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Permit Electrical 2013-5-13
, --"II . rip SPA ANGFIE> ftt a_astii CITY OF SPRINGFIELD Springfield225 Fih S,OR 97477 A�`� Phone: 541-726-3753 - OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00946 www.springfield-or.g ov pe rmitce nter @s pringfield-or.gov PROJECT STATUS: Issued ISSUED: 05/13/2013 EXPIRES: 11/08/2013 STATUS DATE: 05/13/2013 APPLIED: 05/13/2013 SITE ADDRESS: 1785 RAMBLING DR,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703252102300 TYPE OF STRUCTURE:, Residential PROJECT DESCRIPTION: New Panel OWNER: SHEEKS DALE P 8 SHARON F Phone Number: ADDRESS: 1785 RAMBLING DR SPRINGFIELD OR 97477 CONTRACTOR INFORMATION 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 4210 Service Change 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. ii `Rio1,Ll J `1 Sa 13- /3 Owner or Contractor Signature Date NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK ATTENTION: Oregon law requires you to AUTHORIZED UNDER THIS PERMIT IS NOT follow rules adopted by the Oregon Utility nitviltilENCED OR IS ABANDONED FOR Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- . 1 ""n ^AY PERIOD. 0090. You may obtain copies of the rules by calling the center. (Note: the telephone • number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 5/13/2013 1:48:23PM Page 1 of 1 -., ry SPRINGFIELD CITY OF SPRINGFIELD 44 a... 225 Fifth St (OREGON t ; TRANSACTION RECEIPT Springtield,OR97477 541-726-3753 811-SPR2013-00946 w-ww.springtield-or.gov 1785 RAMBLING DR permitcenter©springtield-ar.gov RECEIPT NO: 2013000938 RECORD NO: 811-SPR2013-00946 DATE:05/13/2013 [DESCRIPTION - "- ACCOUNT CODE/TRANS CODE AMOUNT DUE Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68 Technology fee(5%of permit total) 100-00000-425605 2099 4.45 TOTAL DUE: 104.13 - PAYMENT TYPE,_ PAYOR ,1 CASNIER_JLARSON _- _ ___ COMMENTS r .. '. AMOUNT PAID <; Credit Card EASTSIDE ELECTRIC INC 104.13 07881G TOTAL PAID: 104.13 Electrical Permit Application DER ART MENT[USE ONLY .X $PNINGPIELU -{{A 3C sy''- v" .€ "r'k4 i4 Ae{3 2 444a z'q' t 6 CITY�F SPRINGFIELD'4OREGONRe� 11 ?z,,- k .�1 r zt.> .,s cr. �gyfrF ,1t=;4.1 1 , �:1n 'el Permit no.:8//70/ 3 ocez/6 225 Fifth Street♦Springfield,OR 97477*PH(541)726-3753•FAX(541)726-3689 Date: 57; 34" 5 This permit is issued under OAR.918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 4,110CAL;GOVERNMENTa,413,PROVAL_ ? ' ; Al „,, + li ar tt: FEEISCHEDULE,,, ;,u';` ,,, ` fl Zoning approval verified? ❑ Yes ❑No 's; °' c*' }a'. "' llili fi" ."t r "$'`r (Cost ;Total -: Nomber of mspecuon periµtem ( -, 9.ty '1-yeas ca-gt.:ky i ^..CATEGORYlOF.,CONSTRUCTION yti,'fift? , Residential, per unit,service included: ;$J Residential ❑Government ❑Commercial JOB'SITE�.INFORMATION' ANDg4OCATION rs R,xa 1,000 sq. fr. or less(4) $147.50 $ i 7 IS 'Moat hereof additional 500 sq. ft.or portion Job site address: L LNG R. - $ 27.50 $ City: SPFc.D State: ZIP: Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ Wr ^' 1)ESCRIPTION:10F4 WORK;.^ , ,'lr i„ t dwelling service or feeder(2) 11J$-- LL iv 04 EL eel I CAI ?4Ai f i Services or feeders: installation,alteration, relocation 200 amps or less(2) 4 $ 89.00 $ T9 a: : ' .PROPERTVOWNER j,{ i sgY:tral gs 201 to 400 amps(2) $ 104.50 $ Name: DJ, S Lee KS - 401 to 600 amps(2) $174.00 $ Address: /7 Qj ,,,,, ;/,_ l 601 to 1,000 amps(2) $225.50 $ City: ci p4'//� State 0 2 ZIP: F 2 7 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 y_.1%410+{-..ficONTRACTOR-;,INSTALLATION 'yiiilrine Branch circuits:new alteration, extension per panel Business name: C'f 51-51 O E el-EC-111C a. Fee for branch circuits with purchase of a service or feeder fee: Address: 31).5'3 QOSCA GE C 14 . Each branch circuit $ 6.50 $ City: 59 CO F State: 612 g ZIP: 9'?y 7 p b.Fee for branch circuits without purchase of a service or feeder fee: Phone: --?V / 9" i Fax: 734_ y q 0 First branch circuit(2) $ 60.50 $ E-mail: Ro 196 / , Y k N 66. n/in Each additional branch circuit - $ 6.50 $ CCB license no.: 117 770 BCD license no.:2.0•V/65.C Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 4 7,).7 S Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: R6 G F it K IN G- Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: ' _ U Signal circuit or a limited-energy panel, $ 80.00 $ alteration,or extension(2) Each additional inspection:(1) $80.00 $ t Pa APPLICANtiUSEr 7!0 c n$ktc ' ' (A) Enter subtotal of above fees ' (Minimum Permit Fee$80.00) $ S9 (I() (B)Enter 12%surcharge(.12 x[A)) $ (C)Technology Fee(5%of[Al) $ TOTAL fees and surcharges(A through C): $(p yt 440-2584-3(4/012013/COM)