HomeMy WebLinkAboutPermit Electrical 2014-2-28 ,.
SPRINGFIELD 225 Fifth St
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-SPR2014-00454
www.spnngfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/28/2014 EXPIRES: 08/27/2014 •
STATUS DATE: 02/28/2014 APPLIED: 02/28/2014
SITE ADDRESS: 2509 MAIN ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703360000100 TYPE OF STRUCTURE: Industrial
PROJECT DESCRIPTION: Mill A ELI Line
OWNER: ROSBORO LLC Phone Number:
ADDRESS: 2509 MAIN ST
SPRINGFIELD OR 97477 .
_ CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
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4220 Electrical Service Electric Service: Approval required prior to utility company energizing service.
4225 Service or Feeder
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.
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Owner or Contractor Signature Date
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ATTENTION: Oregon lathe Oregon Utility
• {o;;ow rules adopted by
NOTICE:
hOAR952001
Noiiiication Center. Those rules are set or
THIS PERMIT SHALL EXPIRE IF THE WORK obtain copies Dt the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT o0 0Ryou may onto /N to the Noerflcation
COMMENCED OR IS ABANDONED FOR calling the center• ion Utility
ANY 180 DAY PERIOD. • numbercenterr is 1e80o-332 2344).■
- Springfield Building Permit 2/28/2014 1:29:41PM Page 1 of 1
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SPRINGFIELD -- CITY OF SPRINGFIELD
Fr\FOR GON TRANSACTION RECEIPT Springfield, OR97477
OREGON 541-726-3753
811-SPR2014-00454
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www.springfield-or.gov 2509 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000461 RECORD NO:811-SPR2014-00454 DATE:02/28/2014
{ef�Yo(71�IfCo1; ;7 :L t =se - La_ f w� 'ACCOUNT CODE/TRANS,CODE. 'AMOUNTfiDUE_'
Audio/Stereo 224-00000-426102 1004 80.00
Branch circuits with service or feeder each circuit 224-00000-426102 1004 331.50
Data/Telecommunications 224-00000-426102 1004 160.00
Electrical Plan Review(25%of electrical fee) 224-00000-426102 1085 549.75
Services 200 amps or less 224-00000-426102 1004 623.00
Services 201 to 400 amps 224-00000-426102 1004 104.50
Services 601 amps to 999 amps 224-00000-426102 1004 900.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 263.88
Technology fee(5%of permit total) 100-00000-425605 2099 109.95
TOTAL DUE: 3,122.58
PAYMENT TYPEIC-'��-P,AYOR cASwER: - . WEI MMENTS AMOUNTBAID l ,.l
Credit Card ROSBORO LLC 3,122.58
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087224
TOTAL PAID: 3,122.58
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'Eledtrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
C.. ®:. S,P v ` GFIEI�D ®, GOFt�T , , ,,�,.I f7t/- ycy
a f f { `� Permit no.:
225 Fifth Strecl•Springfield OR )7477,111(541)726-3753•F X(541)726-3689 t� "—�- OnEGON
Date: 2/ Z4 i/ ti
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. 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. C Total
ea.ost cost
CATEGORY OF CONSTRUCTION
Residential, per unit,service included:
❑ Residential ❑Government a'Commercial
JOB SITE INFORMATION AND LOCATION . I.000 sq. 0.or less(4) $147.50 $
2So 5 Each additional 500 sq. fl or portion $ 27.50 $
Job site ackess: rh/v __ _ Utereol'
City:SPet„r / State: in- ZIP: 97 '(7 7 Limited energy(2) 3 $ 35.00 $ --
Reference: /70 3 n 3 OO' TaxIoteepeo Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
? P-J Services or feeders: installation. alteration.relocation
200 mops or less(2) 2 $ 89.00 $
M l 1-1- fit CZ".1-(iv6
PROPERTY OWNER 201 to 400 amps(2) I - $ 104.50 $
Name: )0ig D7_.0 401 to 600 amps(2) $174.00 $
Address: -2,57,7 pion-, 601 to 1,000 maps(2) 4 5225.50 S
City: State: ZIP:.-..... —__ Over LOW amps or volts(2) $516.00 $
Phone: - - Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeder's: installation, alteration. relocation
200 amps or less(2) 5 69.00 $
This installation is being. made on residential or farm property
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
479540(1)and 479560(1). 401 to 600 amps(2) 5138.50 $
Signature: ( TR/d /�jam,. Over 600 amps or 1.000 volts, see services or feeders section above
CON ACTOR INSTALLATION Branch circuits: new, alteration, extension per panel
Business name: (70, LL j(� a. Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit sl $ 6.50 5
City: • State: ZIP: b. Pee for branch circuits without purchase of a service or feeder tee:
Phone: - - Fax: - - First branch circuit (2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: BCD license no.: NI iscel laneons fees:service or feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor:
Each sign or outline lighting(2) ,_._,S 69.00 $
Signal circuit or a limited-energy panel. $ 80.00 $
Signature of signing supervisor: • alteration,or cxtonsion(2)
Each additional inspection: (I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B) Enter 12%surcharge(.12 x IAI) $
(CC)Technology Fee(5%of l Al) $
440-2584-4(4/0112ttt31COM) TOTAL fees and surcharges(A through C): $Q��z sr