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Permit Electrical 2014-4-25
SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00916 www.springfield-or.gov permitcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 04/25/2014 EXPIRES: 10/22/2014 STATUS DATE: 04/25/2014 APPLIED: 04/25/2014 • SITE ADDRESS: 1929 E ST, Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703361309300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Service-Repair Meter Base OWNER: MALOS JEFFREY C&VALERIE D Phone Number: 541-521-4547 ADDRESS: 2515 W 22ND AVE EUGENE OR 97405 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JKGUCKENBERGER ELECTRIC INC CCB 45129 04/24/2016 541-746-4656 INSPECTIONS REQUIRED j Inspections 4210 Service Change - • 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 • u �1 ° peter^ ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules enter. Those by the rules are story AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note:the telephone number for the Oregon Utility Notification Center Is 1-800332.2344), Springfield Building Permit 4/25/2014 12:48:24PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 't -....!+w-i 225 Fifth St -; i TRANSACTION RECEIPT Springfield,OR 97477 `"'3" OREGON 541-726-3753 811-SP R2014-00916 www,springfield-ar.gov 1929 E ST permitcenter@springfield-or.gov RECEIPT NO: 2014000924 RECORD NO: 811-SPR2014-00916 DATE:04/25/2014 ,DESCRIPTION LL _ __ ACCOUNT CODE/TRANS CODE_ _t-_Y_AMOUNT_DUE ,-; Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68 Technology fee (5% of permit total) 100-00000-425605 2099 4.45 TOTAL DUE: 104.13 _PAYMENT TYPE PAYORCASHIER:JLARSON' .,_ .COMMENTS_; - : ' -AMOUNT PAID Credit Card JK GUCKENBERGER ELECTRIC INC 104.13 035964 TOTAL PAID: 104.13 • FROM J1103 EIectr-lc Inc. (FRI )APR 25 2014 11 : 16/ST. 11 :14/N4.7600000071 P 1 1 may,/•.•..•..4.ay„nJJIClu.ul.ustuunuwlutng/a urary/btectrlcal l'ermil2_. Electrical Permit A $ plication DEPARTMENT USE ONLY . - .. CITY or sPitiNCftrLU; OREGON :. SP0.INGPIfI Permit nD.:SrrCZoty— o oi l� OK225 I 11,ShrrioSpringlrld,OR 97477ePH(otl)726-3753,Ftx(54172636R9 EGON _. Date: L1 /ZS // 1-/ • Ibis permit is issued under OAR 918-3119-0000. Permits are nontransferable. Permits expire if work is not Varied within 180 days of issuance or if work is suspended for 180(lays. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE ,_Zoning approval verified? ❑ Yes ❑No . Number of inspections per Rent () Qty_[ earl Total CATEGORY OF CONSTRUCTION --- --- "" """-"—-'"-'"'"—"--- Residential,per unit,service included: - 1„", _tesidential ❑ Government ❑Commercial -- -------- -----I JOB SITE INFORMATION AND LOCATION H10 w'R. or lass('I) $147.50 x. r�� Each additional 500 sq. IL or portion Job site address: I QLS 1— St thereof $ 27.50 .$ - --- .-- -_____________ ___;--��)_ - �Q- Stoical- ZIP:c � Limted energy(2) S 35.00 S Reference: Taxlot.: Each manufactured home or modular S 69.00 _-- ---"---- dwelling service or feeder(2) DESCRIPTION OF WORK (N q iv/ Services Or feeders:installation,alteration,re Gentian -Q,� ._.. .. lX �,4t �1. 200 amps or less(2) / swo0 S • -------'--' '""-' 201 to 400 amps 2 _ PROPERTY OWNER ( ) 5 104.50 $ ' Name v I , --___ 401 In 600 amps(2) $174.00 $ Address: - / L_/ z i,I.I 601 to 1,000 amps(2) -_�— $225.50 $ City: 6u ne State:co C._ ZIP: Over 1.000 amps or volts(2) $516.00 $ ctitit1C/Z-1 --Li5---L) 7 Fax: - - Reconnect only(2) 9.00 E-mail' • Temporary services or feeders:iunullntion, nhrraiian, relucatiuu - This installation is being made on residential or farm property 200 amps or lax(2) $ 69.00 S otvnecl by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 S property is not intended for sale, exchange, lease, or rent.OAR ------- ----- 479.5411(1)and 479.560(1). 401 to GOO amps 0) 5136.50 5 Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits:mm{alrerutian, extension per panel Business home:,SI< /,... (J a. Fee for brooch circuits with purchase ors service or feeder Ice: Address: Z.t5'1 -1 ST Each branch circuit —1 S 6,50 $• City: State: ZIP: `F4_-j-] p, rl ��1/I -_�' © f I (t b, Fee for branch circuits without purchase of a service or feeder lee: Phone: - -ft{{p -%5(o I Fax:st --p44:g5$ First branch circuit(2) $ 60.50 S U-mnail: V'lis `Q( ,s ve,G,et/,,c_.corn addition&branch circuit S 6.50 5 CCI1 license no.: 9 BCD license no.: Mbccllnneans fees:Service or feeder not included `(512= �(�� Zh•2l lL Signing supervisor's license no.: As"6 ',S_ _ Each pomp or irrigation circle(2) S 69.00 Print name ol'siguing supervisor: hitch sign or outline lighting(2) $ 60,00 S c lC���rr Signal circuit or n limited-energy panel, Signature of s.unine,supervisor; / $ tl0.00 S _c. .._.. _..._. r..__...___.__-_ �T a alteration,or extension(2) Each additional inspection; (1) 580.00 $ APPLICANT USE (A) Enter subtotal of above Ices (Minimum Permit Fee$80.00) (13)Enter 12%surcharge(.12 x(A]) 5 (C)Technology Fee(6%of[A1) S .440-'_SiU.i p1/01f70l3/C07,4 • TOTAL fees and surcharges(A through C): SR* /3 E - p -m i -11 0 61 ofI 4/8/2013 11:38 AIM.