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HomeMy WebLinkAboutPermit Electrical 2013-4- SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Spnngfield,OR 97477 Phone: 541-726-3753 '\OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00755 www.springfeld-or.gov permitcenter @springfield-ar.gov PROJECT STATUS: Issued ISSUED: 04/15/2013 EXPIRES: 10/12/2013 STATUS DATE: 04/15/2013 APPLIED: 04/15/2013 SITE ADDRESS: 1716 HENDERSON AVE, Eugene,OR 97403 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703343401600 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service and Rewire Existing House OWNER: DIBBLE DAVID P Phone Number: ADDRESS: 27 SHORT LEAF HUFFMAN TX 77336 OWNER: DIBBLE RITA M Phone Number: ADDRESS: 27 SHORT LEAF HUFFMAN TX 77336 _ CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor PHANTOM INC CGS 109864 01/14/2015 541-688-2549 INSPECTIONS REQUIRED Inspections 4225 Service or Feeder 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 property, and the approved set of plans will remain on the site at all times during • c•-struction. • nee - /(1 /.57/S � 7 Owner or Contractor S •n- ure Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: a Notification Center. Those rules are set forth THIS PERMIT SHAH EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001• • 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT • calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 4/15/2013 10:24:30AM • Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spdngfield,OR 97477 C 541-726-3753 "OREGON 811-SPR2013-00755 • www.spdng(eldor.gov 1716 HENDERSON AVE permitcenter©springfeldor.gov RECEIPT NO: 2013000738 RECORD NO:811 SPR2013.00755 DATE:04/15/2013 DESCRIPTION":4!.4r,—.„444i_k. —:Fy0•2 f h 2;'' 2ACCOUNT CODE/TRANSICODE &Ei±AMOUNTio]11#.Li Branch circuits with service or feeder each circuit V-'—v 224-00000-426102 1004 130.00 Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 26.28 Technology fee(5%of permit total) 100-00000-425605 2099 10.95 TOTAL DUE: 256.23 P %ENTET/P,E P.AYOR CASHER:JL'ARSON _ COMMENTS AMOUNTjFAID -- Check PHANTOM INC 256.23 2401 TOTAL PAID: 256.23 • A 4144' s°"'"°FaD, t7CT "0 FP SPRINGFIELD OREGOW '4 .Ft.dac,'• 41•4.?.3, . .aata7h�vtiF2sa4 tarata'�^ki,t, tt'ma .3Y v' S s..#. 225 FIFTH STREET • SPRINGFIELD,OR 97477 • PH:(541)726-3753 •FAX:(541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number r f r `27/3 CO2S5 e ate 1/4-1 /S - 1 FikeATION OF NSTALIT ION t' '.4.:t' 3 COMLTE EE SCHEDULE? ELOW f t 'nom= 3 7/41 et/. ce<04 f exe, se- 2e(3 8 t h .f('b4eCQ ` }y { crag LEGAL DESCRIPTION A New Residential Smgle;or Multi Famdyiperdwelling Service Included JOB DESCRIPTION 1000 sq.ft.or less 6.00 f , �_ Each additional 500 sq.ft.or 4.C' t /I U 4X,w2.4L2- portion thereof $ .00 Permits are non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or $50 10 Suspended for 180 days. Feeder r"•2VYMVF.Hv A•`i I.L.i # D �'. .t PK 1 +.: , 4 Y p a •ee 5w NY r oc 2'ti `+41 2 CONTRACTOR INSTt1I LATI-' _ J B. Services oar Feeders Installation,Alterah t s or„Relocation;;F;= Electrical Contractor 44.4 r5 200 Amps or less / $6 .00 '7 201 Amps to 400 Amps $7 00 • Address ,2`7 `'V / 401 Amps to 600 Amps $1 .00 p _�/6Ol Amps to 1000 Amps .163.00 City S� gcite Phone cq/ 435,/5Y Over 1000AmpsNolts Reconnect Only $51.10 i— C Temp ora Serve es ocFeeders J'' "r °4�yp & Supervisor License Number 6 cc-- s - P arye , , „ - . aa•a r w s?dcs,�_. Expiration Date / O — / 79 Installation,Alteration or Relocation 200 Amps or less $5/.00 Constr.Contr.Number /U g 1z 201 Amps to 400 Amps $6'.00 401 Amps to 600 Amps $101 10 Expiration Date — Over 600 Amps or 1000 Volts see"B"above. Signature of Supervising Electrician D B1.a Circuits `,,, y ='` t',7 ' i n,F=, , i Kst- ';fr_ /v,GG> New Alteration or Extension Per Panel One Circuit $ '3.00 Each Additional Circuit or with /i �J Service or Feeder Permit _/Cl.l $ 3.10 Owners Name L C, 5(;) ! i 5(` , 6/1, / :+}• ts•.t a '9"-. 5y- ,^' x ., " h .R* 'a'y,I Address e (� 7 g,/ - E Mis ellan eous;(Service/feedernotiinclud Eaach,Jnstallation'i Ar City Lam' ( ie 670) - Phone e-//— g ct/-9SZ Pump or irrigation $ 1.00 Sign/Outline Lighting $51.00 OWNER INSTALLATION Limited Energy/Residential $2..00 The installation is being made on property I own which Limited Energy/Commercial $ •5.00 is not intended for sale,lease or rent. Minimum Electric Permit Inspection Fee is$45.00+Surcharges Owners Signature: 4 'SUBTOTAL OFA'BOVE.w'4 4 , ,b,,. W.% ..ems w; ,ato„, 7%State Surcharge 10%Administrative Fee Inspection Request: 726-3769 TOTAL Shared Dnve(T:)/Building Forms/Electrical Permit Application I-03.doc