HomeMy WebLinkAboutPermit Electrical 2014-5-21 SPRMGFIELD • 225 Fifth St
•• CITY OF SPRINGFIELD Springfield,OR 97477
=.::C Cam, ic j Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01119
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/21/2014 EXPIRES`. 11/16/2014
STATUS DATE: 05/21/2014 APPLIED: 05/21/2014
SITE ADDRESS: 250 S 32ND ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702310000502 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Add trash compactor and temp power receptical
OWNER: WILLAMALANE PARK&RECREATION DISTRICT Phone Number:
ADDRESS: 250 S 32ND ST
SPRINGFIELD OR 97478
• CONTRACTOR INFORMATION
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 WIREWORK
In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
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Springfield Building Permit 5/21/2014 6:24:32AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
6,,,,,::: 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
r `.i'r, 541-726-3753
aecor+ 811-SPR2014-01119
www.springfield-or.gov 250 S 32ND ST permitcenter @springreld-or.gov
RECEIPT NO: 2014001113 RECORD NO: 811-SPR2014-01119 DATE: 05/21/2014
(DESCRIPTION; :_v. ._ __ __-ACCOUNTCODE/TRANS,CODE__._1 � AMOUNTDUE-
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 4.00
Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 62.00
Branch circuits without service or feeder-each additional 224-00000-426102 1004 14.00
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:) ARSON- . COMMENTS _. - P
AMOUNTAID._ : - )
Credit Card ---m��JKG Electric —_--- -_-_ ---�--- 93.60- --_-
025050
TOTAL PAID: 93.60
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FROM JKO E I actrlc Inc. <TrJE)MAY 20 2014 16:60./S7. 115:159/Ho. 7600000164 P 1
__..._.... _....._...-.1.... 1 -C.yUprl,.l / 1m,.,1w w w.G.apllI lg/IeIU.OI.11S/USW Um wing Li ui'ary/Ol ecoical rcrmaz...
Electrical Permit Application DEPARTMENT USE ONLY
SPe1NG IELD
CITY OF SPRINGFIELD, OREGON
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OREGON
_ Date: 5-12_/ by
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This permit is issued under OAR 918-309-110110. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if wort: is suspended for 180 clays.
_L_O_CAL GOVERNMENT APPROVAL _ FEE SCHEDULE _
Zoning approval verified? ❑ Yes No I Cost Total ._
❑ Number of inspections per item ( Qly.
CATEGORY OF CONSTRUCTION —1_.l aea cOSt
--- --------------- - Residential,per unit,service included:
❑ Residential I ❑GOVei'nmatl .onmiercial_ _..,__....,_-_.
JOB SITE INFORMATION AND LOCATION LOGO q_O.or less el) $147.50 $ .
--------'— Each additional 500 sq.U.at'portion
Job site address: is 0.._.._S-.._3 Zfr'' thereof S 27.50 $
City: e91/1...p Stale: 04_ ZIP: Limited energy(2) 5 75.00 $ •
Reference: Tasdot.: Each manufactured home or modular g 69.00 5
DESCRIPTION OF WORK duelling service or(ceder(2) _
--- --- -- ---
T (p.K /ItiIWL rw►t 064 >e 1- Services or feeders: installation.n/e,nlian, relocnlial
:011 amps or less(2) $ 89.00 5
PROPERTY OWNER 201Iri400 amps(2) — S 104.60 b
------ --
If1
Name: Vl It? +F eve
401 In 6(0 amps(2)--- 5174.00 $ - -
_ --__.- ._ ._
Address: j; o 601 Io 1,0011 amps(2) $225.50 $
Oily: Cpns�.•/-! State: o, ZIP: 1.000 amps or volts(2) $516.00 $
Phone: - - Pax: Reconnect only(2) S 69.00 5
L':mail: Temporary services or feeders:iu.unllulinn, u0era/inn, relocation
200 maps or less(2) S 69.00 5
'this instillation is being made on residential ur farm property
owned by me or a member of my immediate fancily.This 201 to 400 amps(2) $ 96.00 S
property is not intended for sale, exchange, lease,or rent. OAR
479.540(I)and 479.560(1). 41)1 In 600 amps(2) $138.50 S
Signatu re: Over 6110 amps or 1.000 culls,see services or feeders section above
CONTRACTOR INSTALLATION a ranch circuits: new,alteration,euen.slon per petrel
I4nsiness gong: U n. Pee for branch d rants with purchase of a service or feeder lee:
Address: 251 -bin/3 s'- Each branch circuit fi 6.50 S
C:icy: Suue: ZIP: 41411 b. Fee fur branch circa ils willloul purchase of u service or feeder Re:
Phone: ( - '{4{(p .%s(o I Fax:544 -7t,#•(� $55 First brunch circuit(2) 1 5 60.50 5100 llm0
._._.....— `^/I l i, .-_.._- _ _ __—_- _..._._.__._..._...-...E-mail: rL `rte 31Sf>'EL-‘yC--Carel Each additional branch circuit a S 6.50 S )3-,--„
CCft license no.: .45(2_ BCD license no.: Zip-34-4_, Nlisrehlmteons fees:service or feeder not included
Signing supervisor's license no.: '(5_ g - Each pump or irrigation circle(2) 5 69.00 S -
J Each sign or oullnic lighting(2) $ 69.00 $
Frill( none ol'signutg supervisor: t r 1 9 —.-_' ___--
Siumure of signing supervisor-- ti Signal circuit or a limited-energy paid, 5 8000 1
._.___....__... _....._._.____.-__ it.�_ alteration,or extension(2)
a Each Additional inspection:(I) $80.00 S _---
APPLICANT USE _
(A) Enter suhundofnhovr,fees $ 13•S
(Minimum Permit Fee 580.00)
(B)Enter 1281 surcharge(.12 x(Al) S
(C)Technology Fee(6%of[Al) S
- 4411-2584.1 I4d11/2013/COMI TOTAL fees and surcharges(A through C): _. .S.,-. 31.,`f t
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