS fr State: O ZIP:997 Yo3 Limited energy(2)_ ----.___-_S 35.00 5 Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
________
Services or feeders:installation.alteration.relocation
-.-_.591tl-L.fi _.Ta. t 200 amps or less(2) S 89.00 5
PROPERTY OWNER 201 to400 amps(2) $ 104.50 $
1111 Dp (('� 401 In 600 amps 12) ��-$174.00 $
Name: nG\i\r 1�\tC�_d>"T -_._�_-..-._ - -_
Address: inpgC - . lo 601 to 1.000 amps(2) $225.50 S
City: (-wy�TlgV,S_ State: 0 C. ZIP: 4 7 Ysp-i Over 1.000 amps or volts(2) $516.00
Phone: ��- - Fax: - - Reconnect only(2) $ 69.00 $,—'--
6-mail:
Temporary services or feeders: installation. ahermion. re/olaaian
200 amps or less(2) t
This instal lanon is being made on residential or farm property I $ 69.00 If
I
owned by me or a member or on immediate family. This 201 m 400 amps(2) $ 96.00 S
property is not intended for sale,exchange, lease,or rent.OAR - .--.--'---"-----
479.540(1)and 479.560(1). 401 In 600 amps(2) $138.50 S
SiRnatln.c: Over 600 amps or 4000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: twit: rrlrrrurioa etea.vion()Cr panel
nosiness name: J K J 6-v((] cjuy L., a.Fee for branch circuits with purchase of a service or leeder fee:
Address: a151 jr, 3 E Each branch circuit S 6.50 $
City: Stale: ZIP b. fees for branch circuits without purchase of a service in feeder lee:
�V)---- - 1 ¢ Ic( __ 8V - �f7t-171 -------__
Phone: Pas First branch circuit(2) S 60.50 $
Sy-f - z -`�6��I S�GI -7Y�6-3�rs5_ ---- �
E-mail: V 6 C31•{C,ELA--j,C U Y!� Each additional branch circuit S 6.50 $I CD license no.: Zs-2-fl C Miscellaneous fees:service ar feed nn/iinzrd¢rl
Signing supervisor's license no.: `/'4 S15 5 Each pump or irrigation circle(2) F$ 69.00 $ -
� tt / ,_r ( ( r�-�/t� Each sign or outline lighting(2) S 69.00 $
Prim Whore of signing supervisor' C?L!C.�I !C. ---
Signal circuit or a limited-energy panel. $ 80.00 $
Si_satire of signing supervisor: alteration.or extension(2)
Each additional inspection:(I) $80.00 $ ----
APPLICANT USE
(A) Enter subtotal of above fees
$
(Minimum Permit Fee$80.00)
(B)Enter 12;4,surcharge(.12 x Al)I S
(C) Technology Fee(5%of[A]) S
440-25844 Nr0112013/CONII TOTAL fees and surcharges(A through C): $fr