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HomeMy WebLinkAboutPermit Electrical 2013-4- j SPRINGFIELD 225 Fifth St • hr' CITY OF SPRINGFIELD Springfeld,OR97477 t.� Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00848 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/29/2013 EXPIRES: 10/26/2013 STATUS DATE: 04129/2013 APPLIED: 04/29/2013 SITE ADDRESS: 1104 T ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703261401311 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Adding New Circuit OWNER: FERENCE BRIAN R Phone Number: ADDRESS: PO BOX 11486 EUGENE OR 97440 OWNER: PIPER NEVA A Phone Number: ADDRESS: PO BOX 11486 EUGENE OR 97440 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor BEACON ELECTRIC 8 LIGHTING INC CCB 38497 01/10/2014 541-461-0291 L 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 located at the front of the property, and the approved set of plans will remain on the site at all times during construc�tio7n. �a / /2 y� • VJ v-t �ifYLO 4, //3 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 4/29/2013 3:09:15PM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD •t � 225 Fifth St C•` ecoN TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 811-S P R2013-00848 www.springfieId-ocgov 1104 T ST perrnitcenter©springfield-ocgov RECEIPT NO: 2013000837 RECORD NO: 811-SPR2013.00848 DATE:04/29/2013 {DESCRIPTION =ACCOUNT CODE/TRANS CODE_- AMOUNT DUE_ Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 19.50 Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 (PAYMENT TYPE PAYOR - CASHIER:,JLARSON- COMMENTS ' - _;`` .AMOUNT PAID t ^ f Check FERENCE BRIAN R 93.60 5594 TOTAL PAID: 93.60 • Electrical Permit Application DEPARTMENT USE ONLY + ua•� - - SPRINGFIELD-' ' CITYCOESPRINGEIEED"OREGON ,-' -4 ( Permit no.: &/( 20(- °° MPJ 225 Fifth StreettSpringfield,OR97477•PH(541),2fi3753$FAX(541)726-3689 re'.- EGON i/��//� Date: f 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. I LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑Yes ❑No Number of inspections per item () Qty. east cost I CATEGORY OF CONSTRUCTION Residential,per unit,service included: ( 2-1 idential _I ❑Government I ❑Commercial JOB SITE INFORMATION AND LOCATION 1,000 sq.11.or less(4) $147.50 $ 1 O -�'- Each additional 500 sq.ft.or portion $ 27.50 $ Job site address: / '� S Lee thereof f City: Spr.nq t;e\ci State: OR ZIP: 9747- Limited energy(2) $ 35.00 $ Reference: J Ta%lot.: Each manufactured home or modular $ 69.00 $ s DESCRIPTION OF WORK dtvelltag service or feeder(2) nn II rr (� Services or feeders:installation,alteration,relocation I f'4lclin C1<t'1 h'C ktich„ 1 4'�s• 5 `J 200 amps or less(2) $ 89.00 $ 201 to 400 amps(2) $ 104.50 S PROPERTY OWNER S Name: BR i jt,J Fe E-I∎k L. 401 to 600 amps(2) $174.00 $ j Address: 2(11 11 1h S lierT 601 to 1,000 amps(2) $225.50 S I 11 1 City: it.-[r•A I State: OR, ZIP: I747:7- Over 1,000 amps or volts(2) $516.00 $ SfJr i� Phone:S`](- ft'(- Ze`ro I Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation hug,,i I e qq•Ckn,r' This installation is being mdde on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale,exchange, lease,or rent.OAR t 479.5400)and 479.560(1). 401 to 600 amps(2) $138.50 $ 1 Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits:uetr•alteration,extension per panel Business name: T7PA(Ann �- a.Fee for branch circuits with purchase of a service or feeder fee: Address: 2- G �-ocevf e-a, /GQ Each branch circuit S 6.50 $ City: _ j)( StateQK, ZIP:Q/7 N 07 b.Fee for branch circuits without purchase of a service or feeder fee: Phone: Fax: l First branch circuit(2) $ 60.50 $ off �� nz,� �tl �fra! 2� (� E-mail: irje c6yt � k7 c'exti4 es-t Each additional branch circuit $ 6.50 $ CCB license no.: 58997 BCD license no.: ZQ--T✓�✓(� Miscellaneous fees:service or feeder not included (t Signing supervisor's license no.: nnnnyyy�y8'S S Each pump or irrigation circle(2) I $ 69.00 $ I Print name of signing supervisor -i Each sign or outline lighting(2) $ 69.00 $ i Signature of signing supervisor: __ '' oo Signal circuit or a limited-energy panel, $ 80.00 . $ P har y 1n vlse('I alteration,or extension(2) p Each additional inspection:(I) $80.00 $ } APPLICANT USE (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) ' i (B)Enter 12%surcharge(.12 x[A]) $ I i (C)Technology Fee(5%of[Al) $ 440-2584.1(4101/2013/COM) TOTAL fees and surcharges(A through C): $ c ; 6—� , t