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Permit Electrical 2014-4-15
SPRINGFIELD- 225 Fifth St '•' CITY OF SPRINGFIELD Springtiield,OR97477 L`"( C� Phone: 541-726-3753 .OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00807 www,springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/15/2014 EXPIRES: 10/12/2014 STATUS DATE: 04/15/2014 APPLIED: 04/15/2014 SITE ADDRESS: 950 INTERNATIONAL WAY,Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703153000201 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 10 branch circuits OWNER: GOLDEN TEMPLE OF OREGON LLC Phone Number: ADDRESS: 950 INTERNATIONAL WAY SPRINGFIELD OR 97477 OWNER: NORTHBANK PROPERTY LLC Phone Number: ADDRESS: PO BOX 529 EUGENE OR 97440 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JB ELECTRIC INC CCB 104929 03/14/2016 541-687-5770 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 NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 95 -001-O Center. 0thro through OAR set 001- AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 4/15/2014 12:51:52PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD kis- � 225 Fifth 5l «, TRANSACTION RECEIPT Springfeld.OR 97477 1.OREGON 541-726-3753 811-SPR2014-00807 www.springneld-or.gov 950 INTERNATIONAL WAY permitcenter @springfield-or.gov RECEIPT NO: 2014000815 RECORD NO: 811-SPR2014-00807 DATE: 04/15/2014 [DESCRIPTION______ ' ' "_s ACCOUNT CODE/TRANS CODE . ` ' 'AMOUNT DUE__1 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 58.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 14.28 Technology fee (5%of permit total) 100-00000-425605 2099 5.95 TOTAL DUE: 139.23 t PAYMENT TYPE. '_.: PAYOR CASHIER:JLARSON '_;'. COMMENTS _-_ ' .,_� AMOUNT PAID .' Credit Card JB ELECTRIC INC 139.23 760170 TOTAL PAID: 139.23 • ' 04/15/2014 09: 24 5413028296 JBELECTRIC PAGE 01/01 Electrical Permit Application OgtARTGMENT P E CINI. Y ' 9PAINORa1G 'm• 'CiTy OF SPI�INGFJELJ) ,(IRE O r �!,: iM ° ,y Soy —OOgo—) 1. 1 v. + , .,,:::-s':%,,,. . r; 4.2r: ,e _-n ; tl:f . lti"% Soy 1 225 Fif h Street•Springfield,OR,97477♦P13(S41)726-3753•FAX(541)726-3689 // J Date: `( ( l 5 I I '-i This permit is issued under OAR 918-309-0000.Permits are no transferable.Permits expire if work is not started within 180 . days of issuance or if work is suspended for 180 days. ,WKWM5M, ,. r S M� �l�- ° Iry-G:d44f '.�! Y� � � d Zoning approval verified? It es `J�.©No 4th. t vt ' X, #tl ' r l s,.'r` 'y Residential,per unit,service included: l]Residential []Government r ommercial 1,000 sq,ft.or less(4) $147.60 $ • s`'oc v -'I m w 6b.r,,MIT :y,:;l;q 4.k ! �p Each,additional 500 sq.ft.or portion $ 27,60 $• lob site address: /*�^�Cli � thereof City: �yy��JJ�JG6 State: OA- ZIP: I Limited energy(2). $ 35.00 $ Reforende: I Taxlot Each manufactured home or modular $ 69.00 $ ik } ; ; dwelling service or feeder(2)fina Services or feeders: installation, alteration, relocation ((J[re- CI'Ma p k"'4-�/ /1,7"0"°101> 200 amps or less(2) $ 86.00 $ I•' yS tf zactri9'h':r.V rv',at iA:tav • 1.JtT W4'fC 'mm4 201 to 400 amps(2) $ 104.50 $ .401 to 600 amps(2) $174.00 S Name: $226.60 $ n �� < 601 to 1,000 amps(2) _ Address: �/ / L/ $516.00 $ y : Over 1,000 amps or volts(2) - Ciry: {/� I State: O I ZIP: Reconnect only(2) $ 69,00 S Phone: - - I. Fax: - - relocation Temporary services or feeders:installation, alteration, E-mail: Temporary amps or less(2) S 69.00 $ This installation is being made on residential or farm property 66.00 $ owned by me or a member of my linmediate family,This 201 to 400 amps(2) $ property is not intended for sale,exchange,lease,or rent.OAR 401 to 600 amps(2) $10e.60 _ $ 479.5400)and 479.560(1). Over 600 amps or 1,000 volts,see services or feeders section above Signature: -.y, . � 1 rPr' i6�".at r4 i3+2i lE.O.,�ut -e if•-i It i)'('�. is uhk;ii'.;Lid I Branch circuits:Haw,alteration, extension per panel - / a.Fee for branch circuits with purchase of a service or feeder fee: Business name: v ,,,. L e•YleCi Y/g,/ aa,/ ea 5--� Each branch circuit ' I I $ 6.60 I $ Address://���� y�p� S r�-vw`� �i/ 1 / I State: o�I ZIP:?i b.Fee for branch circuits without purchase of a service or feeder fcc: ciy: _ _/ / Pllone�s�/�� —....$7-49 I pax���.3Dc2�nA First branch circuit(2) / $ 60.60 $ t:U[hc_ lart., Each additional branch circuit 9 $ 6.60 $ E-mail: rbGat.0}t .eGei ' � CCB license no.: 05/9.2.9 v.9a9 I BCD license no,:37 S-57 Miscellaneous fees:service or feeder not included Each pump or irrigation circle(2) $ moo $ Signing supervisor's license no.: 387 s $ 69.00 $ Each sign or outline lighting(2) Print name of signing su 'grin'circuit or a limited-energy panel, $ 80.00 $ Signature of signing supervisor:sor: alteraton or extension(2) Each additional Inspection:(I) 56800. 80 00 $ '���"rrk':°� �') .6'��fl� � ���. ) 'tiu�F,WRr�4`��'"��t".i, ��' (A) Enter subtotal of above fees $ (Minimum Permit Pee$50.00) (B)Enter 12%surcharge(.12 x(A)) ' $ (C)Technology Fee(5%of[Al) $ . TOTAL fees and surcharges(A.through C): $ 13cl 440.2584-1(4/012013/COM) •