HomeMy WebLinkAboutPermit Electrical 2014-6-24 s.
SPRINGFIELD • 225 Fifth St
A CITY OF SPRINGFIELD Springfield,OR 97477
�� • Phone: 541-726-3753 •
`" -• OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01359
www.Springfield-or.gav pemineenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/24/2014 EXPIRES: 12/20/2014
STATUS DATE: 06/24/2014 APPLIED: 06/24/2014
SITE ADDRESS: 4535 MAIN ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702324200600 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Fireworks Stand Reconnect
OWNER: BERAKAH LLC Phone Number:
ADDRESS: PO BOX 221
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION ` -
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
•
INSPECTIONS REQUIRED -,/
Inspections
•
4200 Reconnect Service
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
constructio
Owner or Contractor Signature ' Da
ATTENTION: Oregon law requires you to NOTICE:.
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
• Center is 1-800-332-2344).
•
Springfield Building Permit 6/24/2014 1:32:21PM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
f .st9....p •`+ 225 Fifth St
R M TRANSACTION RECEIPT Springfield.OR 97477
F `‘
I( '" OREGON 541-726-3753
81 1-S P R2014-01359
www.springfield-or.gov 4535 MAIN ST permitcenter @springtield-ar.gov
RECEIPT NO: 2014001366 RECORD NO: 811-SPR2014-01359 DATE:06/24/2014
,DESCRIPTION ACCOUNT CODE/TRANS CODE -,a-.AMOUNT.DUE,
Balance of Minimum Electrical Permit Fees ~ 224-00000-426102 1004 11.00
Electrical Continuing Education fee 224-00000-425606 1032 2.50
Service reconnect only 224-00000-426102 1004 71.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.84
Technology fee(5%of permit total) 100-00000-425605 2099 4.10
TOTAL DUE: 98.44
PAYMENTTYPE PAYOR CASHIER:JLARSON = , — . COMMENTS AMOUNT
Credit Card Check Giddens 98.44
0'7553B
TOTAL PAID: 98.44
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Electrical Permit Application .DEPARTMENT USE ONLY.
C�,,� SPRINGFIELD
Qg '.' +wi: `4,. S:Sr C1._'w a atingt -N-2 ::SrTT"F1nt r:.y '-7x -4 ',� .I3
{CT OF SP NGFIELD OREG®Nni r rx t:3, -s
a 3"s�,°"`i�'r' .-�6r:Ft_. ��'Ray.:a n"^'filka Yti s Varagl~a hge U Lc S t>4 Perm it no.:
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689 "'"
Date:
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.
r
-, .;LOCAL',-GOVERNMENT,APPROVAL C, -'=' . - ;' :.'i- : ;';'TT-,iFEE SCHEDULE , ;- .. ', ,,;,;
Zoning approval verified? ❑ Yes ❑No -Number of inspections;�per item,O -: Qty ':,Cost Total
,=CATEGORY ;OF''CONSTRUCTION ea. ;cost :.r
Residential,per unit,service included:
❑Residential ❑Government '(Commercial 1,000 sq. ft. or less(4) $151.00 $
• . JOB _SITE JNFORMATION4 AND'.LOCATION _•t --
�{5 2' 1" 4C1 t in .Jr Each additional 500 sq.ft.or portion
Job site address:c (� �{ /n, thereof $ 28.00 $
City , S Rf th GC(,c4 State: (5 iZ ZIP:Vl Limited energy(2) $ 36.00 $
Reference: tVJ Taxlot.: Each manufactured home or modular $ 71.00 $
CDESCRIPTION,;OF WORK; rf) dwelling service or feeder(2)
�p M e- I fr to�S e Services or feeders:installation, alteration, relocation
S 1 e lr 1 \ 'T tS .200 amps or less(2) $ 91.00 $
.( , , .. . )::. PROPERTY`OWNER „•'i:.l ,„ (+` 201 to 400 amps(2) $106.00 $
Name: ger-Ate<Ak L—t-- C 401 to 600 amps(2) $178.00 $
Address: r d U p), 2`y( , 601 to 1,000 amps(2) $230.00 $
City: Sir t�cj4ct t a State: 0 ZIP: Over 1,000 amps or volts(2) $527.00 $
Phone: - - Fax: - - Reconnect only(2) $ 71.00 $
E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less(2) $ 71.00 $
owned by me or a member of my immediate family:This 201 to 400 amps(2) 1 $ 98.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.5400) and 479.5600). 401 to 600 amps(2) $142.00 $
Signature: Over 600 amps or 1;000 volts,see services or feeders section above
,, „ CONTRACTOR ANSTALLATION- . :`F Branch circuits:new, alteration, extension per panel
Business name: a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 7.00 $
City: 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: Each additional branch circuit $ 7.00 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: - Each pump or irrigation circle(2) $ 71.00 $
Print name of signing supervisor: Each sign or outline lighting(2) $ 71.00 $
Signature of signing supervisor:
Signal circuit or a.limited-energy panel, $ 82.00 $
P alteration, or extension(2)
• Each additional inspection:(I) $82.00 $
?s;`,._ ./z;= `,APP,LICANT USES Yt z .-H.,..
(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): $
440-2584-1(5/21/2014/COM)