HomeMy WebLinkAboutPermit Electrical 2013-6-11 .. - SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR 97477
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Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
. PERMIT NO: 811-SPR2013-01230
www.springfield-or.gay pe rmitcenter @s pringfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/11/2013 EXPIRES: 12/07/2013
STATUS DATE: 06/11/2013 • APPLIED: 06/11/2013
SITE ADDRESS: 7945 S C ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702363004703 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Extend service mast thru roof, reconnect only
OWNER: BUNDRANT JAMES L&SHARON Phone Number:
ADDRESS: 7945 S C ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
II
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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 11
Inspections
4200 Reconnect 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.
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the teleph..
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR .
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
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Springfield Building Permit 6/11/2013 9:48:34AM Page 1 of 1
- SPRINGFIELD CITY OF SPRINGFIELD
lilt 225 Fifth St
t02EGON TRANSACTION RECEIPT SpringfieldoR 97477
541-726-3753
811-S PR2013-01230
www.springfield-or.gov 7945 S C ST permilcenter @springfield-or.gov
RECEIPT NO: 2013001188 RECORD NO: 811-SPR2013-01230 DATE:06/11/2013
;DESCRIPTION.'_=_ «. ACCOUNT CODE/TRANS CODE,- . :__AMOUNT DUE-,_-I
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00
Service reconnect only - 224-00000-426102 1004 69.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
"AMOUNT PAID
L PAYMENT TYPE : - PAYOR,„ cnswER ccnaPeNrER ,_ ,COMMENTS' - ., ;=" ,;;,... .._,_.._.... ..- v . • ,I
Credit Card Roger King v_ay._�____..�_ -- —"` 93.60
01163g
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY :
- SPRINGFIELD 3.,^^^�
=4CITIWE SFRINGFIELWOREG-6W l3- (�3O
Permit no.:
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 //"^
Date: W// //(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.
'ii=LOCAL= GOVERNMENT APPROVAL as= 2 FEE'SCHEDULE vi: ,'*,
Zoning approval verified? ❑ Yes ❑No ',Number of inspections per item}Orx, Qty osthr:'
i c.; CATEGORY-OFSCONSTRUCTION Residential, per unit,service included:
, Residential ❑ Government ❑Commercial
?��
JOB;SITE::INFORMATION=?AND LOCATION"!`, 1,000 sq. fr. or less(4) $147.50 $
Each additional 500 sq.ft.or portion
Job site address: 7$1S C ST. thereof - $ 27.50 $
City: 'S PC-D State: 0 ZIP: cI 7 / 7 SS Limited energy(2) $ 35.00 $
Reference: Taxlot : Each manufactured home or modular $ 69.00 $
' z DESCRIPTION'jOF WORK;: - , ' S =Y dwelling service or feeder(2)
�.x?Er✓D Yr)AS T 'i-ARou g00 F Services or feeders: installation, alteration, relocation
200 amps or less(2) $ 89.00 $
Ril 'Z, ;141— ), `=;PROPERTY,,:OWNER 'r. 201 to 400 amps(2) $ 104.50 $
Name: go,vpy -/✓7- 401 to 600 amps(2) $174.00 $
Address:79q,j G Sj 601 to 1,000 amps(2) $225.50 $
City: syR..1, State:77X_ ZIP: '177Y Over 1,000 amps or volts(2) $516.00 $
Phone: - - Fax: - - Reconnect only(2) J $ 69.00 $ 6<1
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
479.5400)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
-r ,CONTRACTTOR,,,INSTALLATION " - :,' Branch circuits:new alteration, extension per panel
Business name: 6 as-r$/D E E LCG7/C i6 a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 31, .s'3 3OSCAGE Ltiv6 Each branch circuit - $ 6.50 $
City: 5 P F L 9 State: OR ZIP: 9 7 V 7 g b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: -7 -( ^/ y 9 9 Fax: 7 36- V cJ 4 0 First branch circuit(2) $ 60.50 $
E-mail: R p K J 96 J a 7 A 1') Ub• coin Each additional branch circuit $ 6.50 $
CCB license no.: t J7 70 BCD license no.: 20^y OS'C Miscellaneous fees:service or feeder not included
Signing supervisor's license no.:., 4-17 27 S Each pump or irrigation circle(2) $ 69.00 $
I`
Print name of signing supervisor: O C(2 t‹)to 6- Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: (2-0 -2/%4 Signal circuit or a limited-energy panel, $ 80.00 $
-0 alteration,or extension(2)
Each additional inspection:(1) $80.00 $
"r`r ,.. 1 s 1.00.:`ICANTJT USE µ ,1 4211 A 1
(A) Enter subtotal of above fees $ ^
(Minimum Permit Fee$80.00) WOi
(B)Enter 12%surcharge(.12 x[A)) $ 5 CLo___
(C)Technology Fee(5%of[A)) $ 69—
TOTAL fees and surcharges(A through C): $
440-2584-3(4/01/2013/COM)