HomeMy WebLinkAboutPermit Electrical 2014-3-24 •
SPRINGFIELD 225 Fifth St
• CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
6,4,•• OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00609
www.springfeld-or.gov permitcenter@spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 03/24/2014 EXPIRES: 09/20/2014
STATUS DATE: 03/24/2014 APPLIED: 03/24/2014
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SITE ADDRESS: 244 6TH ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703353190003 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: 4 circuits
OWNER: SCHILT PROPERTIES LLC • Phone Number:
ADDRESS: 244 6TH ST
SPRINGFIELD OR 97477 '
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JB ELECTRIC INC COB 104929 03/14/2016 541-687-5770
INSPECTIONS REQUIRED 1
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
pe y' card is located at the front of the property, and the approved set of plans will remain on the site at all times during
con r
Owner r r Contractor Signature • Da e •
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952=001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR
• Center is 1-800-332-2344). ANY 180 DAY PERIOD.
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Springfield Building Permit 3/24/2014 10:03:14AM Page 1 of 1
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SPRINGFIELD" CITY OF SPRINGFIELD
.-- 225 Fifth St •
TRANSACTION RECEIPT Spnngreld,OR 97477
OREGON 541-726-3753
811-SPR2014-00609
www.springfeld-or.gov 244 6TH ST permitcenter@spnngfield-or.gov
RECEIPT NO: 2014000619 RECORD NO: 811SPR2014-00609 DATE:03/24/2014
O '. .3:_l22±±:ACCOUNT CODE/ RANS'CODE
Branch circuits without service or feeder-1st circuit 224-00000-426102 1004 60.50
Branch circuits without service or feeder-each additional 224-00000-426102 1004 19.50
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
TOTAL DUE: 93.60
PAYME ifirtY.E. PAYOR creir .ARSm OR COMMENTS' MQUNT PAID°. _ .
Check JB ELECTRIC INC • 93.60
124269
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT.U SE ONLY
SPNINGFlELO b - ..
'^ ` Yi )`t F-.fey.µ -0 ^ Y'hN 3..n. t:=•.k :: i` ' °'14 £+ r&i.b iz,
4 CITY OF,SPRLNGFIELD; OREG6}lf rr,�i Perin;t nn.: S�z�,, H xi
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225 Fifth Street♦Springfield,OR 97477♦PH(541)726-3753♦FAX(541)726-3689
Date: /Z y N
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.
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*,LOCAL GOVERNMENT:,QFPROVAL4, ,,. ;'t ,FEE;SCHEDULE',t.. a
Zoning approval verified? ❑ Yes ❑No =Number of:i:nspecttons.per item(j�": Qty: "' st ;costl.x'
'' 9 ;CATEGORY*OF°,CONSTRUCTION ,:11 .,
Residential,per unit,service included:
❑Residential ❑ Government 54 Commercial 1,000 sq.fr. or less(4) $147.50 $
JOB'SITE:INFORMATION' AND;i1OCATION:;,; ,,,, ,
�,//J L Each additional 500 sq. ft.or portion
Job site address: / 7 £� thereof - $ 27.50 $
Cityl�+(26/1/ tee State: 92 ZIP: Limited energy(2) $ 35.00 $
Reference Taxlot Each manufactured home or modular $ 69.00 $
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A/„' ,jj4DESCRIPTION„OF,WK-
OR ” "tah= , dwelling service or feeder(2)
n Jl , ,I,c /., 9 ,^/�C / Services or feeders:installation, alteration,relocation
C (�� (c-W. 77.K/ vLO� 200 amps or less(2) $ 89.00 $
r
a cr tik'.a. r,,`fr'f "ti. ." OPERTY OWNERrt , --,:__`tt-q 201 to 400 amps(2) $ 104.50 $
Name: SGG r Al_f/79/C7 e:j 401 to 600 amps(2) $174.00 $
Address: /Z/ .91 6 '1.4" 601 to 1,000 amps(2) $225.50 $
City: n I State: I ZIP: Over 1,000 amps or volts(2) $516.00 $
Phone: - - I 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
479.5400)and 479.5600). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
",f`t4 l`a"i .E CONT.RACT,OR 4NSTALLATION 0:r i,v, .4, Branch circuits:new alteration, extension per panel
Business name: L '`a a.Fee for branch circuits with purchase of a service or feeder fee:
Address: y/j$L ' E2 ' ' I Each branch circuit $ 6.50 $
City: ��'�'/� .24..1. I State: � J ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: 5-3//` -- b 7—SCM4 Fax: - - First branch circuit(2) / $ 60.50 $
E-mail: Each additional branch circuit 3 $ 6.50 $
CCB license no.: !bl ylag I BCD license no.:37__7e Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 67702___c / Each pump or irrigation circle(2) $ 69.00 $
67702___c Print name of signing supe olu %irimpt at y Each sign or outline lighting(2) $ 69.00 $
Signature of signing supernso . Signal circuit or alimited-energy panel, $ 80.00 $
alteration,or extension(2)
Each additional inspection:(1) $80.00 $
> .. al:V ; 'APPLICANT;:USEM"-al'f" 5ii t
(A) Enter subtotal of above fees -
S
(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): $ 7 3i
440-2584-1(4/01/2013/COM)