HomeMy WebLinkAboutPermit Electrical 2014-5-6 SPRIt 3FIELD--" 225 Fifth St
kl.,. (� CITY OF SPRINGFIELD Springfeld,OR97477
'- -"�,�o aeG o N Phone: 541-726-3753
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00996
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/06/2014 EXPIRES: 11/02/2014
STATUS DATE: 05/06/2014 APPLIED: 05/05/2014
SITE ADDRESS: 1810 M ST,Springfield, OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703253401900 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Limited Energy
OWNER: LINCOLN CAPITAL LLC Phone Number:
ADDRESS: 1580 VALLEY RIVER DR STE 270
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor BURRELL BROS ENTERPRISES INC CCB 136446 08/20/2015 541-747-2724
INSPECTIONS REQUIRED II
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
4550 Limited Energy
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 UtilitY1 w a
Notification Center. Those
rail s�tforth ,,, �° NOTICE:MIT SHALL EXPIRE 1F THE WORK,
In OAR 952-001-0010 through O R 9 ules bk
AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain center. (Note: y 4 COMMENCED OR IS ABANDONED FOR
calling the center (Note: the telephone
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1.600-332-2344).
•
Springfield Building Permit • 5/6/2014 8:14:07AM Page 1 of 1
SPRttSGHIELD CITY OF SPRINGFIELD
k• 225 Falb St
TRANSACTION RECEIPT Springfield.OR97477
541-726-3753
OREGON 811-SPR2014-00996
www.springfield-or.gov 1810 M ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000991 RECORD NO: 811-SPR2014-00996 DATE: 05/06/2014
IDESCRIP_TION--' _ - - - , ;r • ACCOUNT CODE/TRANS CODE„_ _AMOUNT DUET- }
Data/Telecommunications 224-00000-426102 1004 80.00
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
;'__PAYMENT TYPE -`- `' PAYOR_,cASHIER:JLAasoy _ TCOMMENTS ;v t__ —11_ _ `,'AMOUNT PAID •
Credit Card BURRELL BROS ENTERPRISES INC -9-3.66
005591
TOTAL PAID: 93.60
Lletrical Permit Application SPRINGFIELD DE PARTMENT USE ON L,.
Y C;
•. � ,:
x _F'. dx#i X14; tY7 rf �byyfTas :.,-a�zs '* d
4 CI>T�Yt OE SPRLNGFIELI ,OREG-ON _ Permit no.: /p 7 p
?a-4n.. ,,, slit ' «-,.-......�'s FS ..rf- iGr' -Y..=v r. ;r, , 6, w. ; 5OC mil 9 "� 1X
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689. a + I
Date: 5
This permit is issued under OAR 918-309-0000. Permits are nontransferable.Permits expire ii work is not started within 180
days of issuance or if work is suspended for 180 days.
t; ILOCALi GOVERNMENT APP[tOVAL S h' , • ;'-` 902 ,dat,,,FEE;SCFIEgULE,,, xy; 44 °,3 yr; sy ,
Zoning approval verified? ❑ Yes ❑No 'numbe��of insAec[tons'erittem t t tnf x;Cost s,v tTotal,,a
„ � �, -, ,� '''''''''''''''L P . ._P .,i,)s. Q.r14.,,tea , , e ^.post ily
CATEGORY,OEcCONSTRUCT;ION jo
Residential,per unit,service included:
❑Residential I ❑Government I�Commercial
,� y . JOB;SITE�INF.ORMATION'AND,; `O ATION:1 ',, ; 1,000 sq.ft.or less(4) $147.50 $
Job site address: j Q vii= Each additional 500 sq.ft.or portion
thereof $ 27.50 $
City: State: ZIP: 0 7y 7 Limited energy(2) $ 35.00 $
Reference: I Taxlot.: / Each manufactured home or modular
dwelling service or feeder 2 $ 69.00 $
<'` �t"t.L�,,,". $DESCRIPTIQQN`:tQEyWORK;°: 'ittr;!i'>` :1, g ( )
J0 _ /O ] m�� Services or feeders: installation, alteration,relocation
/ IV/ / 200 amps or less(2) $ 89.00 $
laiiiifliVYKRZYg$11,1P R jpPERT}1r GINNER'*' l:' s i ';:F uk ; 201 to 400 amps(2) $ 104.50 $ -
Name: I v (6 /Jr� J l m ^I �g / 401 to 600 amps(2) $174.00 $
Address: ,(-80 / /,/ ?0 601 to 1,000 amps(2) $225.50 $
City: V (Z�„t✓t I State: I ZIP: Over 1,000 amps or volts(2) $516.00 $
01;0'7
Phone: - - $.At 1701 Fax: - - Reconnect only(2) $ 69.00 $
•
E-mail: e .Q- - - p (�, 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
. , ? a CO CTOR,zINSTA ' ATION u` 3� 1t',.t Branch circuits:new alteration,extension per panel
Business n e: Q V Y Y I 1 ' 1 IO6 E714Y) c a.Fee for branch circuits with purchase of a service or feeder fee:
Address: f{r/J;11111----//// /9 Q x /- /yJ// / Each branch circuit $ 6.50 $
City: 5 ,I i d State:0 ' / ZIP@ 7 79 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: �VI, 7 y Fax: ?(0 /0 y 7 First branch circuit(2) $ 60.50 $
E-mail: / / / Each additional branch circuit $ 6.50 $
CCB license no./3Gt/I/ly I BCD license no.:�D -11/21 Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: L.I.i i ) `S Each pump or irrigation circle.(2) $ 69.00 $
Print name of signing supervisor: J I Each sign or outline lighting(2) $ 69.00 $
k' II t Signal circuit or a limited-energy panel,
Signature of signing supervisor. \ v�` alteration,or extension(2) $ 80.00 $
0 Each additional inspection:(1) $80.00 $
ca ?; °APPLICANT„USE aiSr6
(A) Enter subtotal of above fees $
5 JJJ /� (Minimum Permit Fee$80.00)
J / - ✓/ / 3 1271 / 1 (B)Enter 12%surcharge(.12 x[A]) $ -
/ / / (C)Technology Fee(5%of[A]) $ �y� /_ 7
TOTAL fees and surcharges(A through C): $'� t-(
•
440-2584-1(4/01/2013/C0M) 6 ii I re 11 tiros Jo 5 friV a e it il by Y cuQ,/7/7/2 e, ` Q r - /