HomeMy WebLinkAboutPermit Electrical 2013-6-10 •
SPRINGFIELD • 225 Fifth Si
CITY OF SPRINGFIELD Springfield,OR 97477
'Sys r Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01222
www.springfieldor.gov permilcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/10/2013 EXPIRES: 12/06/2013
STATUS DATE: 06/10/2013 APPLIED: 06/10/2013
SITE ADDRESS: 945 N ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703264305500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Capping off upstairs electrical due to fire damage.
OWNER: CHARLES E&TREVA J HORINE LIVING TRUST Phone Number:
ADDRESS: 945 N ST
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
L INSPECTIONS REQUIRED
Inspections
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 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
NOTICE' ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001-
fOMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
""R/1 DAY PERIOD. calling the center. (Note: the teleph.,s-.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•
Springfield Building Permit 6/10/2013 4:36:01 PM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
• 225 Fifth St
` E'9 TRANSACTION RECEIPT Spnngfield,OR 97477
541-726-3753
811-SPR2013-01222
www.springfield-or.gov 945 N ST permitcenter@spdngfield-or.gov
RECEIPT NO: 2013001185 RECORD NO:811SPR2013-01222 DATE:06/10/2013
{e1 1th lJltlfoll __ $ n'_':'° 2i '?r...-: -ACCOUNT.-' o e q..: : . 1 o e Y;= -AMOUNT'iDUE. 1
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Service reconnect only 224-00000-426102 1004 69.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.62
Technology fee(5%of permit total) 100-00000-425605 2099 4.43
TOTAL DUE: 103.55
_PAYMENT TYPE „-, ;s PAYOR 4 'I - ztk ., S _= ''COMMENTS L re "$ 2 w t AMOUNTPOJD?t'_ _ r,4_
Check CHARLES E&TREVA J HORINE LIVI 103.55
6104 TRUST
TOTAL PAID: 103.55
Electrical Permit Application DEPAkTMENT:USE ONLY SPRINGFIELD____
‘tjCITY5()FSPRINGFIELD.ttOREG-ON II
Permit n° Ze (3 t7 1 222-
• itlk::1;;,.34,:..•**it2:4:sritr:•;:,:-;fs•th•i•crmrcr4,43,47- it-4::.••::•,€4• 11.4i1 riFt ,:
225 Fifth Streets Springfield,OR 974779P11(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.
CALCGOVERN M Emu?p ROVAL;;T:tiVAN':,* ::`,ER:ics&I,AlaaltizTEEit:SPHERCICEttglkt:Wc•:Ni
Zoning approval verified? E Yes E No 4- , ,, 2rig4t4IP44(V , nettc:c vc25is, Total,";Qty tost
PV„:iCATE6ORYSOFis,PONSTRUCTION:7:ktiniM1 -
Residential,per unit,service included:
1p Residential 0 Government El Commercial
- 1 000 sq. ft. or less(4) $147.50 $
:JOB-2:1SITE:31NEORMATIOWANES5,`LOCATIOWthiOn
Each additional 500 sq.ft.or portion
Job site address: 9. W thereof - $ 27.50 $
City: Se't State: 6.(' ZIP: 97 hI 77 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular
dwelling service or feeder(2) $ 69.00 $
Services or feeders: installation, alteration, relocation
Ms°in tr cPcevvietcf, ea) 0.3e2
200 amps or less(2) $ 89.00 $
Czikreftragar:IPIR 0 RE RTlY40-WN E 201 to 400 amps(2) $ 104.50 $
Name: oQ H tn_e.
401 to 600 amps(2) $174.00 $
Ltd, ct
Address: 9 tic \ t\j ( st 601 to 1,000 amps(2) $225.50 $ •,
Over 1,000 amps or volts(2) $516.00 $
City:Stpci "'tuck 2_10Q I State:(9c, ZIP:q 7-4 7 7
Reconnect Only(2) $ 69.00 $
Phone: ,5--21 M] _ 73-3 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 $ 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
479.5400)an 79.560(1 4 401 to 600 amps(2) $138.50 $
Signature: 24..efosz
0 Over 600 amps or 1,000 volts,see services or feeders section above
4.?:.-144,:q6briCONIERACTWINSTALIZATI 0 N 4i 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 3 $ 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
Signin supervisor's license no.: _
Each pump or irrigation circle(2) $ 69.00 $
g
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 $
ktritieli";i4RWEICOUU:StlieTalleMii
(A) Enter subtotal of above fees
(Minimum Perm it Fee$80.00)
(B)Enter 12%surcharge(.12 x[A])
(C)Technology Fee(5%of[A])
TOTAL fees and surcharges(A through C): $(03
440-2584-1(4/01/2013/C0M)