HomeMy WebLinkAboutPermit Electrical 2014-1-16 .1 .
SPRINGFIELD ....- 225 Fifth St
A Law" ' CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00113
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 01/16/2014 EXPIRES: 07/15/2014
STATUS DATE: 01/16/2014 . APPLIED: 01/16/2014
SITE ADDRESS: 651 W CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703274305805 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Low voltage •
OWNER: CENTENNIAL SHOPPING CNTR LLC Phone Number:
ADDRESS: 7831 SE STARK ST STE 103
PORTLAND OR 97215
L CONTRACTOR INFORMATION i
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Low Voltage Electric CERTIFIED SYSTEMS INC CCB 187589 07/31/2015 541-343-1608
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. - •
Owner or Contractor Signature Date .. •
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Springfield Building Permit 1/16/2014 9:03:32AM Page 1 of 1 •
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
SLate TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2014-00113
www.springlield-or.gov 651 W CENTENNIAL BLVD permitcenter @springfield-or.gov
RECEIPT NO: 2014000107 RECORD NO:811-SPR2014-00113 DATE:01/16/2014
'DESCRIPTION � -1, ! ACCOUNT CODE/TRANS CODE___::„. .:.._.:
_ raAMOUNTDUE
CCTV 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
L.'_PAYMENT_TYPE PAYOR_-`CASHIER OCARPENTER • _COMMENTS,:._ _ _ AMOUNT PAID • •
Credit Card CERTIFIED SYSTEMS INC 93.60
. 091306
TOTAL PAID: 93.60
•
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Electrical Permit Application DEPARTMENT.USE ONLY
SPRINGFIELD v�oi\
-,..e- 3.rPt a.Y�..altar i -xa 3 b. ..a_+. !zzat :fs�F't ■
CI=KT F SPRINGETELDI ORREEG-ON—` pg -... , T_ L/ / �j
ti*I. . ' - ,..:. ,ZtSu 41 1:. 'A'', 3 _, Permit no.: S� ��( J _... ._.tok
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(54I)726-3689 �s9�
Date: I//(II V
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.
z"Th:iti to LOCAL-;GOVERNM ENT i4PP ROYAL;: ," . ,era .=t„, A41EEE,ISCHEDU LE"55 = ' t ,, c-.!Rt"r;
Zoning approval verified? ❑ Yes ❑No 'Number of inspectiont persdem O Qty vI'Cost Total i
'" " ;r;IlCATEGORYCOF-t,CONSTRUCTIONE, t" Residential,per unit,service includ 't `z=ea ,,, costd'4
• ❑ Residential ❑ Government /Commercial
,• , JOB)SITE;:INFORMATION ANO LOCATION .. 1,000 sq.ft.or less(4) $147.50 $
Each additional 500 sq.ft.or portion
Job site address: 625-1w. h�.tl, 133ht &. thereof - $ 27.50 $
City: SPc\ �‘,0 State: d(L ZIP:91 y 7/ Limited energy(2) $ 35.00 $
Reference: ho '3 27 y 3 Taxlot 0 CLOS Each manufactured home or modular $ 69.00 $
, r 2ke.s,DESCRIPTION-;OF WORK / ' dwelling service or feeder(2)
add �1v �� 5-ts\--k� Services or feeders: installation, alteration, relocation
GOGI 1 � 200 amps or less(2) $ 89.00 $
ei ite( ; *8n\r - PROPERTI OWNER °.<: :, C=*37 201 to 400 amps(2) $ 104.50 $
Name: (g.c\Qt \ iv\v4ski.'Q' 401 to 600 amps(2) $t 7a.00 $
Address: L Q\sfik, 601 to 1,000 amps(2) $225.50 $
City: State: ZIP: 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) $ 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
I'r{t CONif RACTO RI INSTALLATION°4 a 'v.- f; Branch circuits: new alteration, extension per panel'
Business name: (cS:ed S'1'S 'e...\rr‘5 li\L, a. Fee for branch circuits with purchase of a service or feeder fee:
Address: A-LA (Jlsrnr$.dx � Each branch circuit $ 6.50 $
City: eafterq_, ` __11.•ff State:D(1_ ZIP: 0[7({6 1 b. Fee for branch circuits without purchase of a service or feeder fee:
PhoneSlll-3'l}- [(,,p Z� Fax: - - First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: l` roil BCD license no.: 0..619 , Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: )e.,A-17gb Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: I\f,_ 1/)�'; Each sign or outline lighting(2) $ 69.00 $
el/ �_') Signal circuit or a limited-energy panel, y7)
Signature of signing supervisor: iL� alteration,or extension(2) I $ 80.00. $/J=/
Each additional inspection:(I) $80.00 $
i ,-,y a, g%M ,fA�P_P,LICANT USE"f�'*1c,tKO . ,seP,,�M,
,.. � xf s,-s..; .
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[AD $ 2,fr
(C)Technology Fee(5%of[A]) $ ad
TOTAL fees and surcharges(A through C): $ o/
440-2584-J(4/012013/COM)