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HomeMy WebLinkAboutPermit Electrical 2014-2-13 SPRING5IELD - 225 Fifth St 't ( CITY OF SPRINGFIELD Springfield,OR 97477 V-X13;:€ \t Phone: 541-726-3753 . Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00327 vmay.spdngfield-or.gov permitcenter @springfield-or.gov . PROJECT STATUS: Issued ISSUED: 02/13/2014 EXPIRES: 08/12/2014 STATUS DATE: 02/13/2014 APPLIED: 02/13/2014 • SITE ADDRESS: 1357 E ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703362304100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service Change/Garage Panel/Garage Branch Circuit OWNER: KUBICEK KATHERINE M 8 CHARLES E Phone Number: ADDRESS: 1357 E ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION . Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JK GUCKENBERGER ELECTRIC INC CCB 45129 04/24/2014 541-746-4656 INSPECTIONS REQUIRED Inspections 4220 Electrical-Service 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 ��,�Deate P a� - .e v---- -- p `� ATTENTION: Oregon law requires you to r r follow rules adopted by the Oregon Utility �l e 1.; Notification Center. Those rules are set forth NOTICE:PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- THIS 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregcn Utility Notification ANY 180 DAY PERIOD. Center is 1-800-32-2344). Springfield Building Permit 2/13/2014 12:29:04PM Page 1 of 1 SPRINGNIELD CITY OF SPRINGFIELD 225 Fifth St (\ TRANSACTION RECEIPT Springfeld,OR 97477 `j5 541-726-3753 \ OREGON 811-SP R2014-00327 www.springfield-or.gov 1357 E ST permitcenter @springfield-or.gov RECEIPT NO: 2014000309 RECORD NO: 811-SPR2014-00327 DATE: 02/13/2014 [DESCRIPTION _ = ACCOUNT CODE/TRANSCODE AMOUNTDUE_,J Branch circuits with service or feeder each circuit 224-00000-426102 1004 13.00 Services 200 amps or less 224-00000-426102 1004 178.00 State of Oregon Surcharge (12%of applicable fees) 821-00000-215004 1099 22.92 Technology fee (5% of permit total) 100-00000-425605 2099 9.55 v �T_ TOTAL DUE: 223.47 . PAYMENT.TYPE• 'PAYOR - CASHIER:JLARSON - ' COMMENTS - AMOUNT PAID Credit Card JK GUCKENBERGER ELECTRIC INC 223.47 035710 TOTAL PAID: 223.47 FROM -WO E I Octrlc Inc. <THU)FEB 13 2014 8:24/611. B:24/Ho. 7500000763 P 1 ..... , ..;,.... 11 L.. LA huh.n0o•re.e,.api.,l )lclu.Ul.unlulu/UUllulllltfLuialylraecti Itch'ennui... y� Electrical Permit Application ( DEPARTMENT USE ONLY F SPRINGFIELD, OREGON i ' 225 HIM ul eel Pehmil no.: (� Zol cJO�Z CITY O Spruigneld,Mt 97477w1115-11)72rt775.3•I \\(541)726-3689 • LOaeGOH Date: 240/ (-7 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within ISO • days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑ No Number or inspections per item Qty. CosI Total CATEGORY OF CONSTRUCTION p V _f) Q V ea. cost .._....__._._.._.__..____- — Residential,per unit,service included: s — _ r Residential 1 ❑Government 0 Commercial JOB SITE INFORMATION AND LOCATION 00 w. h.or less(4) $147.60------ Each additional 500 x). U or minion lob site address: ! —? .e.-- thereof 5 27.50 if : Stale: 062_ ZIP: A Limited energy(2) $ 35.00 $ Reference: faxluL: Each manufactured home or nwdnlnr S 69.00 DESCRIPTION OF WORK — - dwelling service ur 2e der(2) )-- Services or feeders: insialloelou.altered on,rel°coin,» C-eU/Ge_ -4Cye_ er r 47C 200 amps o less(2) 2,0 $ 89.00 • " - 7- ----------...----.... PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: RLC e( S / e/rlAq✓er a m p s ) $174.00 $ Address: 3S .. S 7-- 6011u 1.,000 amps(2) 5225.50 5 /Q p 9 y Over 1,000 amps or volts(2) 5516.00 $ City: r2/se, - State: m Z(P:7 7 .__. _.____._.-....._...___._ Reconnect only(2) 5 69.00 $ Phone: o.: -d ..0 Fax: - - — — ❑.-mail: ------------ Temporary services or feeders: install(uinn, nheralion, relocation This installation is being made on residential or farm properly 2(10 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 5 properly is not intended for sale, exchange, lease. or rent. OAR -----------------� 479,540(I)and 479.5600). 401 m 600 amps(2) St 38450 5 Signature: Over 600 umps or 1,00(1 volts,see services or feeders secs ion above CONTRACTOR INSTALLATION Branch circuits:unit uGerarion.e.oen.rimt per panel Business named( (J a. Fee for branch circuits with purchase of service or feeder lee: Address: 2-151�i ST Each branch circuit 11..,1 S 6.50 $ Cit': 1�'k'( I State:© s( ZIP: 4 4-i'i b. Fee for brunch circuits without purchase of a service ur feeder lee: Phone: d. .�.- '-.J Pax: - g5 DTI fit" -�S I___ 51 ��b� S First branch circuit(2) 5 60.50 1 S E-mail: v-b60 c--, KGB(-c c 'yl _ - Each nddilimml branch circuil S 6.501 S CC:B license no .45 mei [ BCD license no.: Lb- --1-I(., Miscellaneous fees:service or feeder not Urclu led __. . ._. .. _. ..____.-..__.._____e _..._ Fach pump or irrigm run circle(2) — --- S 69.00 Signing supervisor's license nu.: �5 L�j- S- ___—._.—_. .___. Print name of signing supervisor: 1 r , s f Each sign or outline lighting(2) _$ 60:00 _$ Si_nuturc of siguin'�su supervisor: • Signal circuit or a I inlitcd-encrgy Panel, $ su.6o $ _..__..:_... _.. ' 1 :dictation,or extension(2) Each nddilional inspection:(I) $80.00 $ • APPLICANT USE (A) Filler subtotal of above fees $ (Minimum Permit Fee S80.00) (B)Enter 12%surcharge(.12 x[Al). S - (C)'Technology Die(6%of IAl) 5 — 440.25;144(-1/1/1/2013/COM) TOTAL,fees nod surcharges(A through C): S2-23 d E - pcm l l iI0C --i of 1 4/8/2013 11:38 AN1 •