HomeMy WebLinkAboutPermit Electrical 2013-10-29 SPRINGFIELD 225 Fifth St
.A. C CITY OF SPRINGFIELD Springfield,OR 97477
(. Phone: 541-726-3753
S• OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02408
www.springlield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/29/2013 EXPIRES: 04/27/2014
STATUS DATE: 10/29/2013 APPLIED: 10/29/2013
SITE ADDRESS: 5880 MAIN ST, Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702343200400 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: 21 Branch Circuits
OWNER: FEDAK DARYL A Phone Number:
ADDRESS: 85788 PARKLAND CIR
PLEASANT HILL OR 97455
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JB ELECTRIC INC CCB 104929 03/14/2014 541-687-5770
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
*itsure that all required inspections are requested at the proper time,that each address is readable from the street,that the
card is located at the front of the property, and the approved set of plans will remain on the site at all times during
its /o 7 // 3
Owner .'r Contractor Signature Date
ATTENTION: Oregon law requires you to
NOTICE: follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 95M01-
You may obtain copies of the rules by
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
'°Y 180 DAY PERIOD. number for the Oregon Utility Notification •
Center is 1-800-332-2344). -
•
Springfield Building Permit 10/29/201 952:21AM Page 1 of 1
SPRINGFIELD ' CITY OF SPRINGFIELD
225 Fifth St
OREGON TRANSACTION RECEIPT Springfiehf,OR97477
i 541-726-3753
811-SPR2013-02408
www.springfield-or.gov 5880 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002378 RECORD NO:811-SPR2013-02408 DATE: 10/29/2013.77[DESCRIPTION - - : '— "ACCOUNTC,ODE/TRANSCODE AMOUNT.DUE I
Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50
Branch circuits without service or feeder-each additional 224-00000-426102 1004 130.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22.86
Technology fee(5%of permit total) 100-00000-425605 2099 9.53
TOTAL DUE: 222.89
LPAYMENT TYPE `-PAYOR CASHIER:JLARSON . COMMENTS AMOUNT.PAID _ I
Check JB ELECTRIC INC 222.89
123942
TOTAL PAID: 222.89
•
•
Electrical Permit Application DEPARTMENT USE ONLY `;
CIIR OF�SPRINGI-gEL`D .DREG=9N= " ,-
' .f.w0eig sa'i'" '"m3 .ii .w4' .CS .�r,i,E3e-S. ^*°-."a'. ». -1 at, - Permit no Q](1, 7-013 0 i"tee
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 > ..
Date: (0/29/ 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 "COVERNMENT APPROVAL„!At.), ` n 34 ,. , FEE SCHEDLE , r " st„ t
Zoning approval verified? —, ,r fes
❑No 'Number of gnspect�onsper�rtemlO ''Qty k Cost r wk Fotal
as`,
CAT EGO RY2;OFzt;CONSTRUCTION .T;"v;;";,t, , ?. ” "ea ;,,cost 3
Residential,per unit,service included:
❑Residential ❑Government 12't_ommercial 1,000 sq.ft. or less(4) $147.50 $
„? JOB?=SITE ANFORMATION ANC°LOCATION');�„ �"Is
��j �l Each additional 500 sq. ft.or portion $ 27.50 $
Job site address: 71i4/il CI" thereof -
City: /'//rj7 �, / State: a� ZIP: Limited energy(2) $ 35.00 $
Reference: / Taxlot.: Each manufactured home or modular
4 04 *veW , ' DESCRIPTION f,OF WORK , is �,z'tZ1:12: _°"'” dwelling service or feeder(2) $ 69.00 $
P1`f n Services or feeders: installation,alteration,relocation
(KX� 200 amps or less(2) $ 89.00 $
?t< i ,;,,F:44,,3�'PROPERTI OWNER `"'a, r ',t`}C:$? 201 to 400 amps(2) $ 104.50 $
Name: ` . 401 to 600 amps(2) $174.00 $
�`",,71 ( r 601 to 1,000 amps(2) $225.50 $
Address: `. ,S 7 eE5 1 i.V IAL- � C t✓
City: C\� 1- kL L 1. State: oft,_ ZIP: Over 1,000 amps or volts(2) $516.00 $
Ci 4 y
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
479.540(1)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
v igiMcONTRACTOR. INSTALLATION; ii', ss ; Branch circuits:new alteration, extension per panel
Business name: Z.�y� � � L _ a. Fee for branch circuits with purchase of a service or feeder fee:
Address: �'jt/v0� - /9y�e S Each branch circuit $ 6.50 $
City: 2Z.GC�-' -ere.j2 State: ep,ez_ ZIP?7yQ� b. Fee for branch circuits without purchase of a service or feeder fee:
Phone 0,f,be 7i,C7 i2 Fax 3"a_R.196:::7 First branch circuit(2) /, $ 60.50 $
E-mail: ,® Jhje`„e k r 45,12 Each additional branch circuit gc, $ 6.50 $
CCB license no,: /799a9 BCD license no.37-€/3j7c Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 39701, 6 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supers, r: q:-)4,..t Ass,...-c_ Each sign or outline lighting(2) $ 69.00 $
Signature -....--"L„....---- _ Signal circuit or alimited-energy panel, $ 80.00 $
ignature of signing supe
alteration,or extension(2)
Each additional inspection:(1) $80.00 $
triAPP,LICANT'-USE 53-Weir; .°`Asfvzi.t�?
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[A]) - $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $ - —
440-2584-1(4/01/2013/COM)