HomeMy WebLinkAboutPermit Electrical 2013-12-12 SPRIr4GFIELD
CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477
r . s Phone: 541-726-3753
Uitt1a°N Building ! Commercial Permit Inspection Phone 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02660
www.springfield-or.gov permitcenter @spnngfield-or gov
PROJECT STATUS: Issued ISSUED: 12/12/2013 EXPIRES: 06/10/2014
STATUS DATE: 12/12/2013 APPLIED: 12/12/2013
SITE ADDRESS: 250 S 32ND ST,Springfield, OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702310000502 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Branch circuits and low voltage
OWNER: WILLAMALANE PARK 8 RECREATION DISTRICT Phone Number:
ADDRESS: 250 S 32ND ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Eleclncal Contractor OWNER CC8 000000 08/01/2025
KENNETH D RANDALL (S)Electrician,Go 40235 10/01/2016 541-736-4102
L INSPECTIONS REQUIRED
Inspections
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.
e...k... ..) "ra"Va (7.---/Z- 3
Owner or Contractor Signature Date
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COIVI!';1ENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Springfield Building Pern1N 12/12/201 11 20 27AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 FAth St
TRANSACTION RECEIPT Spnngfield,OR97477
r
541-726-3753
OREGON 811-SPR2013-02660
www Springfield-or gov 250 S 32ND ST permitcenter @springfield-or gov
RECEIPT NO: 2013002648 RECORD NO:811-SPR2013-02660 DATE: 12/12/2013
DESCRIPTION ACCOUNT CODEfTRANS CODE AMOUNT DUE
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 6.50
Data/Telecommunications 224-00000-426102 1004 80.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17 64
Technology fee (5% of permit total) 100-00000-425605 2099 7.35
TOTAL DUE: 171.99
PAYMENT TYPE PAYOR CASHIER:CCARPENTER COMMENTS AMOUNT PAID
Check WILLAMALANE PARK&RECREATIO 171.99
97369 DISTRICT
TOTAL PAID: 171.99
Permit no.: 5(-3 — 2(40
223 Ft{tb Street•Spriagfetd,OR 97477 en OREGON
Date: / 2//Zi13
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. Boast I Total
cost
CATEGORY OF CONSTRUCTION
❑ Residential Residential,per unit,service included:
Government ❑Commercial
1,000 ft. I (4)SITE INFORMATION AND LOCATION sq. .or less( ) St47.so S
Each additional 500 sq.ft.or portion
Job site address: 2. 5 p S.. 3�r.a o 'Z thereof $ 27.60 $
City: SPR-..0, ,F+gt�n Stale: oe._ ZIP;9 ,- Limited energy(2) $ 35.00 S
Reference: Tax lot.: Each manufactured home or modular 5 69.00 S
DESCRIPTION OF WORK dwelling service or feeder(2)
Services or feeders:installation, alteration,relocation
L-,TAC-C Z Peru: art'- C.t r r L.A.t"t'. (a 1-,n 200 amps or less(2)
S 89.00 5
A-T 4. L t ■..4-- ,
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: FA?-r..erl Zeee 401 to 600 amps(2) $174.00 $
Address: Z S� S - 3 r 601 to 1,000 amps(2) 5225.60 $
L/,,,/,,,a., -� gam'
Ci Over 1,000 amps or oohs(2) $518.00 $
ty;S f 4 I r,-, /6 State:p e_ _ ZIP:c 7 c,,
t -736.yS q Fax: - Reconnect only(2) S 69.00 $
Phone:5
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 S
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) 5138.60 S
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits:new,alteration,extension per panel
Business name: JUG /L/ :7---- a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit 1 I $ 6.50 S
City: "State': ,. ZIP: h.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - - Fax: - - First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit i 5 6.50 S fns c,
C tcense no.: BCD license no.: Miscellaneous fees:service or feeder not Included
Signing supervisor's license no.: `{pz.3 S
Each pump or irrigation circle(2) $ 69.00 S
Print name of signing supervisor:( �,r rijy r).--0-/-1 f�a(–C Each sign or outline lighting(2) $ 89.00 $
Signature of signing su ervisor���, ��� Signal circuit or a limited energy panel,
Sn gn g P $ eo.oa $
alteration,or extension(2) � Flo cz,
Each additional inspection:(1) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(13)Enter 12%surcharge(.12 x[AJ) $ % 4_,,,7,
(C)Technology Fee(6%of[AJ) $ 7,3 S
440-25844(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ (Z(^"1/