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HomeMy WebLinkAboutPermit Electrical 2013-5-13 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfeld,OR 97477 M ryr( • Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00943 www.springfieldor.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/13/2013 EXPIRES: 11/08/2013 STATUS DATE: 05/13/2013 APPLIED: 05/13/2013 SITE ADDRESS: 1290 F ST,Springfield,OR 97477 - SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703362207900 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Temp Power Service OWNER: MCCOOL MICHAEL A Phone Number: ADDRESS: 933 TROON ST NW ALBANY OR 97321 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor STEVEN R GEISLER CCB 95472 11/23/2014 541-726-0618 INSPECTIONS REQUIRED - Inspections 4000 Temporary Power Service 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. Owner or Contractor Signature Date • ATTENTION: rtgwao rkTed d tee gos Utility itifIoatidnnter../Thgslj 13 rules are set forth in,40AI3.�o91-0010 through OAR 952-001• NOTICE: o ."You may obtain q�pisA of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK calling the center. (llte: e telephone AUTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon Utility NotificatioD Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 5/13/2013 1:08:45PM Page 1 of 1 • SPRINGFIELD - CITY OF SPRINGFIELD ' 71. - ° 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 FOR 541-726-3753 OREGON 811-SPR2013-00943 www.springfeldor.gov 1290 F ST permitoenter @springfield-ar.gov RECEIPT NO: 2013000934 RECORD NO:811-SPR2013.00943 DATE:05/13/2013 'DESCRIPTION , ft, ' u' I 1 +ndanax* s'/ ACCOUNT'CODE/TRi4NS+CODE -a: wr1`+ -`AMOUNT,DUE ' Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 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 Temp services 200 amps or less 224-00000-426102 1003 69.00 y�, TOTAL DUE: 93.60 pr+PA\YMENTzTYPE='*` PAYOR cnsrtiea iaasox. v� COMMENTS". PkiltenINTAMOU.KRAIPagnillS Credit Card Stevens Electric 93.60 513160 TOTAL PAID: 93.60 • • • • • • Electrical Permit Application SPAINSPIELO DEPARTMENT USE ONLY , :CITY,LOESPRINGFIELD.LOREGON '-,,-,- 4 4-anu'll" p ;+ .71 eii.:),/,‘,1flt',„ .,:t.'.---,-':--,"--es:-5::.:.:27.4e-%:,:itz 4.4,',;::.'";--.1y,f;;..,!"..:,•..-t,-,-,;,,,;;;,-•if lt...-1-:It. * al Permit no.: eq Zt(3 0099 3 ifdztv 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: ch 3/ 3 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'•-•"'"f:... 'I,' c'"'"?':?:K-54t;r1.1.,PWP, FEE=.kSCHED,ULIE.F.ZA':if;=:- Zoning approval verified? [7] Yes 9 No .Number of inspections per Item ()...- Qiy. 9aSt Tothl CATEGORY5OF .CONSTRUCTION" '''.- •- ' - . Residential,per unit,service included: (k)Residential 0 Government 111 Commercial . .. 1'000 sq. ft. or less(4) $134.00 $ §:6417:10KSITE INFORMATIOWANInO,CATIONV‘:.,V3) tEhaecrheoafdditional 500 sq. ft.or portion $ 25.00 $ Job site address: /2_949 ---- 5 City: dir 9-742.? State: 0 k ZIP: ??4-07 Limited energy(2) i $ 32.00 $ Reference: Taxlot.: Each manufactured home or modular $ 63.00 $ . ..:. , .. dwelling service or feeder(2) DESCRIPTION OF WORK - Services or feeders: installation, alteration, relocation / -es^-71 tio wer ,....7-4-7,---e 200 amps or less(2) $ 81.00 $ PROPERTY OWNER 201 to 400 amps(2) $ 95.00 $ 401 to 600 amps(2) Name: /4,4,4,/ $158.00 $/46-0„7 . Address: 9 -;-s 601 to 1,000 amps(2) $205.00 $ Fre., Over 1,000 am s or volts 2 , P ( ) $469.00 $ City: 44.,,,,71 State: 0 C ZIP: 7 7 t 2? Reconnect only(2) $ 63.00 $ Phone: - - Fax: - - E-mail: Temporary services or feeders: installation, alteration, relocation 200 amps or less(2) This installation is being made on residential or farm property ( $ 63.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale, exchange, lease,or rent. OAR 479.540(1) and 479.560(1). 401 to 600 amps(2) $126.00 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION - Branch circuits:new, alteration, extension per panel Business name: 5TC-09\-6 f—Ittit-CC. a. Fee for branch circuits with purchase of a service or feeder fee: Address: fb 60( t63 Each branch circuit $ 6.00: $ CitY:0645COIF 44111 State: ene— ZIP: qmcs-- b. Fee for branch circuits without purchase of a service or feeder fee: Phone: PH qj Os-Aos-o Fax:51.0 7-46 -V212- First branch circuit(2) $ 55.00 $ E-mail: 0 L 1 Opt-Ale6httl .....a....A .C-att-i Each additional branch circuit $ 6.00 $ CCB license no.: 15479. BCD license no.:;.6-5 ta C Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 11074 2 Each pump or irrigation circle(2) $ 63.00 $ Print name of signing supervisor: .grebelJ ,Ce-t s LER_ Each sign or outline lighting(2) $ 63.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisortcel_er,-4Pre $ 63.00 $ alteration,or extension(2) , Each additional inspection: (I) $58.00 $ la_nIA,004- ::]-1;■/];':4[00C:):e;;;I:1:AP:PLiCANT=USEL-,C1. ,::".-. ..:',R .<•'', , . (A) Enter subtotal of above fees .s, $ Qtr.-- (Minimum Permit Fee$58.00) (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $q3‘-' 440-2584-1(9/08/COM)