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HomeMy WebLinkAboutPermit Electrical 2013-6-19 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfeld,OR 97477 k iOREGON Phone: 541-726-3753 Building I Residential Permit Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01325 www.spdngfield-or.gov permitcenter(©spengfeld-or-gov PROJECT STATUS: Issued ISSUED: 06/19/2013 EXPIRES: 12/15/2013 STATUS DATE: 06/19/2013 APPLIED: 06/19/2013 SITE ADDRESS: 1629 F ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703362116500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Reconnect OWNER: OTOOLE-PAULUS SHANNON L&PAULUS WILLIAM Phone Number: ADDRESS: 1629 F 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 INSPECTIONS REQUIRED 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. :,g>-- CQ ( ICI (C3 Owner or Contractor Signature Date !NICE: • 'HIS PERMIT SHALL EXPIRE IF THE WORK UTHORIZED UNDER THIS PERMIT IS NOT • ATTENTION: Oregon law requires you to JOMMENCED OR IS ABANDONED FOR follow rules adopted b"y the Oregon Utility Notification 01-0010 thr a rilles are set fora ANY 180 DAY PERIOD. in OAR 952-001-0010 through OAR 952.00tt, 0090. You may obtain copies of the rules bar calling the center. (Note: the teleph•,, . number for the Oregon Utility Notification Center is 1-800 332 2 • Springfield Building Permit 6/19/2013 11:37:36AM Page 1 of 1 SPRINGFIELD `" CITY OF SPRINGFIELD ilit e 7* OREGON TRANSACTION RECEIPT Sp 225 Fifth$t fth St R97477 541-726-3753 811-SPR2013-01325 www.springfield-or.gov 1629 F ST permitcenter @springfield-or gov RECEIPT NO: 2013001269 RECORD NO:811-SPR2013-01325 DATE:06/19/2013 (al Xi_CAIIMAfe11 -w "°"'•rt-1t --*CSr a`"gCC a ACCO ∎. • 0a a'.: - CODE " 7fi -AMOUNTDUE'`'`' 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 PAYMENT. _ .PAYOR EMIERxccanPErirErr _. COMMENTS AMOUNT#PA ID _ Credit Card OTOOLE-PAULUS SHANNON L& 93.60 091624 PAULUS WILLIAM TOTAL PAID: 93.60 Electrical Permit Application ,i. ., bEP.ARTNIENTAISE ONLY :'r.' zfv;.,..:,::..?4,:..i::. ;?:-.7;‘,,i,si•.:!(..-:-:,thtstv.:wrt4;14.59,-.4%?;e7griaz.:44,-,.;“. ..if.i24;:f.,,, ;CoITY,,,OFSPRINGFIELD_,t'OREGON-a: -:-*-t-'' - :--c-q-, p - 5/3 — paLzsi-eb,t,:e.*.rai:,..9, --t.,11.....!;-,5:4c,gyk,,,,IsReptayizpo . ' • — . •emut no.: 225 Fifth Street•Springfield,OR 97477•Pf1(541)726-3753•F4X(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. e„— ( ;;::1,.:Lekit..14iLrocAL... gov,ERNiviENTiAppROVAli-;• ;:i.g4t-: •:::.1.:V1-,,Moia-1.44.9FEE::::SCHED.ULE:'4eliza&HEMUIVth Zoning approval verified? E*es 0 No .1-t.44-----tkitit.TtibitAliilltiiiVirittl=13-21,'W lr:#ric-6§€4 iluT661,-j If'rNiinli*l9f1PC4Cii.C111.sl*tilrllActitil:9tx:lwe-a\tv:,,,,,,l -c-a§t.t; :'•;:,: e:irrNtATEGtiqy.,50F.::;:cONSTRUCTION-StiMpW4. -'" x '"'''-"'-• - ' -'4'''''' '1- ''''-a!" --z ' 'a i Residential,per unit,service included: .i..., cliiesidential III Government 0 Commercial - . . tsiTEJNEORmATiON., . -,..: .,.. 1,000 sq.ft.or less(4) ) Arifc1.10BLLANDL;;LIOCATION?Z* $147.50 $ site address: l(0 act I .s4-, Each additional 500 sq. ft.or portion Job s thereof - $ 27.50 $ City: epiii,141c d A State: 611,_ ZIP: cf 7y 77 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ Vil7.7:`,MNA1Riglp ESCRIPTION,k3,0Fg.-VVORKY:iti:V.4:;;MC: 1 dwelling service or feeder(2) Services or feeders: installation, alteration,relocation ea....cni141.4.4 ie—le.04-rli C. 200 amps or less(2) $ 89.00 $ Miiril:1-1;14.:MnPF.ZORERTY40.WNER:ClliWl..:licrkill:R 201 to 400 amps(2) $ 104.50 $ Name: 5\natty's)," L. 0 To4k _ Pew s 401 to 600 amps(2) $174.00 $ Address: t(c, 2,-, c--, 5-1-. 601 to 1,000 amps(2) $225.50 $ Over 1,000 amps or volts(2) $516.00 , $ City: S 9 v't iitg cLit State:ea., ZIP: C17 c-t-7-7 Reconnect only(2) ( $ 69.00 $1, Phonefq, -31-i- le.4 2-7 Fax: - - E-mail: alun Temporary services or feeders: installation, alteration, relocation slci./.44cl, 5: 200 amps or less(2) This installation is being made dfi 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)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signaturea A,....,„ . .... C) .+.s. -..9ca.....---- Over 600 amps or 1,000 volts,see services or feeders section above .1 tilikinlitlill: 1 TRACTO +1114STALLATIONe;if7.':77,L4,NL,g*:1" Branch circuits:new alteration extension per panel Business name:(7e....1 Okle.c.--7----- 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 1 $ CCB license no.: 1 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 $ rialitt.: :,:sigrailadrataUtinaliiing (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ TO-0-G e-- (8)Enter 12%surcharge(.12 x[A]) $ C? ef3t (C)Technology Fee(5%of(A)) $ TOTAL fees and surcharges(A through C): $ ?ICS) 440-2584-J(4/01/2013/COM) Property Owner Statement • Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. • Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or • I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. r 0-(iuv -- Wye - aw A3 S • Print Name of Permit Applicant (� let_ t3 gnature of Permit pplicant Date Permit#: S I 3 ' /5Z 5 o F- o 5 Address: 41 set- 4%7- FQ resit i0 n N �a:I Issued by: `�6Y -- Date: a//�!// 3 �e•59/ This Copy for Permit Offices