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HomeMy WebLinkAboutPermit Electrical 2014-4-2 • SPRf,NGFIELD- 225 Fifth St zei CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 -4"-w OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00714 vrww.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/02/2014 EXPIRES: 09/29/2014 STATUS DATE: 04/02/2014 APPLIED: 04/0212014 SITE ADDRESS: 6120 MAIN ST,Springfield,OR 97478 SCOPE: Electrical Only • ASSESOR'S PARCEL NO: 1702343103400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 3 circuits for Heat Pump OWNER: HOWARD&LOTTIE ANTONE FAMILY TRUST Phone Number: ADDRESS: 6120 MAIN ST SPRINGFIELD OR 97478 , CONTRACTOR INFORMATION III Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JK GUCKENBERGER ELECTRIC INC CCB 45129 04/24/2016 541-746-4656 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 construction. 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 IF THE WORK In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ,;number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • • • Springfield Building Permit 4/2/2014 12:06:49PM Page 1 of 1 SPRINGFIELD=' CITY OF SPRINGFIELD 225 FlRh 5t TRANSACTION RECEIPT Spnngfield,OR 97477 OREGON 541-726-3753 811-SPR2014-00714 www.spnngfield-or.gov 6120 MAIN ST permitcenter @spnngfield-ar.gov RECEIPT NO: 2014000716 RECORD NO: 811-SPR2014-00714 DATE: 04/02/2014 loll fol if h�teia aFuT r`.. _i, "`a_,. C,r VAce OAT CODEFTRANS O o _ .._ AMOUNTOUE` : Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 6.50 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 13.00 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 r`W - 7"`°"" dMOUNT P.AIDb'P"' '` €� PAYMENTaTYP_E P,4Y,OR cgsweR:uu:RSbN „„ -��COMMENT� - '� :.A Credit Card JK GUCKENBERGER ELECTRIC INC 93.60 015692 . TOTAL PAID: 93.60 • • FROM JKG El octrlc Inc y . (WED)APR 2 2014 10:01/ST. 10:01/MO. 7500000026 P 1 __..._.... _......_,. .,,... uup.rrwww.et.springoel a.or.uslasrouJIa inguoraryttlecvlcalPermlt2... -Electrical Permit Application DEPARTMENT USE ONLY r - _.. Y SPRINGFIELD CITY OF SPRINGFIELD. OREGON ` Pctnitno.: 61 1."5Pt2rgy —CC-7IL/ 225 ldtII Sher'•Sp iogleld.OR 97477 4PH(S41)725-375J41 \S(541)72636R9 oOEGON _ \\)3 � � Date: ��z- /( L( •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 ISO days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE 'Conine approval verified'.' ❑ Yes ❑No Number of inspections per item( Qty. Cost Total --- ea. cost CATEGORY R_Y OF CONSTRUCTION - --".- - Residentinl,per unit,service included: _ Residcuti.d ❑Government [11 Commercial '----__ -- --- 1,000 s'(. fi or less(4) 1 $147.50 $ tub site address: • a .Each a._____ al JOB SITE INFORMATION AND LOCATION ¢h additional SU(1 sq. Ile or portion ereof $ 27.50 $ Cih': 5`.yy /4 State: OR. 71P: 740 Limited energy(2) -S-75-.01; S Reference: Taxlot.: Each manufactured home or modular S 69.00 $ ___..- .___--.—.._-.-.-_ dwelling service or feeder(2) DESCRIPTION OF WORK --------- - Services or feeders:inslnflalinu,alteration,!'elacnlion i �hc7c-I/... .. t7?' i — ---__ 14, 2110 amps or less(2) $ 89.00 5 . _err i t.g_ 9V- Hec7 d PROPERTY 6WNEam+e• '201 to 100 amps(2) S 104.50 5_ Name: A. t( al,/ _ c'ri t -.._._ 401 In titlll imps(2) $174.00 Address 601 to I.,000 amps(2) 5225.50 S 4. ' State': ZIP: Over 1.000 amps or volts(2) $516.00 $ Fax: - - Reconnect only(2) S 69.00 $ .--.,- - L-mail: Temporary services or feeders: iva7al/alinn. alteration. reluauiun r. This installation is being made on residential Or farm property 200 naps or less(2) I t 69.00 $ owned by me or a member or my immediate family.This 201 to 400 amps(2) $ 96.00 S property is not intended for sale, exchange, lease dr rent. OAR ----- ----- 479.540(1)and 479.560(1). 401 in 600 amps(2) 5138.50 S Signature: Over 600 amps or 1,1)00 volts,see services or feeders section above ICONTRACTOR INSTALLATION Branch circuits: eau•, ulterulian,es ru.ciou per panel Business name: `a'y�U - n. Fee for branch circuits with purchase ul'a service or feeder lee: Address: 2._∎ —[ �O ST . _ Each branch circuit S 6.50 CiCv' r (� State:© ZIP: Q '(1 b. Fee I'or branch circuits without purchase of a service or feeder lee: Phone: ', •( ^- -2}(os Pans 'f -34;155 First branch circuit(2) $ 60.50 S�p�- li-mail: Y Ca J (yt� L-GAY) 8nuh addi'iuntd brooch circuit Z $ 6.50 5 /3r CCftbcenscno.: `451L BCD license no.: Z..0-2-1-1C, Miscellaneous fees:service m'fe'rder not induJrd Signing supervisor's license nu.: �y�+A+15 6�j- g- Each pump or irrigation circle(2) f $ 69.00 S -Punt name or signing supe'v isor:0- r • s I Each sign pr outline lighting(2) S 69.00 t SI n dare of signing supervlsar: �a Signal circuit or a limited energy panel. $ 80.00 $ ' __.-_..... alteration,or aSlctlSinla(2) Each-additional r inspection: (I) $8000 $ APPLICANT USE (A) Enter subtotal a'''bove tees ----- •(Minimum Permit Fee 580,00) $ (0)Enter 12%surcharge(.12 x Al)[ S (C)Technology Fee(5%of[Al) S :m-�ja.l l rrnln_o1LCf)ktl TOTAL fees and surcharges(A through C):---._$ �'��0 - p -m ii� C6-1 of I - 4/8/2013 11:38 AM