Loading...
HomeMy WebLinkAboutPermit Electrical 2014-2-20 SPRINGFIELD 225 Fifth St 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-SPR2014-00380 w ew.springfield-or.gov permitcenter©spnngfield-ocgov PROJECT STATUS: Issued ISSUED: 02/20/2014 EXPIRES: 08/19/2014 STATUS DATE: 02/20/2014 APPLIED: 02/20/2014 SITE ADDRESS: 1169 HARLOW RD,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703272200600 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Service for DSL xmitter • OWNER: BAKER MICHAEL P Phone Number: ADDRESS: 2920 COUNTY FARM RD EUGENE OR 97408 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor TONY KOTH CCB 59748 05/19/2014 541-688-8996 INSPECTIONS REQUIRED Inspections • 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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. Vol, may obtain copies of the rules by calling the center. (Note: the telephone HIS PERMIT SHALL EXPIRE IF THE WOR • number for the Oregon Utility Notiflcation JTHORIZED UNDER THIS PERMIT IS NOT• Center is j800.3322344)• OMMENCED OR IS ABANDONED FOR • \NY 180 DAY PERIOD. Springfield Building Permit . 2/20/2014 11:31:23AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD _.... ....... di Ai 225 Fifth St = t TRANSACTION RECEIPT Springgeld,OR97477 .OREGON 541-726-3753 811-SPR2014-00380 wwvi.spnngfeld-or.gov 1169 HARLOW RD permitcenter @springfield-or.gov RECEIPT NO: 2014000365 RECORD NO: 811-SPR2014-00380 DATE:02/20/2014 DESCRIPTION,.c :. 1rr x. .4 .T f s 1: .'a?_ '. .". ACCOUNTICODE/TRANS CODE.r'cAMMEAMOUNTDUEM 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 TOTAL DUE: 104.13 P.AYMENTZYPE P.AYOR cnswER.,ccARpeRTER COMMENTS .�.M4_0UNTiPAID _ Check TONY KOTH 104.13 7675 TOTAL PAID: - 104.13 • Electrical Permit Application DEPARTMENT USE ONLY SeRINGFIELO CITYQE SPRI1�tGFIELD,OREGON '` t Permit no.: `}((1 _ YR) A, c. ; 225 Fifth Sheet•Splmgfield.OR 97477•011(54))726-375311 AC(540726-3689 771417,4 OREGON . Date: 2. ZUJ ( y 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. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential, per unit,service included: ❑ Residential government [commercial JOB SITE INFORMATION AND LOCATION 000 sq. ri. or less(I) $147.50 I bg Each additional 500 sq. fl, or portion Job site address: LD W fr--'0 thereon' $ 27.50 $ City: S pep- State:O2- ZIP: Limited energy(2) $ 35.00 $ Reference: /-7JY 77Z2- Taxlot.. t7 Each manufactured home or modular $ 69.00 $ DESCRIPTION OF WORK dwelling service or feeder(2) 1 o b 4-;^-1 p t//�7t/1'�U e-'4! t.im-// Services or feeders: installation, alteration.relocnliun 200 amps or less(2) J $ 89.00 S tit OSL , PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: -jt-L 401 to 600 amps(2) $174.00 $ Address: ?,9' .‘1 /i / 7/151-1, _ 4-0 601 to 1,000 amps(2) $225.50 S City: K Stale ZIP:9770 O Over 1,000 amps or volts(2) 5516.00 $ Phone: - - Fax: - - Reconnect only(2) 5 69:00 $ E-mail: Temporary services or feeders: installation, alteration. relocation This installation is being made on residential or farm property 200 mops 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 ' CONTRACTOR INSTALLATION Branch circuits: new alteration.extension per panel Business name: t,) ry c C. a. Pee for hnmch circuits with purchase ofa service or feeder fee: Address: p• 0 • ,i3/Jx I / /3/ Each branch circuit S 6.50 $ City: �bee"c7(..-e State: Q/2 . ZIP: Q / yO h. Fee for branch circuits without purchase of it service or feeder fee: PholiC'i'f -e5 p fib Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 S CCB license no.: 51.7 y BCD license no.:20 -2Sg6 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 3 SS 3 5 Each pump or irrigation circle(2) 5 69.00 $ Print name of signing supervisor: • TO IA' V /ea 77-4 Each sign or outline lighting(2) $ 69.00 $ ti(ofil, Signal circuit ar a limited-energy panel. Signature of signing supervisor: Signal cir or extension(d- S 80.00 $ Farb additional inspection: (I) $80.00 $ • _ APPLICANT USE (A) Enter subtotal of above lees • (Minimum Permit Fee$80.00) (B) Enter 12%surcharge(.12 x Al)I $ 109, (C)Technology Fee(5^.o of)AI) $ ait< 440-2584T(4/0l/2013/COM) TOTAL fees and surcharges (A through C): $ / 'y,/0 •