HomeMy WebLinkAboutBuilding Electrical 2014-09-24SPRINGFIELD
225 Fifth St
'
CITY OF SPRINGFIELD
Springreld,OR97477
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Phone: 541-726-3753
OREGON
Building / Commercial Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-02072
vmm.springfield-ocgov,
permitcenter@spdngfield-ocgov
PROJECT STATUS:
Issued ISSUED: 09/24/2014
EXPIRES: 03/23/2015
STATUS DATE:
09/24/2014 APPLIED: 09/24/2014
SITE ADDRESS: 204 STH ST, Springfield, OR 97477
SCOPE: Electrical Only
ASSESOR'S PARCEL NO:
1703353102900 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Single circuit for shore power
OWNER: CITY OF SPRINGFIELD
ADDRESS: 225 5TH ST
Phone Number:
SPRINGFIELD OR 97477 CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
Electrical Contractor RS ELECTRIC LLC CCB 149509 11/02/2015 541-359-1192
INSPECTIONS REQUIRED
Inspections
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 to ed at the front of the property, and the approved set of plans will remain on the site at all times during
construction. 177 %)
Ownd or Contractor Signature Date
P"'TICE:
II IIS PERMIT SHALL EXPIRE IF THE WORK
All HIORIZED UNDER THIS PERMIT IS NOT
COIAMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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).
Springfield Building Permit 9/24/2014 2:22:49PM Page 1 of 1
SPRINGFIELD "' CITY OF SPRINGFIELD
225 ` ; St
TRANSACTION RECEIPT Spn gg�Id,0R 97477
' OREGON 541-726-3753
811-SPR2014-02072
w .spnngfieldorgov 204 5TH ST permitcenter@spdngfield-or.gov
RECEIPT NO: 2014002117 RECORD NO: 811-SPR2014-02072
DATE: 09/24/2014
:DM
AQrnOUN•
A111f0 ,
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
CITY OF SPRINGFIELD
050405
TOTAL PAID: 98.44
11 -
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`tC�lit`�Y�..`s�.�'��=auT^�evar&'a",.".-=,�'F..
DEPARTMENT USE ONLY
Permit no.: p / Z
Date: 1Z / t
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.
„LOCALGOVERNMENT APPROVAL
Zoning approval verified? ❑ Yes ❑ No
CATEGORZF: CONSTRUCTION
11 Residential Government
Commercial
-'JOB:SITE_ INFQRMATION AND LOCATION'';`, .
Job site address: X41 d. ST.
City: —
State:8q2—
ZIP:
Reference:
Taxlot.:
- DESCRIPTION OF WORK:
1i
PROPERTY QWNER .. � - �.
Name: s ,
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
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
{;CONT CTOR INSTALLATION.
Business name:
Address:
City: ' �7c Ci
State: 0J2
1 ZIP: g7vd
PhonegW -a5`)- //9A
Fax W - - psp
E-mail: leiC/{ec r�-rz_-_,_-
CCB licenny9s
BCD license no. - 07 C
Signing supervisor's license no.: 195
Print name of signing supervisor: / W64,40 Y,
4441k*,P_
Signature of signing supervisor:
440-2584-J (4/012013/COK
FEE SCHEDULE,
m
Nuber of inspeetwns per item O '. Qfy
Cost
Total
Residential, per unit, service included.
1,000 sq. ft. or less (4)
$147.50
$
Each additional 500 sq. ft, or portion
thereof
$ 27.50
$
Limited energy (2)
$ .35.00
$
Each manufactured home or modular
dwelling service or feeder (2)
$ 69.00
$
Services or feeders: installation, alteration, relocation
200 amps or less (2)
4�61 to 400 amps (2)
$ 89.00
$ 104.60
$
$
401 to 600 amps (2)
$174.00
$
601 to 1,000 amps (2)
$225.50
$
Over 1,000 amps or volts (2)
$516.00
$
Reconnect only (2)
$ 69.00
$
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 69.00
1 $
201 to 400 amps (2)
$ 96.00
$
401 to 600 amps (2)
$138.50
$
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension perpanel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit 1
1
$ 6.50 1 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
/
$ 60.50 1
$
Each additional branch circuit
$ 6.50 1
$
Miscellaneous fees: service orfeeder not included
Each pump or irrigation circle (2)
$ 69.00
$
Each sign or outline lighting (2)
$ 69.00
$
Signal circuit or a limited -energy panel,
alteration, or extension (2)
$ 80.00
$
Each additional inspection: (1)
$80.00
$
(A) Enter subtotal of above fees
(Minimum Permit Fee $80.00)
(J
(B) Enter 12% surcharge (.12 x [A])
$
(C) Technology Fee (5% of [A])
$ /v
TOTAL fees and surcharges (A through C):
$