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HomeMy WebLinkAboutPermit Electrical 2013-4- SPRINGFIELD 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR 97477 ,(\IN Phone: 541-726-3753 `,OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00849 www.springfield-or.gov permitcenterespringfield-or.gov PROJECT STATUS: Issued ISSUED: 04/2912013 EXPIRES: 10/26/2013 STATUS DATE: 04/29/2013 APPLIED: 04/29/2013 SITE ADDRESS: 2111 11TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703261401311 TYPE OF STRUCTURE: Residential . PROJECT DESCRIPTION: Splitting 220 to two 110's 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 L 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 construction. � , VA? /-3 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to rules NOTICE: Notification fol{ow Center. Tadopted hose by the rules are Oregon set fortUtility h THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- JTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by JOMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 4/29/2013 3:04:34PM Page 1 of 1 SPRINGFIELD` CITY OF SPRINGFIELD 4. _�w„. t '•= 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-S PR2013-00849 www.springfield-or.gov 2111 11TH ST permitcenter©springfield-or.gov RECEIPT NO: 2013000836 RECORD NO:811-SPR2013-00849 DATE:04/29/2013 DESCRIPTION ;_ ___,LACCOUNT..CODE/TRANS CODE _ 1, ;'. ,AMOUNT DUE._: Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00 Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 6.50 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 - ;P,AYOR; CASHER ULARSON ., a; .;s-COMMENTS Check Brian Ference 93.60 5594 TOTAL PAID: 93.60 . Electrical Permit Application DEPARTMENT USE ONLY CITY O ' SPRING'S `LLlx'OREGON ---,t Permit no.:u l 7�(3 t7 o d l , j : ii 225 fifth Street•Springfield.OR 97477.PH(541)726-3753•EAX(541)7263689 r ..OREGON ■ p Date: Y/2°//7 3 S i 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 FEE SCHEDULE Zoning approval verified? ❑Yes ❑No Number of inspections per item () Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: S ❑ Residential I ❑Government I El Commercial ! JOB SITE INFORMATION AND LOCATION 000 sq. It.or less(4) $147.50 3 Each additional 500 sq. 0.or portion �11 ill $ 27.50 $ 1 Job site address: I I a'ec( thereof r City: S rJ 41 .(1 I State: 0 R I ZIP:,747-7- Limited energy(?) $ 35.00 I $ 1 p; 1 Reference: I Taxlot.: Each manufactured home or modular 1. dwelling service or feeder(2) $ 69.00 $ DESCRIPTION OF WORK f nr� I J I /� Services or feeders:installation,alteration,relocation i ' I10 cue/411s 'irN vTh rags i 200 amps or less(2) $ 89.00 $ PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: 401 to 600 amps(2) $174.00 S �ptau F-FRc-uca_ i Address: 2((( 1 Pa Si,i(4— 601 to 1.000 amps(2) $225.50 $ Over 1,000 amps or volts(2) $516.00 $ ' City: r� fa/ State ZIP:q94/1-7— p' O t rv: S Phone:5eq- / 3S-`/) I Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration,relocation This installation is being made 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 479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $ Over 600 amps s or 1,000 volts.see services or feeders section above Signature: CONTRACTOR INSTALLATION Branch circuits: new.alteration, extension per panel Business name: eAC On E7eCf:1 (.-- a.Fce for branch circuits with purchase of a service or feeder fee: Address: ZA S Roof e re.*. �1 eft Each branch circuit I I $ 6.50 I $ j City: Cb _ State: Op__ ZIP:e nLi n_ b.Fee for branch circuits without purchase of a service or feeder fee: Phone:9,(h cyki,I 07 j01 I Fax: ,�__`{''1 L.t ttt iD First branch circuit(2) z_, 5 60.50 $ E-mail: ypy4,c.cn del t L�.t -kk .x u Each additional branch circuit $ 6.50 ,$ CCB license no.: '3E41017 BCD license no.:ZQ'53C, Miscellaneous fees:service or feeder not included i Signing supervisor's license no.: 5t-(Q'6"5 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor`LI Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: C- Signal circuit er alimited-energy panel, $ 80.00 $ `- �D1�n S2V1 lteration,or extension(2) Each additional inspection:(1) $80.00 $ APPLICANT 'USE I (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $ j 1 (C)Technology Fee(5%of[Al) $ 440-2534-1(4101/2013iCOM) TOTAL fees and surcharges(A through C): $ t ;62.=— I I I