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HomeMy WebLinkAboutPermit Electrical 2013-5-30 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 " eooN Phone: 541-726-3753 Building / Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01105 www.springfieldar.gov - permitceriter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/30/2013 EXPIRES: 11/25/2013 STATUS DATE: 05/30/2013 APPLIED: 05/30/2013 SITE ADDRESS: 3735 E 22ND AVE,Eugene,OR 97403 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1803031300300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace service panel OWNER: MOONEY BENJAMIN Phone Number: ADDRESS: 3735 E 22ND AVE EUGENE OR 97403 CONTRACTOR INFORMATION Contractor Type 'Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4220 Electrical-Service 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. Own • r Con actor Si 9 nature Date •Vto \tee�°,4aNI�� ::- <e0 te90 sett° 1 FtK ON' oPi dgosee0 OPrele�b9 P\P� Me S\10T CFN�ttesastet•. �cou9sott teP "` P� N GO\ 0°. cop\e rete d\o�`�\c 1‘C� SNP�� �N\Se� EgFO� �otti\t gat y2��t ot \�lotU`\\\t 1 Na 1 �\S ERM\� 0) NppN • NCO.4 `�eyoetoCe-\\C o0332.23 ‘S1\\° GEO Q�R\00. 0' t\\o9 to\ .\s P CO 0� • 00'Jm�e\Ge�tec PN� $ 0 Springfield Building Permit 5/30/2013 2:42:51PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD • 225 Fifth St t TRANSACTION RECEIPT Spnngheld,OR97477 OREGON 541-726-3753 811-SPR2013-01105 www.spnngeeld-or.gov 3735 E 22ND AVE permitcenter©springfield-or gov RECEIPT NO: 2013001072 RECORD NO:811-SPR2013-01105 DATE:05/30/2013 told-Y.gifi.MI*Alt i, ,m ( a `k g . .art 3� v :: i h. x rr a . , .s..1`,. _�t_.F r'r�.,R_._�:= '.".�e��ACCOUNT'CODE/TRANS CODE ;��6c..s�';'AMOGNTDUE °"I 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 PAYMENTsTYP-E P.AYOR CASNIERaDW SBY COMMENTS AMOUNTIPAID' Check MOONEY BEN 104.13 779 TOTAL PAID: 104.13 • Electrical Permit Application DEPARTMENT USE ONLY !� 7� !� F�EL[1 f .1„l ''Y 'i-€414PR a7rr., +ZD � a r"� , SA V, Permit no.: Sir —af I C 5 225 Fifth StreetsSpringfeld,OR97477•PH(541)726-3753•FAX(541)726-3689 `Av Date: 5/3 6/ 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 "u -,,;< ,,... FEE. SCHEDULE „ i�r� Zoning approval verified? ❑Yes ❑No Number of inspections per item () Qty ,Cost Tofal„, Residential,per unit,service included: e ~cost, _'. CATEGORY:OF CONSTRUCTION >> ' - Residential ❑ Government ❑Commercial BSITE,INFORMATION~AND LOCATION 'i? 1,000 sq.ft.or less(4) $147.50 $ JO `-23Y i. 22 j Each additional 500 sq.ft.or portion Job site address: S Lid) thereof $ 27.50 $ City: C Li"�� I State: (?& I ZIP: 9 7vo3 Limited energy(2) $ 35.00 $ Reference: / g o 3 6 313 Taxlot bd3 CO Each manufactured home or modular $ 69.00 $ i; DESCRIPTION;I;OF.tWORK '= i gy, dwelling service or feeder(2) .n Services or feeders: installation, alteration,relocation ��- r SCLVI C.�" Y' �L 200 amps or less(2) / $ 89.00 $ G M 5... PROPERTN.;01NNER _ r 201 to 400 amps(2) $ 104.50 $ Name: r l , 401 to 600 amps(2) $174.00 $ Address: 3-7 3 r I AA 601 to 1,000 amps(2) $225.50 $ City: l7'; .P„,--e State: () C\ ZIP: y Over 1,000 amps or volts(2) $516.00 $ Phone:5YC ' 67. 3231 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 't - ded,for r sale, exchange, lease, or rent. OAR 479.5400)an. 4f 9.560.1 . 401 to 600 amps(2) $138.50 $ Signature: t� . Over 600 amps or 1,000 volts,see services or feeders section above „r,ri±C ii Ni CTOR;,INSTAL'L'ATION< i, , ".':: Branch circuits:new, alteration, extension per panel Business name: (.. `y n:/ -Csa,_ a Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit $ 6.50 $ City: State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $ Signature of signing su ery supervisor: Signal circuit or a limited-energy panel, $ 80.00 $ P alteration,or extension(2) Each additional inspection:(1) $80.00 $ 7 yea `5 _ar? t APPLICANT',>USE_ -- ' A (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) O (B)Enter 12%surcharge(.12 x[A]) • $ /0 c (C)Technology Fee(5%of[A]) $ Li LI TOTAL fees and surcharges (A through C): $.�ocf 1 440-2584-3(4/012013/C0M)