HomeMy WebLinkAboutBuilding Electrical 2014-09-08SPRINGFIELD --
225 Fifth St
CITY OF SPRINGFIELD
Springfield,OR97477
6nREGON
Phone: 541-726-3753
Building / Commercial Permit
Inspection Phone: 641-726-3769
j
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01927
w .spnngfield-or.gov
permilcenter@spnngfield-ocgov
PROJECT STATUS: Issued ISSUED: 09/08/2014
EXPIRES: 03/06/2015
STATUS DATE: 09/08/2014 APPLIED: 09/08/2014
SITE ADDRESS: 1024 HARLOW RD, Springfield, OR 97477
SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703220002305 TYPE OF STRUCTURE:
Commercial
PROJECT DESCRIPTION, Installing a newou wer pod for Century Link.
OWNER: BIG 5 SPORTING GOODS #201 INC
Phone Number:
ADDRESS: GATEWAY MALL LLC
NEW YORK NY 10036
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type
Lie No Lie Exp Phone
Electrical Contractor TONY KOTH CCB
59748 05/19/2016 541-688-8996
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
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
-11IIS PERMIT SHALL EXPIRE IF THE VJUf
0iVINIENO D OR 11ABANDO NEDI F0'
AHY 190 DAY PERIOD.
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0090. You may oblainNote: telephone
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calling the center.
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Springfield Building Permit 9/8/2014 10.06:59AM Page 1 of i
RECEIPT NO: 2014001948 RECORD NO; 811-SPR2014.01927 DATE: 09/08/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Electrical Continuing Education fee 224-00000-425606 1032 2.50
Services 200 amps or less 224-00000-426102 1004
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
91.00
10.92
Technology fee (5% of permit total) 100-00000-425605 2099 4.55
TOTAL DUE: 108.97
PAYMENT TYPE PAYOR . CASHIER: RHOLMAN COMMENTS IAMOUNT PAID
7809
TOTAL PAID: 108.97
CITY Oh SPRINGFIELD
iq
TRANSACTION RECEIPT
225 Fifth St
Springfield,OR97477
811-S P R2014-01927
541-726-3753
mm.springfield-or.gov
1024 HARLOW RD
permits nter@spdngfield-or.gov
RECEIPT NO: 2014001948 RECORD NO; 811-SPR2014.01927 DATE: 09/08/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Electrical Continuing Education fee 224-00000-425606 1032 2.50
Services 200 amps or less 224-00000-426102 1004
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
91.00
10.92
Technology fee (5% of permit total) 100-00000-425605 2099 4.55
TOTAL DUE: 108.97
PAYMENT TYPE PAYOR . CASHIER: RHOLMAN COMMENTS IAMOUNT PAID
7809
TOTAL PAID: 108.97
� ' • 1 1 1
CITY ,OF SPI2I IG I LD OI GONi 1
I DEPARTMENT USE ONLY
Permit
Date:
This permit is issued tinder 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
❑ Goverment \ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 107 ( LO e,<)
City:
State:
ZIP:
Reference:
Taxlot.:
DESCRIPTION OF WORK ' ,
U�
201 to 400 amps (2)
PROPERTY OWNER
Name: 7/ M"'t`t G
Address• t 0 F 7L(c �t
City: // State:
ZIP:%UUT
Phone:
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(1) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION
Business name: U
Address: P-0
City: e- w/� I
State:6),1. I
ZIP:
Photf�
E-mail:
CCB license no.:
BCD license no.: Z/1 —2155 -
Signing supervisor's license no.: -$
Print name of signing supervisor: G N v lG e, 7W
Signature of signing supervisor: La 1-4
440-2584-J (5/21/2014/COM)
FEE SCHEDULE .
Number of inspections per item O Qty.
Cost
ea.
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4) $151.00 $
Each additional 500 sq. ft. or portion $ $
thereof 2g,00
mitc&cnergy ( 6.0
Each manufactured home or modular $ 71.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 01.00
$ r
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)
$ 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
1 1
$ 7.00 1
$
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)
$82.00
$
APPLICANT USE;
(A) Enter subtotal of above fees
(Minimum Permit Fee $82.00)
$
(B) Enter 12% surcharge (.12 x [A])
$ 0
(C) Technology Fee (5% of [A])
$ t.
(D) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (A through D):