HomeMy WebLinkAboutPermit Electrical 2014-08-18SPRINGFIELD
225 Fifth Sl
` CITY OF SPRINGFIELD
Springfield,OR97477
Phone: 541-726-3753
--'"'-^ OREGONBudding /Commercial Permit
Inspection Phone: 541-726-3769
Fax: 641-726-3676
PERMIT NO: 811-SPR2014-01788
vnnv.springfield-orgov
permilcenter@spdngfield-or.gov
.
PROJECT STATUS: Issued ISSUED: 08/18/2014
EXPIRES: 02/13/2015
STATUS DATE: 08/18/2014 APPLIED: 08/18/2014
SITE ADDRESS: 369 42ND ST, Springfield, OR 97478
SCOPE: Sign
ASSESOR'S PARCEL NO: 1702322400300 TYPE OF STRUCTURE: Commercial
—PROJECT E-SCR{RTION*.ign--freestanding-sig"ri-H Vw n e d-tre pert
OWNER: RICHARD L CROOK REVOCABLE LIVING TRUST
Phone Number:
ADDRESS: 481 42ND ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type
Llc No Lic Exp Phone
Electrical Contractor DAVID STUCK ELECTRIC LLC CCB
158177 01/01/20% 541-485-8855
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
4999 Final Electrical
Final Electric: When all electrical work is complete.
By signature, I stale 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.
�vo/idly
Owner or Contractor Signature Date
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
numbeCtl
ificatio
Center is 1e-800-332-2344).
I ".i'( ICE:
1l!IS PERMIT SHALL EXPIRE IF THE WORK
,UTFIORIZED UNDER THIS PERMIT IS NOT
;W,Mv1ENCED OR IS ABANDONED FOR
\NY 180 DAY PERIOD.
Springfield Building Permit 8/1812014 9:14:36AM Page 1 of 1
FiLi—A
CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield.OR97477
tlNEGON
811-SPR2014-01788 541-726-3753
mm.springfield-ocgov 359 42ND ST permitoenter@springfield-or.gov
RECEIPT NO: 2014001795 RECORD NO: 811-SPR2014.01788
DATE: 08/18/2014
DESCRIPTION
ACCOUNT CODE/TRANS CODE
AMOUNT DUE
Branch circuits with service or feeder each circuit
224-00000-426102
1004
7.00
Electrical Continuing Education fee
224-00000-425606
1032
2.50
Services 200 amps or less
224-00000-426102
1004
91.00
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
11.76
Technology fee (5% of permit total)
100-00000-425605
2099
4.90
TOTAL DUE:
117.16
PAYMENT TYPE i PAYOR CASHIER: CCARPENTER .'COMMENTS ARWUN I rHw
Credit Card DAVID STUCK ELECTRIC LLC 117.16
015557
TOTAL PAID: 117.16
Electrical Permit Application SPRINGFIELD
,
225 Fifth Street* Springfield, OR 97477*PH(541)726-3753*FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.:
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.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
❑ Residential
El Government
fWCommercial
JOB 'SITE INFORMATION AND LOCATION
Job site address: .5F-
N<r z
tate
I
Reference:
I Taxlot.: ,700
-.322V'
'DESGRIFITION OF WORK
stz^evrc� .se Pct4
�ILL�/tll/J <LLvs/<r�/j—/GN
PROPERTYOWNER'
Name: o✓rocr,4?
Address: pG YOv 3,7
City: D
State: ew
ZIP: 177e jlt
Phone: Su/
Fax:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(l) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION ,
Business name: "C
Address: PC, �G10
City: �$/GC-9/
State: C%l
ZIP.q yUZ
Phone'.ry/ `r ' 06/f/
Fax:
E-mail: srr e eZ Z S z ®G✓ co C. Gcvn
CCB license no.: /�( 7Z
BCD license no.: 2- c, -,573 G
Signing supervisor's license no.: y y Z S
Print name of signing supervisor: d44 -M �q ry v
Signature of signing supervisor:
440-2584-J (5/2112014/COM)
FEE SCHEDULE
Number of inspections per itemO': Qty.
Cost
ea. •
Total
cost
Residential, per unit, service included:
1,000 sq. R. or less (4)
$151.00 $
Each additional 500 sq. ft. or portion
thereof
$ 28,00 $
'mited-energy-R)
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)
$527.00
$
Reconnect only (2)
$ 71.00
$
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 71.00
$
201 to 400 amps (2)
$ 98.00
$
401 to 600 amps (2)
$142.00
$
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee,for branch circuits with purchase of a service or feeder fee:
Each branch circuit
I t
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
$ 62.00
$
Each additional branch circuit
$ 7.00
$
Miscellaneous fees: service orfeeder not included
Each pump or irrigation circle (2)
$ 71.00
$
Each sign or outline lighting (2)
$ 71.00
$
Signal circuit or a limited -energy panel,
alteration, or extension (2)
$ 82,00
$
Each additional inspection: (1)
$62.00
$
APPLICANT; USE
(A) Enter subtotal of above fees
(Minimum Permit Fee $82.00)
(B) Enter 12% surcharge (.12 x [A])
$//76
(C) Technology Fee (5% of [A])
$
(D) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (A through D):
$ 1l 1