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Home My WebLink AboutPermit Electrical 2014-09-18SPRINGFIELD 1 - OREGON wmv.spdngrield-orgov CITY OF SPRINGFIELD Building / Commercial Permit PERMIT NO: 811-SPR2014-02011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@springfield-orgov PROJECT STATUS: Issued ISSUED: 09/18/2014 EXPIRES: 03/17/2015 STATUS DATE: 09/18/2014 APPLIED: 09/17/2014 SITE ADDRESS: 2163 SHADYLANE OR, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703262203861 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 100 amp service and 5 circuits for park lighting OWNER: WILLAMALANE PARK & RECREATION DISTRICT Phone Number: ADDRESS: 260 S 32ND ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone Electrical Contractor BUILDERS ELECTRIC INC CCB 4296 12/10/2015 541-485-0922 INSPECTIONS REQUIRED Inspections 4220 Electrical Service Electric Service: Approval required prior to utility company energizing 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 properly, and the approved set of plans will remain on the site at all times during construction. 1� IA U& r 11AI% �v 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 number for the Oregon Utility Notification Center is 1.800-332-2344). ! "I'M r: I', IS PERMIT SHALL EXPIRE IF THE WORK r.0 I l IORIZED UNDER THIS PERMIT IS NOT Gn, ENCID OR IS ABANDONED FOR f10 DAY PERIOD. Springfield Building Permit 9/18/2014 4:27:52PM Page 1 of 1 SPRINGFIELD CITY OP SPRINGFIELD CITY 225 Fifth St < « TRANSACTION RECEIPT Springheld.OR 97477 ""' OREGON 541-726-3753 811-SPR2014-02011 w .si,Mgheld-or.9ov 2163 SHADYLANE DR pormitc nter@springfield-or.gov RECEIPT NO: 2014002075 RECORD NO: 811-SPR2014-02011 DATE: 09/18/2014 DESCRIPTION ACCOUNT CODEfTRANS CODE AMOUNT DUE Branch circuits with service or feeder each circuit 224-00000-426102 1004 35.00 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 15.12 Technology fee (5% of permit total) 100-00000-425605 2099 6.30 TOTAL DUE: 149.92 'PAYMENT TYPE 'PAYOR CASHIER: RHOLMAN COMMENTS AMOUNT PAID Credit Card Builders Electric 149.92 818182 TOTAL PAID: 149.92 SEP -12-2014 17:00 John Risbrough Electrical Permit ApplicationPIM 9PAIpUF16LK �%�N !&A 225 Fifth St"ettSpringfidd, OR 97477*PH(541)726-37$3$FAX(541)726.3689 P.02 DEPARTMENT USE ONLY Permit no.; �()0_0 / I Date' q (1-1 Im 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 1060manercial JOB SITE INFORMATION AND LOCATION Job site address: Z 1(, � A c vll"&- h IL City: S I State: I ZIP: 2 7(f % Reference: 7Q Z 6 Twat.: DESCRIPTION OF WORK (d r - L-_ $ PROPERTY OWNER Name: iq Address: City: State; ZIP: 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 ro ert is not 1) and 4tended 1) sale, exchange, lease, or rent, OAR property Signature: CONTRACTOR INSTALLATION Business name: Address: City: State: OK ZIP: 177 Lfd?— 7Lfd?— Phone: Phone: Z Fax: S W/ . OS'5r E-mail: -fir v{yt CCB license Z-7 Signing supervisor's license no.: Q 7 S Print name of signing supervisor:J c2N S Signature of signing supervisor r FEE SCHEDULE Number of inspections per item O Qty. Cost coot fl Residential, per unit, service included: 1,000 sq. R. or less (4) $161.00 $ Each additional 500 sq. ft. or portion thereof $ 28.00 $ Limited energy (2) $ 36.00 $ Each manufactured home or modular dwelling service or feeder (2) $ 71,00 S Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 S 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 S Temporary services or feeders: installation, alteration. relocation 200 amps or less (2) F_$7_1'0_0]_$ 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 eireuits: new alteration, sx1ensionperponel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuli $ 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 S hliscellnneous fees: service oefeeder not included Each pump or irrigation circle (2) S 71.00 $ Each sign or outline lighting (2) $ 71.00 S 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 (6tinimum Permit Fee $82.00) $ +2(0 (B) Enter 12% surcharge (.12 x [AI) $ �< (C) Technology Fcc (5% of [A]) $ (D) Continuing Education Fee $2.50 $2,60 TOTAL fees and surcharges (A through D): S Ig 440.2$64-J (5/2112014/CUM) G � TOTAL P.02 09/12/14 FRI 16:22 FAX 5417263689 CITY OF SPRINGFIELD U001 k s$$8F8$$zg�cK$$yr„�gg3 ggz RX REPORT :asx 3ax3x88xs&kRrkgxg8xg;c RECEPTION OK TX/RX NO 7446 CONNECTION TEL CONNECTION Ill ST. TI3IE 09/12 16:21 USAGE T 00'54 PGS. 2 RESULT OK SEP -12-2014 17:00 John Risbrough 'Fro 3100PA� BUILDER'S ELECTRIC, INC. 195 Madison Street Eugene, Oregon 97402 FAX COVER SHEET DATE; I—( Z FROM: TO : 41 /-/ C Arl- r TOTAL NUMBER OF PAGES INCLUDING THIS COVER SHEET; � Please advise if you have not received the complete transmission. Our fax number (541) 485-4055 Telephone number: (541) 485-0922 P.01