HomeMy WebLinkAboutPermit Electrical 2014-2-11 SPRINp FIELD 225 Fifth Sl
CI, ;,.r -c , CITY OF SPRINGFIELD Springfield,OR 97477
' l Phone: 541-726-3753
WS( OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: -811-SPR2014-00280
www.springfield-or.gov permitcenter @springrield-or.gov
PROJECT STATUS: Issued ISSUED: 02/11/2014 EXPIRES: 08/10/2014
STATUS DATE: 02/11/2014 APPLIED: 02/11/2014
SITE ADDRESS: 4197 FRANKLIN BLVD, Eugene, OR 97403 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703344300100 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Service-Storm Damage
OWNER: T1-4197 FRANKLIN BLVD LLC Phone Number:
ADDRESS: 4105 FRANKLIN BLVD
EUGENE OR 97403
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor STEVEN R GEISLER CCB 95472 11/23/2014 541-726-0618
INSPECTIONS REQUIRED
Inspections
4210 Service Change
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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Springfield Building Permit 2/11/2014 10:27:34AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
__ - RFifth St
z TRANSACTION RECEIPT 225 225held.oRg7477
t° ' 1-4-OREGON 541-726-3753
• 811-S PR2014-00280
www.springfield-or.gov 4197 FRANKLIN BLVD permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000264 RECORD NO: 811-SPR2014-00280 DATE: 02/11/2014
[DESCRIPTION ;: - ACCOUNT CODE/TRANS CODEE,` `, AMOUNT DUE_J
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
v --- TOTAL DUE: 104.13
PAYMENT TYPE . PAVOR 'CASHIER:JLARSON.. _3,.. . COMMENTS__ ' ` AMOUNT PAID 1
Credit Card STEVEN R GEISLER 104.13
343218
TOTAL PAID: 104.13
Electrical Permit Application DEPARTMENT USE ONLY
SPgINGi1ClD
CITYOF SPRINGFIELD 'OREGON zr �
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225 Fifth Street 4 Springfield,OR 974774 PB(54l)726-37534 FAX(541)726-3689
Date:
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, east Total
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1,000 sq. ft.or less(4) $134.00 $
Each additional 500 sq.ft.or portion $ 25.00 $
Job site address: Li 1 y 7 cc o..41.-‘,..." thereof
City: �,�( State: p(L ZIP: 9 7 t.1-7.a Limited energy(2) .. $ 32.00 $
Reference:- Taxlot.: Each manufactured home or modular $ 63.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
11 Services or feeders:installation,alteration,relocation
Sec vi Li
e. - S l�:�e W -Nn.cc e
5 200 amps or less(2) I $ 81.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 95.00 $
Name: 1 I - 1..I I. 41 wr:•t W r L. G(Vat t- G 401 to 600 amps(2) $158.00 $
Address: '-)\e En.,,k I. 601 to 1,000 amps(2) $205.00 $
City: "St" Eiei� State: ("<, ZIP:
Over 1,000 amps or volts(2) $469.00 $
Phone: - - Fax: - -
Reconnect only(2) $ 63.00 $
E-mail: Temporary services or feeders:installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less(2) $ 63.00 $
owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 87.00 $
property is not intended for sale,exchange,lease,or rent.OAR -
479.540(1)and 479.560(1). 401 to 600 amps(2) $126.00 $
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: SiL ELEC.-CRC a.Fee for branch circuits with purchase of a service or feeder fee:
Address:PO O 19OX b C3,3 Each branch circuit $ 6.00 $
City: ?C00%S i H-1(.(_ State CR_ ZIP::745. b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: sly q j&-9.0 So Fax:3/f 7444-O e-/ oZ First branch circuit(2) $ 55.00 $
E-mail: S N 1 CO v" Each additional branch circuit $ 6.00 $
CCB license no.: Jc41-7 9, BCD license no.:-0-373 C Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 4O RL}- S Each pump or irrigation circle(2) ' $ 63.00 $
Print name of signing supervisor: (f=.o'a/)i GGEIS>& Each sign or outline lighting(2) $ 63.00 $
Signature of signing supervisor Signal circuit ort x a smn(2)energy panel, $ 63.00 $
�'`� alteration,or extension(2)
Each additional inspection:(1) • $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees
$
(Minimum Permit Fee$58.00)
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $(424/ t 7
440-25841(9/08/COM)