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Home My WebLink AboutPermit Electrical 2013-7-18 SPRINGFIELD'-- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 %x+ Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811SPR2013-01621 www.spnngfield-or.gov permitcenter @spdngfleld-cr.gov PROJECT STATUS: Issued ISSUED: 07118/2013 EXPIRES: . 01/13/2014 STATUS DATE: 07/18/2013 APPLIED: 07/18/2013 SITE ADDRESS: 1536 VERA DR,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703243100100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Branch circuit for outbuilding • OWNER: COMBS GREGORY R&GAIL JOY Phone Number: • ADDRESS: 1536 VERA DR 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 III 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. yak. 7/813 Owner or Contractor Signature Date • • ATTENTION: Oregon law requires you to NOTICE' follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center:Those rules are set forth • in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT . 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephcm ANY 180 DAY PERIOD. ' ' number for the Oregon Utility Notification Center is 1-800-332-2344); Springfield Building Permit 7/18/2013 8:33:44AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD t 225 Fifth St 4 TRANSACTION RECEIPT Spnngfield,OR 97477 541-726-3753 OREGON 811-SPR2013-01621 www.spnngfieldor.gov 1536 VERA DR permitcenter @spdngfield-or.gov RECEIPT NO: 2013001559 RECORD NO:811-SPR2013-01621 DATE:07/18/2013 1il) Y47:71-Wroir9 j. ..,L1s {„'_.fit _ 1 , �1� +A CCOUNTCODE/TRAN5CODE _'_� __=F inaliThiMaa Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00 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 AYNIE ICr—th-E 'niP,AYOR .cas iaWaARPENTER _ COMMENTS AMOUNTE.M.P.. . '; t','-'•'I Credit Card COMBS GREGORY R&GAIL JOY 93.60 763787 TOTAL PAID: 93.60 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 J -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. Print Namel Permi Applicant • Signature of Permit Applicant Date • Permit#: `'' ` 3 / 27 o f • • /5 340 ✓ oor- �, Address: Q:f.:•+a�c?q /!a:,o po pt., 47'f7 _ X1//7/73 Issued by: � Date: g59 • This Copy for Permit Offices Electrical Permit Application : , bEpARTmENT-ysEoNLy. .--: :SPRINGFIELD r . .,,rCY,,,:;.p“.:.:F,,4,,,:,3,So.,..,•;&iPi..,iesiRr.-t,.eI...,2rN2a„:47G„5,:isi,ttL.7Dmit10,--4:.1--.•:i-it.,,o„,E,,.,...:GON * 4gpi ,ermit no /I -16 2/ 225 Fifth Street•Springfield,OR 97477•PH(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. :,(:,:91Ng-5.M1:0Cr0);:00),/,ERNMENITA FIR ROYA:L±:fitiiti,y±,ii ri+0.4:;:ttiaitterPFEEirSCFIE.p.u6Eiey4wintm'cki • Zoning approval verified? 0 Yes 0 No ZP.S4:-',211,:fast1SSII41SWETattrit-_,S6-ang4fr:-,Ther4,-C-r,-;;ia,C-.8iff:A taccti'lli. e/Number,otinspections-perAcmft.t711!,.$1. 1w t‘. 'CoSIN' --;::4-r-T.40CATEGI5F,ZYslifOFA:CONSTRUCTIO6GaTgg: W“Ca'C'''M'.a..".''''i:-.1''''''' ' ' s'Pf: "''''' .74'4' --.t' - ' a:3 Residential,per unit,service included: 0 Residential . 0 Government 0 Commercial 1,000 sq.ft.or less(4) $147.50 $ ::::,e!:::VJOB.LISITE:::i1NFORIWATIO.WANDIle.CATION' 47, Each additional 500 sq. ft.or portion Job site address: IS 3(a t/era. V.Q- thereof - $ 27.50 $ City: 5?),-;".P .2Q State:Oe ZIP:97C/77 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular dwelling service or feeder(2) $ 69.00 $ 1;c5:,,::: ':',0aIDESCRIP,TICIWIOF:illWORKr:i;j:`i*?t:If', .i3`25`. Services or feeders: installation, alteration,relocation 7 . flitorlbC/1 el/24-I-4/..— 200 amps or less(2) $ 89.00 $ .::aeti7t;.100k471.NWARORERIWAOWNEW71F12.n1i:41zP.V./.a,,a 201 to 400 amps(2) $ 104.50 $ /) 401 to 600 amps(2) $174.00 $ Name: (a-rq oty P. (to Atm b 5 601 to 1,000 ampS(2) , $225.50 $ Address: (9,04 17 4 s 0 ,a-kce) City: State: ZIP: Over 1,000 amps or volts(2) $516.00 $ Phone:"5-z--1 t -7q 7_797(/ Fax: - - Reconnect only(2) $ 69.00 $ E-mail: k-7 ,,e ceako-o Temporary services or feeders: installation, alteration, relocation Z- 6 . 0,0-.).—._ 200 amps or less(2) This installation is being‘Aade 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 479.540779.560(Lt 401 to 600 amps(2) $138.50 $ Signature: , ttc"? deo Over 600 amps or 1,000 volts,see services or feeders section above Mg`gcONTRACTPFeINSTALLATIOW.:;1::::: tgii,>ilw Branch circuits:new alteration, extension per panel Business name: -1,JA_/e71 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) i $ 60.50 E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: 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:(I) $80.00 $ earatiVErgWEIC7MTVLICENSM*7444.11 (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ TO (B)Enter 12%surcharge(.12 x[A]) $ 9 6,0 (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $ 3€6)-- 440-25844(4/01/2013/COM)