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Home My WebLink AboutPermit Electrical 2014-07-16ELD 225 Fifth St FEE"' CITY OF SPRINGFIELD Springfield,OR 97477 X3Phone: 541-726-3753 OREGON Building If Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01533 v w .spnngfield-orgov permitcenter@spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 07/16/2014 EXPIRES: 01/11/2015 STATUS DATE: 07/16/2014 APPLIED: 07/16/2014 SITE ADDRESS: 801 42ND ST, Springfield, OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702290002903 TYPE OF STRUCTURE: Industrial OWNER: IP EAT THREE LLC ADDRESS: PO BOX 2118 Phone Number: MEMPHIS TN 38101 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone Electrical Contractor OLSSON INDUSTRIAL ELECTRIC INC CCB 63473 01/26/2015 541-747-8460 INSPECTIONS REQUIRED Inspections 4120 UFER Ground 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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center, Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090, You may obtain Copies of the rules by Calling the center. (Note: the telephone number for the Oregon Utility Notification Center Is 1.800-332.2344). Date L f: PERMIT SHALL EXPIRE IF THE WORK ;0RIZED UNDER THIS PERMIT IS NOT .'LANCED OR IS ABANDONED FOR Y 180 DAY PERIOD. Springfield Building Permit 7/16/2014 1:19:11PM Page 1 of i LSPRINGFIELD CITY OF SPRINGFIELD t .�,. - - 225 Fifth St ��; TRANSACTION RECEIPT Springfield,OR97477 " "' ONEGON 541-726-3753 811-SPR2014-01533 v v.spdngfield-or.gov 801 42ND ST permitcenter@springfield-orgov RECEIPT NO: 2014001534 RECORD NO: 811•SPR2014.01533 DATE: 07/16/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 20.00 Branch circuits without service or feeder - 1st circuit 224-00000-426102 1004 62.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 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 VAYP/lt: V I :I TYt VAT VK : - GAJNIM WARFENM11 wmmory la ^ �•••- Check OLSSON INDUSTRIAL ELECTRIC IN( 98.44 66929 TOTAL PAID: 98.44 Electrical Permit Application SPanUFI'L Z 225 Fifth Street4Springfield, Oil 974771 PH(541)726-37534 FAX(541)726-3689 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION ❑ Residential I ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: 801 42nd St City: S_rin field state: OR ZIP: 97478 Reference: I Taxlot.: DESCRIPTION OF WORK Ground Grid $ $ PROPERTY OWNER Name: IP Eat Three LLC Address: PO Box 2118 city: Mem hissrfltc: TN ZIP: 38101 Phone: - - Fax: - - E-mail: This installation is being made on residential or farm properly owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR INSTALLATION Business name: OISSon IndUStrial Electric, Address: PO Box 70413 City: SpringfieldState: OR ZIP: 97475 Phone: �41 747 8460 Fax: 541 747 4846 E-mail: CCB license no.: 63473 BCD license no.: 20-241 C Signing supervisor's license no.: Print name of signing supervisor: DO las Heer Signature of signing supervisor: _ 6't-7-- — 440-2584-J (5/21/2014/COM) FEE SCHEDULE Number of inspections e•item P I O Qty, Cost ea Total cost Residential, per unit, service included: 1,000 sq. R. or less (4) $161.00 $ Each additional 500 sq. 0, or portion thereof Limited energy (2) $ 28,00 $ 36.00 $ $ Each manufactured home or modular dwelling service or feeder (2) $ 71.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 $ 601 to 1,000 amps (2) $230.00 $ Over 1,000 amps or volts (2) $627.00 $ Reconnect only (2) $ 11.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 71.00 $ 201 to 400 amps (2) $ 88.00 $ 401 to 600 amps (2) $142.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extensionperpanel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) s 62.00 $ Each additional branch circuit I I $ 7.00 $ Miscellaneous fees: service orfeeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited -energy panel, alteration, or extension (2) t7l.00 L82 Each additional inspection: (1) 1 APPLICANT USE (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ 82 (B) Enter 12% surcharge (.12 x [A]) $ 9,84 (C) Technology Fee (6% of [A]) $ 4.10 (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): $ 98.44