HomeMy WebLinkAboutPermit Electrical 2014-3-20 •
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SPRINGFIELD - 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
08 Phone: 541-726-3753
OREGON
Building / Commercial Permit Inspection Phone: 541-726-3769 •
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00588
www.spnngfield-or.gov permitcenter@spnngtield-or.gov
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PROJECT STATUS: Issued ISSUED: 03/20/2014 EXPIRES: 09/16/2014
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STATUS DATE: 03/20/2014 APPLIED: 03/20/2014 -
SITE ADDRESS: 525 MILL ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: • 1703352304500 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Fire Alarm
OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number:
ADDRESS: 525 MILL ST
SPRINGFIELD OR 97477 - •
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CONTRACTOR INFORMATION • -
Contractor Type Contractor Name Lic Type • Lic No Lic Exp Phone
Electrical Contractor - OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
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Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
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4550 Limited Energy
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.
(� �, 3���/ y
Own- .. signature • Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility - NOTICE:
• Notification Center. Those rules'are set forth M SNALI IF MI RITE
in OAR 952-001-0010 through OAR 952-001- THIS AUTHORIPERZED IT UNDER THIEXPIRE S PERMIT IS WORK NOT
0090. You may obtain copies.of the rules by
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD-
Center is 1-800-332-2344).
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Springfield Building Permit 3/20/2014 10:28:33AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
- 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
OREGON 541-726-3753
811-SPR2D14-00588
www.springfield-or.gov 525 MILL ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000595 RECORD NO: 811-SPR2014-00588 DATE:03/20/2014
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ACGOUNT�CODE(.LRANSCODE.""_�=. �-==.AMOUNTDUE�"3
Fire Alarm 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
PAYMENT#TYPE reartI ASNIER uR EA COMMENTS; r AMOUNTAPAID -
Credit Card SPRINGFIELD SCHOOL DISTRICT 19 93.60
134034
TOTAL PAID: 93.60 -
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Electrical Permit Application DEPARTMENTUSE ONLY
SPRINGFIELD ++vr l'" _
x+ l+t �` ? chx 7 Pr .T,1 ">:--''-`t 2 1 fij',7*+'r• "2Sx w*' i{x F ."ly
- ONE OE S PRIN GF. I E LD rOREG-. �-N s , g
e4-. re .: F. .. .x. f',; �.f k.t '. r.-at -` -
0 -e Permit no.:C� � !
Y — OP �
225 Fifth Street•Springfietd,OR 97477•PH(541)726-3753•FAX(541)726-3689
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Date: ;!�( 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.
_li`, eLOCi4L;;GO.VENMENT',3APPRO.VAL xS "a ,:.. t'' " i N A '.` tig' ;t`.F,EE_SCHEDULE #e„'„sk- ,3, , 3
Zoning approval verified? ❑ Yes ❑No Numb r of inspec ions'per Iteri Q�"_ Qtyf 1:,ea t ' cost.
4 :'?v4` `x rrCATEGORY;�OF;:%.CONSTRUCTION ,r'"-,,n i"`, -''
Residential,per unit,service included:
❑Residential ❑Government ❑ Commercial
JOB. SITE„INFORMATION' AND:=LOCATION 1,000 sq.ft.or less(4) $147.50 $
Job site address: thereof additional 500 sq.ft,or portion
525 Al N) tL.. S . $ 27.50 $
City: siclrtFSb Stater g..._ ZIP: 9 3 t{77 Limited energy(2) . $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
-' ,4 _''µ;,, `IDESCRIPTIQNIOF'•WORK: 't,Tt !'wG+-% dwelling service or feeder(2)
Services or feeders: installation, alteration, relocation
lnlciAli( Af&u) Fa k' 4(ALAI Sy5Zr- kt
200 amps or less(2) $ 89.00 $
%;=y M n;I,�.0 ..Vi !.PROPERTY4.0WNER U.t. ?, '„kt^.s ` 201 to 400 amps(2) $ 104.50 $
Name: 5 t.AA Ste. SC,LctLb,5tticc 401 to 600 amps(2) $174.00 $
Address: 7E90 A.L .2_4 fe 601 to 1,000 amps(2) 5225.50 $
City: SPcj p t?r I Stater,{ I ZIP: °2177 Over 1,000 amps or volts(2) $516.00 $
Phoner'yl� q9_ 637C I Fax:Sf/f— ?94 -637 Reconnect only(2) $ 69.00 $
,,1 Temporary services or feeders: installation, alteration, relocation
E-mail:/�, •S Akattlxu6 m cet,A"d�i}ta ,AJ t- tf{ • iJl 200 amps or less(2)
This installation is being made on residdntial or farm property $ 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
479.5400)and 79.5600). 401 to 600 amps(2) $138.50 $
Signa e, Over 600 amps or 1,000 volts,see services or feeders section above '
''�„ C. NTRACTPRINSTAL"LAT,ION t vno- '`' S�n`'§'4 Branch circuits:new,alteration,extension per panel
Bustnes .I tie: ( lJ __ a Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 6.50 $
City: I State: I ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: •
Phone: - - I Fax: - - First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: I BCD license no.: Miscellaneous fees:service or feeder nor included
Signing supervisor's license no.: l 73 of Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: a LA SA.e,4". 4^'a Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: u Signal circuit or alimited-energy panel, $ 80.00 $
alteration,or extension(2)
/ T ( $
Each additional inspection:(I) $80.00 $
`” .4t 7.27514 tQPPLICANV.USES Ef'.W.,,,,,t.. '
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x [A]) - $
(C)Technology Fee(5%of[Al) $
TOTAL fees and surcharges(A through C): $ 9 3-e'—
440-2584-1(4101/2013/COM)