HomeMy WebLinkAboutPermit Electrical 2014-6-9 •
SPRINGFIELD 225 Fifth St
_AL °`` CITY OF SPRINGFIELD Springfield,OR 97477
"_ :c"ctti �'' Phone: 541-726-3753
OREGON
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01247
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/09/2014 EXPIRES: 12/05/2014
STATUS DATE: 06/09/2014 APPLIED: 06109/2014
SITE ADDRESS: 5335 MAIN ST,SPC#37,Springfield, OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702330001300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Meter Bases Repair
OWNER: SANTIAGO ESTATES ASSOCIATES LLC Phone Number:
ADDRESS: 11211 GOLD COUNTRY DR STE 100
GOLD RIVER CA 95670
Li 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
Inspections
4200 Reconnect 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
Lr,k4 .\ - 9��
NOTICE' „ u,- ATTENTION:ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK a V follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT 4 Notification Center. Those rules are 52.00th .
COMMENCED OR IS ABANDONED FOR in OAR You may obtain through OAR 952 001-
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 1-800-332-2344).
Springfield Building Permit 6/9/2014 3:00:06PM Page 1 of 1
Electrical Permit Application 'DEPARTMENT,USE ONLY
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CITY OF SPRINGFIELD; OREGON 1 1
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Permitno.5/�
225 Fifth Street*Springfield,OR 97477•PA(541)726-3753•FAX(541)726-3689 / /
Date: C l /r
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
`,,LOCALYGOVERNMENT. APPROVAL , ea e 1, FEE;SCHEDULE z ,n , e3: x;1:3
Zoning approval verified? ❑ Yes ❑No -Number ofins ectwnsr.er rt m t Cost Total 1
P ,- p z U ,- y E,i ea .0 ;, •Ecost r
'; ' ; CATEGORY OF CONSTRUCTION ', .« , " . ' '"
Residential,per unit,service included:
❑Residential I ❑Government I ❑Commercial
JOB°,:SITE' INFORMATION ANDaLOC N,:,-,-,:::::;t 1,000 sq. ft. or less(4) $151.00 $
n 3 iv i 1 \�j / Each additional 500 sq.ft.or portion
Job site address: Jh ,�I / thereof $ 28.00 $
City: State: I ZIP: Limited energy(2) $ 36.00 $
Reference: I Taxlot.: Each manufactured home or modular $ 71M0 $
x t ,. ,�-. dwelling service or feeder(2)
„i „ .171 ;=x.1DErgCRIPTION OF,WORK < s,t.•,.`,
,/�� 1_� / In K i /ln )( Services or feeders:installation, alteration, relocation
// 1 /( 1 //✓✓ 1 /V' 200 amps or less(2) $ 91.00 $
201 to 400 amps(2) $106.00 $<-;:,;:%,..1;:e. .ROPERTY-OWNE < r F ?1::1 i (
Name: I 1 q 17 ) 01/) �S � 401 to 600 amps(2) $178.00 $
Address::...11l5) 5 J /d State: ZIP: �7/ 9 V t/)g in
�J 601 to 1,000 amps(2) $230.00 $
City: State: Over 1,000 amps or volts(2) $527.00 $
700
Phone: - - Fax: - -
/ Reconnect only(2) / $ 71.00 $ 7/
E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less(2) $ 71.00 $
owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 98.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 401 to 600 amps(2) $142.00 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
,'',' 4 17 1.CONT CTOR' INSTAL 'ATION° +s. x';.;#;3;` `^;° Branch circuits: new alteration, extension per panel
Business name: a.Fee for branch circuits with purchase of a service or feeder fee:
Address: / u r r i ll ros rAy- yl Each branch circuit I $ 7.00 L $
City: OA i ✓✓)i11/4-e State: ZIP: b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 62.00 $
E-mail: &,rrr // him . /n '�-P cf pc._0,4(ta e„y Each additional branch circuit $ 7.00 $
CCB license no.:/3(j BCD license 111o.: Q y ,c' Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 7�) / Each pump or irrigation circle(2) $ 71.00 $
Print name of signing supervisor l ' Each sign or outline lighting(2) $ 71.00 $
Signature of signing supervct
\ ' i4 Ul 1\1\II I Signal circuit or a limited-energy panel, $ $
VVV��` VVV VVV `�"WWW 1 alteration or extension(2)
Each additional inspection:(1) $8822..0000 $
? j ka' V€k "APP,LICANri SE Ve t ._'^. i'f;
' (A) Enter subtotal of above fees $
(Minimum Permit Fee$82.00)
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
(D)Continuing Education Fee$2.50 $2.50
TOTAL fees and surcharges(A through D): s-tb"la-
440-2584-1(5/21/2014/C0M)
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