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Permit Electrical 2014-3-24
• 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-SPR2014-00610 www.springfield-ar.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/24/2014 EXPIRES: 09/20/2014 ' STATUS DATE: 03/24/2014 APPLIED: 03/24/2014 SITE ADDRESS: 225 5TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703353103300 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: Extend existing circuit OWNER: CITY OF SPRINGFIELD Phone Number: ADDRESS: 344 NORTH A ST SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor RS ELECTRIC LLC CCB 149509 11/02/2015 541-359-1192 INSPECTIONS REQUIRED Inspections • 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 constructio • • (VZ-ei-A/ Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE. Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE 1F THE WORK • in OAR 952-001-0010 through OAR 952-001- 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 Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building Permit 3/24/2014 10:34:30AM Page 1 of 1 • • , SPRINGFIELD CITY OF SPRINGFIELD 225 Fdth St OR�GON TRANSACTION RECEIPT Spdngfield,OR97477 541-726-3753 811-SPR2014-00610 www.springlield-or gov 225 5TH ST permitcenter @springfield-or.gov RECEIPT NO: 2014000621 RECORD NO:811-SPR2014-00610 DATE:03/24/2014 • - • IION:F.OW&+ I+.I .r.�:": ..� ' ":_it `ci+ .A ACCOUNT:CODE/TRANSICODE i"° .`.,°-.:.'. AMOUNT°DUE : Balance of Minimum Electrical Permit Fees 224-00000-426102 1004. 19.50 Branch circuits without service or feeder-1st circuit 224-00000-426102 1004 60.50 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 t„,,-�.• TOTAL DUE: 93.60 FaPAYMENVYP-E. PAYOR_ cAS t. n/uRSON _ -COMMENTS' _ !iMOUN_T A_ID _ Credit Card CITY OF SPRINGFIELD 93.60 080510 . • TOTAL PAID: 93.60 • • • • • • • • • • • • • Electrical Permit Application USE ONLY SPRINGFlELO F' 'g„ - - ilCI.,rTY� OF_ SP.-;R ING*. t1Er.LTsa-?- CREa,a±Gt Ot N T - ` 1j..:_:-` A 225 Fifth Stree[•Springfeld,OR 97477♦PH(541)726-3753•FAX(541)726-3689 . y - OoGI a � Date: ` /4-f%cic 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. LOEAL;.GOYERNNI ENT`.APPROYA1 , FJ*,_ ,IEEEiSCHEDULE Zoning approval verified? ❑ Yes ':' pe Cost Total' ❑No Number of inspections per dem O �-� Qty e'a ,cost--. CATEGORY tsOF. CONSTRUCTION .,�.. - Residential,per unit,service included: ❑Residential ❑Government Commercial ' `'JOB.SITE,JNFORMATION' AND; LOCATION 1,000 sq.ft.or less(4) $147.50 $ - Each additional 500 sq.ft.or portion Job site address: .S S fl'UZr, thereof $ 27.50 $ City:Sg,(^J6 n State: - ZIP: 974"7,'_ Limited energy(2) $ 35.00 $ Reference: Taxlot / Each manufactured home or modular $ 69.00 $ dwelling service or feeder(2) tD ESC RIPTION 'OFc WORK ;: ' R • 7-90<77,06 j/E&z'Y 7O Ai � Services or feeders: installation, alteration,relocation Ill 200 amps or less(2) $ 89.00 $ SC1tG TS i gar ' ' PROPERTY ,,OWNER e, 201 to 400 amps(2) $ 104.50 $ Name: o, y-(J (ci . cP5%L o , 401 to 600 amps(2) $174.00 $ Address: •/ 601 to 1,000 amps(2) $225.50 $ City: State: ZIP: Over 1,000 amps or volts(2) $516.00 $ Phone: - - Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 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 ', :'. '+- ,CONY CTOR INSTALLATION. .. Branch circuits:new alteration, extension per panel Business nanme: C. g�rn9/' L.G _. a. Fee for branch circuits with purchase of a service or feeder fee: Address: (✓`D • go-x, tva/.,2(p Each branch circuit $ 6.50 $ City: &(t State: Cie. ZIP: q71/4 y b.Fee for branch circuits without purchase of a service or feeder fee: PhoneSW359- //9a I Fax n/-4/ -0507 First branch circuit(2) ( $ 60.50 $A9 S-p E-mail: >`et elf-€/ Sg-Gc'C'e72zC (CL-con? Each additional branch circuit $ 6.50 $ CCB license no.: /4/96—a5) I BCD license no.&0"y6702 C Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 17 798 Each pump or irrigation circle(2) $ 69.00 $ J�� Each sign or outline lighting(2) $ 69.00 $ Print name of signing supervisor: � 449 c/[44/0te Signature of signing supervisor: Signal circuit or a limited-energy panel, - .���� alteration,or extension(2) $ 80.00 $ Each additional inspection:(1) $80.00 $ E.Wfiriu*V airall CANT„FUSE ll s (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $73 i 440-2584-f(4/01/2013/COM)