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Home My WebLink AboutPermit Electrical 2013-11-20 • SPRINGFIELD 225 Fifth St '`° -c' CITY OF SPRINGFIELD Springfield,OR 97477 :;'t Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676" PERMIT NO: 811-SPR2013-02530 www.springfield-or.gov permitcenter @springfeldor.gov PROJECT STATUS: Issued ISSUED: , 11/20/2013 EXPIRES: 05/19/2014 STATUS DATE: 11/20/2013 APPLIED: 11/18/2013 • SITE ADDRESS: 1625 MOHAWK BLVD,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703253106200 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: EL-New Key Bank,Demo existing structures OWNER: ANNA B WALTON SURVIVORS TRUST Phone Number: ADDRESS: PO BOX 150161 SAN RAFAEL CA 94915 - • OWNER: DOROTHEA B GUYNUP SHARE A TRUST Phone Number: ADDRESS: PO BOX 2308 SANTA ROSA CA 95405 OWNER: HERBERT WALTON JR MARITAL QTIP TRUST II Phone Number: ADDRESS: PO BOX 150161 SAN RAFAEL CA 94915 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor CONTRACTORS ELECTRIC LLC • COB 190503 04/29/2014 541-343-2222 L INSPECTIONS REQUIRED r Inspections 4000 Temporary Power Service 4225 Service or Feeder • 4500 Rough Electrical Rough Electric: Prior to Cover 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 construction. • Owner or Contr tq ignature Date ATTENTION: Oregon law requires you to THIS PERMIT foilow 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 952-001- • COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by tdlrig�e�,n0 DAY PERIOD. • calling the center. (Note: the telephone Springfield Bui 11/20/201 2:30:29PM number for the Oregon Utility NotificatiaiDe 1 of 1 Center is 1-800-332-2344). SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT sPnngfield,OR 97477 OREGON 541-726-3753 811-SPR2013-02530 wwwspringeeldocgov 1625 MOHAWK BLVD permitcenter @spnngfield-ar.gov• RECEIPT NO: 2013002546 RECORD NO:811-SPR2013-02530 DATE: 11/20/2013 D SCRIPTION t1IVECTiS - °a 7t 'a 1 - o L, OR q.RANSCODE WO.,*AMOUNT.DUEs Branch circuits with service or feeder each circuit 224-00000-426102 1004 533.00 Services 200 amps or less 224-00000-426102 1004 89.00 Services 201 to 400 amps 224700000-426102 1004 . 209.00 Signal circuit(s)or limited-energy panel, alteration, or extension 224-00000-426102 1004 160.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 127.20 Technology fee(5%of permit total) 100-00000-425605 2099 53.00 Temp services 200 amps cr less 224-00000-426102 1003 69.00 TOTAL DUE: 1,240.20 ?'PAYMENi?TWir PAYOR cdstirgre a7Aasc` COMMENTS ,. _ MAMOUNTFAID, , , - ;s-r ` Credit Card Inline Commercial Construction Mirand. 1,240.20 02097j Corrigan TOTAL PAID: 1,240.20 • Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD CITY OF SPRINGFIELD, OREGON Pertnir 513 `283 3 225 Fifth StreeteSpringfietd,OR \f. Date: // I1 s1, 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 ID No Number of inspections per item () Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: Residential ®Government ®Commercial JOB SITE INFORMATION AND LOCATION 1.000 sq. ti.or less(4) $147.50 $0.00 Each additional 500 sq. ti.or portion $ 27.50 $0.00 Job site address: 1625 Mohawlk Boulevard thereof City: Springfield State: OR ZIP:97477 Limited energy(2) $ 35.00 $0.00 Reference: Taxlot.: Each manufactured home or modular $ 69.00 $0.00 DESCRIPTION OF WORK dwelling service or feeder(2) New Bank Branch Building -- All Electrical Services or feeders: installation,alteration,relocation 200 amps or less(2) 1 $ 89.00 $89.00 Services Except Telecom Wiring by Others PROPERTY OWNER 201 to 400 amps(2) 2 $ 104.50 $209.00 Name: Herbert Walton Jr. Marital QTIP Trust II 401 to 600 amps(2) $174.00 $0.00 Address: PO Box 150161 601 to 1,000 amps(2) $225.50 $0.00 City: San Rafael State:CA ZIP: 94915 Over 1,000 amps or volts(2) $516.00 $0.00 Phone: - - Fax: - - Reconnect only(2) $ 69.00 $0.00 E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) 1 $ 69.00 $69.00 owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $0.00 property is not intended for sale,exchange, lease,or rent. OAR 479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $0.00 Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits: Heir, alteration, extension per panel Business name: Contractors Electric, LLC a. Fee for branch circuits with purchase of a service or feeder fee: Address: PO Box 22233 (4224 W. 7th Ave., #1) Each branch circuit 82 $ 6.50 $533.00 City: Eugene State: OR ZIP:97402 b. Fee for branch circuits without purchase of a service or feeder fee: Phone: 1 -541-343-2222 Fax: 1 -541-344-0155 First branch circuit(2) $ 60.50 $0.00 E-mail: Permits @ContractorsElectricLLC.com Each additional branch circuit $ 6.50 $0.00 CCB license no.: 190503 BCD license no.: C611 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 5251 S Each pump or irrigation circle(2) $ 69.00 $0.00 Print name of signing supervisor:Jeff Brown Each sign or outline lighting(2) $ 69.00 $0.00 Signature of signing supervisor: / J� Signal circuit or a limited-energy panel, 2 $ 80.00 $ 160.00 Signature signing ‘90/ %Y alteration,or extension(2) Each additional inspection:(I) $80.00 $0.00 APPLICANT USE (A) Enter subtotal of above fees $ 1,060.00 (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 s IAJ) $ 127.20 (C)Technology Fee(5%of[A]) $ 53.00 440-2584-J(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ 1,240.20