HomeMy WebLinkAboutPermit Electrical 2013-5-13 SPRINGFIELD - , 225 Fifth St
` CITY OF SPRINGFIELD Springfeld,OR 97477
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Phone: 541-726-3753
\OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00947
wwwspringfield-or.gov perm itcenter @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: 2515 31ST ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702193400400 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Elec.Service-Remodel
OWNER: BRANDT B J Phone Number:
ADDRESS: PO BOX 1312
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
II
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499
INSPECTIONS REQUIRED
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
4999 Final Electrical Final Electric: When all electrical work is complete.
4225 Service or Feeder
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.
Rill) Will 5-13 -13
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to
•
follow rules adopted by the Oregon Utility
NOTICE: Notification NTIONCenter.
Thoseruh OAR 952f001-
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001 obi�n ceples of the rules by
.' UTHORIZED UNDER THIS PERMIT IS NOT 0090. You may
nOMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone
!Y 180 DAY PERIOD. number Cfenteriss 800-332-2344 iflcaUOn Oreg
on •
Springfield Building Permit 5/13/2013 2:00:46PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
WirdaL.... 225 Fifih St
«-V TRANSACTION RECEIPT SpringfieldpR 97477
OREGON 541-726-3753
811-SPR2013-00947
www.springfleld-or.gov 2515 31ST ST pennitcenter @springfield-or.gov
RECEIPT NO: 2013000939 RECORD NO:811-SPR2013-00947 DATE:05/13/2013
LDESCRIPTION _, - _ :' ACCOUNT CODE/TRANS CODE .: '. AMOUNT,DUE.
Branch circuits with service or feeder each circuit 224-00000-426102 1004 78.00
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 20.04
Technology fee(5%of permit total) 100-00000-425605 2099 8.35
TOTAL DUE: 195.39
LPAYMENT TYPE;____.PAYOR - CASHIER:JLARSON <--• COMMENTS. Y . '--. ' , AMOUNT PAID -. k . j
..
Credit Card EASTSIDE ELECTRIC INC — 195.39 �
04528G
TOTAL PAID: 195.39
•
Electrical Permit Application DEPARTMENT!USE ONLY
$PRINGFIELO a+�r.
iF'LitY rlc: 4 Y:"i. Frt7 '1. YKYy :9 » a p p
I CITY OE SPRING.1E;LD;(OREG-ON=7 f1R ' O [
i Permit no.:137/Zot3 09 r7
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689
Date: S745// 2j
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.
LOCALI. GOVERNMENTzAFPROVAL ,§ „, , ??` 1,x,1,' .<`'-r SCHEDULEi,1*.,t x;' Is,, ; A6
Zoning approval verified? ❑ Yes ❑No ,15umber of inspections,geritem O Qty Yeffea t Totalty
-�U .a ,..rea
`� ;i " , 'CATEGORY.�OF`zCONSTRUCT;ION „„ua'rr_`.�„�,,
Residential,per unit,service included:
Residential ❑Government ❑Commercial
v it 1,000 sq.ft.or less(4) $147.50 $
;ds� cJOB'sSITE,'.INF.ORMATION AND, LOCATION �s; Y ?
Each additional 500 sq. ft.or portion
Job site address: .Z S 1 S 31 37 27. thereof - $ 27.50 $
City: S Q c LO State: O Q ZIP: X17`/ 7 g Limited energy(2) $ 35.00 $
Reference: Taxlot Each manufactured home or modular
�R. 4 .6 y ,vr-�_f�y�, dwelling service or feeder(2) . $ 69.00 $
„ nO�:, #DESCRIPTION;,OF WORK+ x'�,„„� ,F, F,
ELECTR.I C&L SEQVICC, ' REmboE C - Services or feeders: installation, alteration,relocation
�
.00ITI�u 200 amps or less(2) $ 89.00 $ V9
a 1,,, tOTO, %P..ROPERTY CIWNER tr a r., i - 201 to 400 amps(2) $ 104.50 $
Name: /3� l� �-�
401 to 600 amps(2) $174.00 $
Address: I),0, ?,,c /3i Z c /c/ 601 to 1,000 amps(2) $225.50 $
City: �7<G/.) State: o 2 ZIP: ?' 7 y 77 Over 1,000 amps or volts(2) $516.00 $
Phone: - - 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 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
";I @e`µ'�I e r ilCONTRACT,OR ;INSTALLATION k xj'tfg'I . -,„ Branch circuits:new, alteration, extension per panel
Business name: 11E AS-1-51 0E ECE CT RI C. a. Fee for branch circuits with purchase of a service or feeder fee:
Ud
Address: 3 -S 3 8OSCA GE C N • Each branch circuit 1 a $ 6.50 $ 8
City: 5PF'LD State: OR /ZIP:971/7 g b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - ')T I” /y of q Fax: BC, ^5'160 First branch circuit(2) $ 60.50 $
E-mail: RO K 1 q6 1 @ Y AN 00-C 0 hi Each additional branch circuit $ 6.50 $
CCB license no.: I 1 777.0 BCD license no.:d0 NOS C Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 47 7S Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: rZ6 GCtc 10 Id G Each sign or outline lighting(2) . $ 69.00 $
Signature of signing supervisor: R.p��.t
Signal circuit x a lion(2)
panel, $ 80.00 $
alteration,or extension(2)
Each additional inspection:(l) $80.00 $
°' r•' . APP,LICANTUSE ° an
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $ 167.00
(B)Enter 12%surcharge(.12 x[Al) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $/9 'J?
440-2584-1(4/012013/0OM)