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HomeMy WebLinkAboutPermit Electrical 2013-7-8 SPRINGFIELD 225 Fifth St hr CITY OF SPRINGFIELD Springfeld,OR 97477 .0 Phone: 541-726-3753 IOFEGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01549 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/08/2013 EXPIRES: 01/03/2014 STATUS DATE: 07/08/2013 APPLIED: 07/08/2013 SITE ADDRESS: 1106 J ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703264414200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Meter Base and Panel OWNER: SEATON ERNEST A JR&S N Phone Number: ADDRESS: 1106 J STREET • SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor ROY HAROLD HAUGLAND GCB 138110 10/26/2013 541-343-9030 INSPECTIONS REQUIRED Inspections • 4225 Service or Feeder 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 ATTENTION: Oregon law requires you to iOTICE: follow rules adopted by the Oregon Utility . Notification Center. Those rules are set forth ;HIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by \UTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR calling the center. (Note: the teleph:.c, number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1.800-332-2344). Springfield Building Permit .7/8/2013 1:47.47PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD St _.1 .(`�s. 225 Fifth St `ONEGON TRANSACTION RECEIPT SpringfielQOR 97477 541-726-3753 811-SPR2013-01549 www.springfield-or.gov 1106 J ST permitcenter©springfield-ocgov RECEIPT NO: 2013001457 RECORD NO: 811-SPR2013-01549 DATE:07/08/2013 1DESCRIPTION� . . ;� . __AC000NT CODE/TRANS CODE - - AMOUNT DUE__ Services 200 amps or less 224-00000-426102 1004 178.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 21.36 Technology fee(5%of permit total) 100-00000-425605 2099 8.90 TOTAL DUE: 208.26 L PAYMENT TYPE_PAYOR CASHIER:CCARPENTER _COMMENTS . AMOUNT PAID_ Check ROY HAROLD HAUGLAND 208.26 6987 TOTAL PAID: 208.26 Electrical Permit Application ,--., DEPAFtTMENTUSE ONLY C ? J J�J — / �. 9 ITY CIF SPRINGFIELWOREGO . a—tea ��( s...kv = c " ' ;, y,,, , �,' 'f P:_ Permit no.: 225 Fifth Street•Springfield,OR 97477♦PH(541)726-3753♦FAX(541)726-3689 '`` / 'ade Date: (/?-7/5/3 , 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. i, . , :LOCAL `GOVERNMENT:APPROVAL 4'^, t ,: = t. .9 'FEE,'SCHEDULE , -,r- x; ,'`,t Zoning approval verified? ❑ Yes ❑No ;:Number of inspections per item() Qty`s .east costl,i'' CATEGORY:',OF„ CONSTRUCTION ' Residential,per unit,service included: ErFesidential ❑ Government ❑Commercial ,.. 1,000 sq. ft.or less(4) cc $147.50 $ r, , JOB`,SITE;".INFORMATION';AND LOCATION ,> m , Each additional 500 sq.ft or portion ' Job site address: / ( d (o j 5 T thereof p______$ 27.50 $ City:3Pg Fr N ' State: 0 2 7.y.27 7.y.27 ZIP: / � � Limited energy(2) $ 35.00 $ l Reference: i7,7 &L% v Taxlot.:/`/ZQO Each manufactured home or modular $ 69.00 $ . < .....-. dwelling service or feeder(2) ',, ,,, 'ADESCRIPTION';QF;W2ORK i > - P4.-ACJ /VL(- !t 2. � 1-S /IAJ1, Services or feeders: installation, alteration, relocation ?��� l 200 amps or less(2) 1/ $ 89.00 $ (iS .ru`[3 j c,�:r •?PROPERTY:=OWNER=,[ , ' :" x5] 201 to 400 amps(2) $ 104.50 $ Name: et N 1 F S-�Tr, ,1/4.) 401 to 600 amps(2) $174.00 $ Address: (U (, J S 601 to 1,000 amps(2) $225.50 $ City: SY ,�[. , State: b < ZIP: q 7 '7 7 Over 1,000 amps or volts(2) $516.00 $ Phones'((- )y? a i (,, Z 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 intended for sale, exchange, lease, or rent. OAR 479.540(1)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 , ..;'i-,i,rte CONTRACTORr.INSTALL'ATION t' t..,.,,.a Branch circuits:new, alteration, extension per panel Business name: „q_,L,C. r j,,,,...4.\ —/ _Co ..S a. Fee for branch circuits with purchase of a service or feeder fee: Address: A c . 3ok l q ( Each branch circuit $ 6.50 $ City: 5/2 Q t'L- 11 State: d iC ZIP: 2 V7 7 b.Fee for branch circuits without purchase of a service or feeder fee: Phone: SYI 3 y-3_ qt o3 p. Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: /3E/ /n BCD lice- no.: Miscellaneous fees:service or feeder not included (- -/1 Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Rot/ h�yl 6i 4-,U n Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: Signal circuit or extension(2)energy panel, $ 80.00 $ alteration,or extension(2) Each additional inspection:(1) $80.00 $ x €` tin- APPLICANTrUSE...,, a;r °"s}Kt`kxr? "gi (A) Enter subtotal of above fees $ / (Minimum Permit Fee$80.00) (7 h (B)Enter 12%surcharge(.12 x[A]) $ Th (C)Technology Fee(5%of[A]) $ 3 9° TOTAL fees and surcharges(A through C): $ZAn p 2{' 440-2584-1(4/012013/COM)