HomeMy WebLinkAboutPermit Electrical 2013-7-16 SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfeld,OR 97477
'�(\`OEGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01603
www.springfield-or.gov permitconter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/16/2013 EXPIRES: 01/11/2014
STATUS DATE: 07/16/2013 APPLIED: 07/16/2013
SITE ADDRESS: 422 S 37TH ST ADU,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702314302701 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Electrical for ADU
OWNER: PARKER CLAY D II&KATIE D Phone Number:
ADDRESS: 422 S 37TH ST
SPRINGFIELD OR 97478
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor INTERSTATE ELECTRIC INC CCB 117121 09/05/2014 503-393-2223
Plumbing Contractor 3T PLUMBING INC CCB 147077 03/04/2015 503-932-2719
Mechanical Contractor PACIFIC AIR COMFORT INC CCB 39237 03/25/2014 - 541-672-9510
General Contractor ADAIR HOMES INC CCB 593 03/19/2014 360-448-6050
L INSPECTIONS REQUIRED r
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
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4999 Final Electrical Final Electric: When all electrical work is complete.
4220 Electrical-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.
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Owner or Contractor Signature Date
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Springfield Building Permit 7/16/2013 10:04:23AM Page 1 of 1
Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD /
Si FUN FTE°LD, ORE CON L t Permit not6/3.: $/r - O/ 0 3 p(
225 Fifth Street•Springlield,OR 97477•PI1(5111726-3753•FAX(541)7263689 Cs OREGON t
LI ZZ S . 3fL S1— Dale: l'
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if w started within 180
days of issuance or if work is suspended for ISO days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Number of inspections per item() Qty. Cost Total r
ea. cost
CATEGORY OF CONSTRUCTION Residential,per unit,service included:
V(Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION
1,000 sq. ft.or less(4) $147.50 Sir/75%y
Each additional 500 sq. R.or portion fb
/ $ 27.50 $1'7
Job site address: ,y S, 3 7 - .5-7S thereof
City:S ,:sm`,.. l q a State: Cte ZI P:5.79-77 Limited energy(2) $ 35.00 $
Reference: V Taxlot.: Each manufactured home or modular g 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
i
fiS / e F� Services or feeders:installation,alteration,relocation
U 200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: nip-, 401 401 to 600 amps(2) $174.00 $
Address: 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 $
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
property is not intended for sale,exchange, lease,or rent.OAR P (2) $ 96.00 $
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
CONTRACTOR INSTALLATION Branch circuits:new alteration,extension per panel
Business name: ,p jade 5 iN C a. Fee for branch circuits with purchase of a service or feeder fee:
Address:/2 J, /30 x 73 YZ Each branch circuit $ 6.50 $
City:_y,446„..„ State: 0),C. ZIP97.303 b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: S-g3-^1?-3-2,11 3 Fax: 8733 3?3 5722 First branch circuit(2) $ 60.50 $
E-mail:
Each additional branch circuit $ 6.50 $
CCB license no.: //'7/2/ BCD license no.Jq jS VC Miscellaneous fees:service nrfeeder not included
Signing supervisor's license no.: 4 j-6/S Each pump or irrigation circle(2) S 69.00 S
Print name of signing supervisor:,e Cc ki /4744/Z ti Each sign or outline lighting(2) S 69.00 $
Signature of signing std ervisor: _e, -ice Signal circuit or a limited-energy panel, $ 80.00 $
signing p z- alteration,or extension(2)
Each additional inspection:(1) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees /7,.5
(Minimum Permit Fee$80.00)
(13)Enter 12%surcharge(.12 x IAJ) $ 2
(C)Technology Fee(5%of IAJ) $ ej7J
440-2584-J(4/012013/COMI) TOTAL fees and surcharges(A through C): $.10"1,7:
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
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'P' `CO OREGON TRANSACTION RECEIPT 6pringfh St 97477
541-726-3753
811-SPR2013-01603
www.springfield-or.gov 422 S 37TH ST ADU permitcenter @springfield-or.gov
RECEIPT NO: 2013001541 RECORD NO:811-SPR2013-01603 DATE:07/16/2013
IDESCRIPTION _.«._ . _ ' _ - _•-.._. ACCOUNT,CODE/TRANS.CODE ,,,,,.. CAMOUNTDUE:7:
Each added 500 sq.ft. or portion 224-00000-426102 1004 27.50
Residence wiring 1,000 sq.ft. or less 224-00000-426102 1004 - 147.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 21.00
Technology fee(5%of permit total) 100-00000-425605 2099 8.75 ,
TOTAL DUE: 204.75
,PAYMENT TYPE PAYOR CASHIER DBOWLSSY __ `.-''_,COMMENTS -. 'AMOUNT PAID.:
Check INTERSTATE ELECTRIC, INC. 204.75
19488
TOTAL PAID: 204.75
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