HomeMy WebLinkAboutPermit Electrical 2014-5-16 SPRINGFIELD-W+ 225 Fifth St
'' CITY OF SPRINGFIELD Springfield,OR97477
°( et Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01039
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/16/2014 EXPIRES: 11/11/2014
STATUS DATE: 05/16/2014 APPLIED: 05/12/2014
SITE ADDRESS: 224 64TH ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702343102100 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Relocate Sub Panel •
OWNER: LANCASTER GAIL FRANCIS Phone Number:
ADDRESS: 43637 CEDAR GROVE CRT
COARSEGOLD CA 93614
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
4220 Electrical Service Electric Service: Approval required prior to utility company energizing service. •
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
•
Springfield Building Permit 5/16/2014 1:37:45PM Page 1 of 1
SPRINGFIELD ' CITY OF SPRINCiFILLO
225 Fifth 5t
`ti, TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-SPR2014-01039
www.springfeld-or.gov 224 64TH ST permitcenter @springfield.or.gov
RECEIPT NO: 2014001082 RECORD NO: 811-SPR2014-01039 DATE: 05/16/2014
DESCRIPTION _- ; . ,'. ACCOUNT CODE/TRANS_CODE . AMOUNT DUE
Branch circuits with service or feeder each circuit 224-00000-426102 1004 91.00
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 21.60
Technology fee (5%of permit total) 100-00000-425605 2099 9.00
TOTAL DUE: 210.60
ti PAYMENT TYPE _PAYOR• 'CASHIER:JLARSON __ -"COMMENTS ' ' • AMOUNT PAID
Credit Card JB Electric 210.60
807676
TOTAL PAID: 210.60
•
05/09/2014 10:38 54130282% JBELECTRIC PAGE 01/01
Liectrical Permit Application USE o rlL�r '
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225FirthStrect4$pringfeld,OR 97477•PH(541)726-3753•FAX(541)72r36.9 s,
Date: S//Z//t'
This permit is issued under OAR 918-309-0000. Permits are nlntransferable. Permits expire if work is not started within 180
days of issuance� tl�Y
+ porr if work is suspended for 180 days. '
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Zoning approval verified? Iii Yesp ❑No 1.,, 7(q` ,:hoc 1” "c7,1' "gT1 t e i 4 77 gYn1■''-':i14� r .. , m ,152• 'l 1... A SITU G'�_[^ �^'�`t 4. ' 1 1. :a till C, 1+ '11.:1.'"' Y , ..'A. ■Lin 3SnNltlr� kot.
❑Residential f , Residential,per unit,service included:
❑Government 2 Commercial 1 t( ., -
o ' o , o o ¢ p'' 1,000 sq,ft.or less(4) $147.50 $
-afialA' IM ,3' Each additional 500 sq.ft.or portion
Job site address: J• thereof - $ 27.50 $
City: /'M y�l.�fe I State: ZIP: Limited energy(2) $ 35.00 $ -
Reference: 1(J Taxlot.: $aeh manufactured home or modular $ 69,00 $
tog Efil fl',s D.'1 :0 ,: i 62,1 n'. r,7 r 4 q dwelling service or feeder(2)
La • • uG!so-e) ,/131F� @ Services or feeders: installation;alteration,relocation
J 200 amps or loss(2) p $ 89.00 $
1 kiu e, .i �' �;, aiG. is fn ?a t 'l , 3 201 to 400 amps(2) $ 104.50 $
Name: ,F1',-„=..:5.,_-. (np.. c. Lay\ , +sfev%., 401 to 600 amps(2) $174.00 $
Address: L13637 Ge�,.r Gib 601 to 1,000 amps(2) .. $226.50 $
City: „La, _ - State: ZIP: •• ./y Over 1,000 amps or volts(2) $516.00 $
Phone:-- - Fax: - -
Reconnect only(2) $ 89.00 $
E-mail: Temporary services or feeders: installation, alteration relocation
This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 S
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
479.540(1)and 479.560(1). 401 to 600 amps(2) $138.60 $
Signature: Vii, y_ 9' I Over 600 amps or 1,000 volts,sco services or feeders section above
'"4 I t,R1O_�T-g:E g�° `y,'EME/41.116 { ' Branch circuits:new alteration, extension per panel
Business name: C� ` ;Cc_ a.Fee for branch circuits with purchase of a service or feeder fee:
Address: %per ..../z-oo e( - '/. Sr. Each branch circuit /9 $ 6,60 $
City; . State: / • ZIP: ii,,,y — b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: h 17 5710 Fax:SL,7 goo—Sep9a' First branch circuit(2) 9 60.50 $
E-mail: .c (2) iv.M.cI-eclv1,c.-/,.Ce^a Conn Each additional branch circuit $ 6.so $
CCB license no.: /09€,,,a7 BCD license no.: 3?—slry Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: - s Each pump or irrigation circle(2) $ 89.00 $
Print name of signing suhrvisor.f;.e ' Each sign or outline lighting(2) $ 59.00 $
Signature of signing supe a•':. Si•_al circuit or alimited-energy panel, $ 80.00 $
a tcration,or extension(2)
Each additional inspection:(1) $ o0 $
- F r
: p� spudm � N
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[Al) $
(C)Technology Fee(5%of[A)) $
6c'
TOTAL fees and surcharges(A through C): $Z 1.0'-
440-25844(4/01/2013/COM)