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HomeMy WebLinkAboutPermit Electrical 2013-6-7 SPRINGFIELD -- 225 Fifth St • ' — CITY OF SPRINGFIELD Springfield,OR 97477 ' !o EGON Phone: 541-726-3753 Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01188 www.spdngfieldar.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/07/2013 • EXPIRES: 12/03/2013 STATUS DATE: 06/07/2013 APPLIED: 06/07/2013 • SITE ADDRESS: 1367 PIEDMONT ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703253204500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service Change OWNER: TURLEY JACOB 0 Phone Number: ADDRESS: 1367 PIEDMONT ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER COB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4210 Service Change 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 1 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. • 6/7/20 l� • or Contractor Signature Date • • on law requires you to ATTENTION: Dreg the Oregon Utility NOTICE WORK follow rules adopted by THIS PERMIT SHALL EXPIRE IF THE Notification Center. Those ruh OAR 952 00 h in OAR 952-001-0010 throng AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may nlOr. Not copies terephIes by carting the center ( COMMENCED OR IS ABANDONED FO number tor the Oregon Utility Notification ANY 180 DAY PERIOD. n,9rrier is )-h60-332=2344). - Springfield Building Permit 6/7/2013 8:12:20AM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfeld,OR97477 . iOREGON 541-726-3753 811-SPR2013-01188 www.springfield-ocgoy 1367 PIEDMONT ST petmitcenter @springfield-or.goy RECEIPT NO: 2013001154 RECORD NO:811 SPR2013-01188 DATE:06/07/2013 D Pi .IoN ___- . . , I._ �_. et ='a'_+ ACCOUNT.GOOEY'RAMS CODE = AMOUNTDUE •. 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 PAsEN7TTIPE PAO.R casRMR"S OR1 ENT *WA--.MOUNTgPAID Check TURLEY JACOB O 104.13 1327 TOTAL PAID: 104.13 Electrical Permit Application ,• .,. DEIDARTMENT:USE ONLY. LTitistitirgiltaggielP1551E76-iga2 1.. ./' --a, -1 tterNi // 70/"S 0 'AI,a;:zif*eg;,#:76:$41494.-i-evals.- 7)Pir;I:,,,-;:t1 ,E*):14-34AT2:4:.; !Of.-t., b -4; Pennit no.:0 i , - _.- // OS • 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. .diJiqt4StLEOCAL];',GOVERNMENTZIA:FrkE).1312VALGM&APW:: 'grt-4tgiaaltar4WFEE.6"SC.HEDUCEMAY3*.n?W°.151 Zoning approval verified? 0 Yes 0 No ,}t,'-'i.4.:.ttal,..T.M7g;4 .:Tai:,elb.27FeVS,Z4T:..cr.Al.C4Sfirei c-i-iTofilz; ''..N9J.P4g0P?acloR -PT,qP;(9i-to yq- Itml-Ea‘t??.$ cos ar.4cATEGORVibEtoNsTROcTIoNRAWIM,c ' "'''''''''''-- .--''''n'''''' 'u--- n6 - '- ---- Residential,per unit,service included: 0 Residential 0 Government 0 Commercial 1,000 sq.ft.or less(4) $147.50 $ .:./X:iii';',i",!;f:JOB..'.51T.E1NFORMATIONAN Eff, LIOCATION't,:ISN Each additional 500 sq ft.or portion Job site address: 13C"7 Pr1/4(1.4‘on 4-- ) t- thereof - $ 27.50 $ City: Sp 0 Oa la( State: CIE- ZIP: 7 f 77 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular VitiaiNtInlID ESC RIETION c'.10F,MORK 41:',::.:S3E:Salaa dwelling service or feeder(2) $ 69.00 $ Services or feeders: installation, alteration, relocation gt(e,.. dizt, ot- e(ecov-r&-i( „5.erv,z...e._ 200 amps or less(2) / $ 89.00 $ Z 1,0 174.111Therinngae R 0 R.E R MO W N E 13F14241Mial4 201 to 400 amps(2) $ 104.50 $ Name: ,),-,...ce L L-----1-c-, 401 to 600 amps(2) $174.00 $ Address: r3 C-7 Pf•cpe,---n r 5s--, 601 to 1,000 amps(2) $225.50 $ City: State: ZIP: Over 1,000 amps or volts(2) $516.00 $ Phone: - - Fax: - - Reconnect only(2) $ 69.00 $ Temporary services or feeders: installation, alteration, relocation E-mail: ? ii-c,t0L/h,Leie._• (.0,,c„54-.4.et ..;=--- 200 amps or less(2) Thiljnitallation is being inade on residential or farm property $ 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 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above tiNinqr,PONTRAciterONsTAEtmiloniVAPWria: Branch circuits:new alteration, extension per panel Business name: 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 $ Signal circuit or a limited-energy panel, Signature of signing supervisor: . $ 80.00 $ • _ , alteration,or extension(2) Each additional inspection:(1) $80.00 $ 0,17a:::#:74MTAtaffergWitaCiS Cat' :::::475eng (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ $1.6v (B)Enter 12%surcharge(.12 x[A]) $ (C,6I (C)Technology Fee(5%of[A]) $ 44-S TOTAL fees and surcharges(A through C): $iO 1, /3 446-2584-1(4/01.2013/C0M)