HomeMy WebLinkAboutPermit Electrical 2013-7-24 •
SPRINGFIELD • 225 Fifth St
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CITY OF SPRINGFIELD Springfeld,OR97477
Phone: 541-726-3753
DRE°°" Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01680
www.spnngfieldor.gov . - permitcenter @spnngfieId-or.gov
PROJECT STATUS: Issued ISSUED: 07/24/2013 EXPIRES: 01/19/2014
STATUS DATE: 07/24/2013 APPLIED: 07/24/2013
SITE ADDRESS: 422 S 37TH ST ADU,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702314302701 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: CAN,CATS, Phone and Audio/Low Voltage
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
- INSPECTIONS REQUIRED `
Inspections
•
4550 Limited Energy •
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 e re that all required inspections are requested at the proper time,that each address is readable from the street,that the
per ads loca -• . - - • • •- -••roved set of plans will remain on the site at all times during
a
%t.Si-i Heliiiiimpii ce `(- zo t 3
.�lr —' .Date
Nuf��/--
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
NOTICE: Notification Center. Those rules are set forth
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&n:
COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification
NY 180 DAY PERIOD. Center is 1-800-332-2344).
•Springfield Building Permit 7/24/2013 11:53:31AM Page 1 of 1
. SPRINGFIELD ---- CITY OF SPRINGFIELD
"
TRANSACTION RECEIPT Spnngfield`OR97477
OREGON - 541-726-3753
811-SPR2013-01680
www 9pri19991d-or.gov 422 S 37TH ST ADU permitcenter @springfeld-or gov
RECEIPT NO: 2013001626 RECORD NO:811-SPR2013-01680 DATE:07/24/2013
m a- J-ej, as .4 .. - _ .
bESCRIPTION �I � ���u:�. a- ���.�."= .e�`n-"��ACCOUNTsCODERRRNS�CODE�`�. s@ !f� �MO NT,DUE
Audio/Stereo 224-00000-426102 1004 69.00
CCTV 224-00000-426102 1004 69.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 16.56
Technology fee(5%of permit total) 100-00000-425605 2099 6.90
TOTAL DUE: 161.46
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�`�PA`LMENT�TYP,E �PAYOR �cnsliiER:,NMncNnoo= . yy., COMMENTS��� .� ... - -.� �= a;.'pMOUNTOi?AIDWM
Cash Clay Parker 161.46
TOTAL PAID: 161.46
Electrical Permit Application :::.., bEEfARtMENT:USE ONLY
SPRINGFIELD v,w....�.. • „� ,,,
* 33E,: .c. 'r' ;.:i21,1,3kc X.S.':-+ ?3it3.,?MYicir1i*(8147 ,.1;1� _
'Atnf-eTY F�SPR �F,�. ,Dj tnR '' V:p^ b ,.. 0. ; Permit no.: �j/ t 2,013 O� O
225 Fifth Street.Springfield,OR 97477*PH(541)726-3753•FAX(541)726-3689
Date: 247/-5
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.
x,4 ..ii ilr:OCAL= GOVERNMENT tAPP. ROVAL=, _ ig ,' 14 0,11.1 W EEE.`SCHEDULEvast :1„ ` , , ;3
Zoning approval verified? ❑ Yes ❑ No number of msp on`sper item O ri Qty,.1.1-s$eay",'I x cost.,.=;
,;`+:Olie44(aCATEGORY OF�`t,CONSTRUCTION y x17:71P5 ,t:,
Residential,'per unit,service included:
El Residential ❑Government ❑Commercial
`JOBvSITE:INFORMATION AN D,,LOCATION':', k t 1,000 sq. ft.or less(4) $147.50 $
Each additional 500 sq.ft.or portion
Job site address: c-1a,2 5 37 n" 5.9- thereof - $ 27.50 $
City: spf(k\ State: (9-C" ZIP: .\ 7(/75 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
c ?1 �. ,� �, - dwelling service or feeder(2)
„ I„ °�DESCRIPTION�OF�;WORI( .. , , a'r„
VVl
�� Services or feeders: installation, alteration, relocation
'A t ' , 200 amps or less(2) $ 89.00 $
L7 lM7 J to l
k ice; g a P.RQPERTY''QWNER i _,=t�,,. a - 201 to 400 amps(2) $ 104.50 $
Name: , P _'^l�r 6,-- Q 401 to 600 amps(2) $174.00 $
Address: (-/Z^ S0 .i t^ ,374_ 3 4. 601 to 1,000 amps(2) $225.50 $
Over 1,000 amps or volts(2) $516.00 $
City: s��iti ',�� state:Q(I ZIP:S7�7S
Phone:5y-g7(9 3s3s I 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 o _(t� .. immediate family. This 201 to 400 amps(2) $ 96.00 $
+e..:
property is •.�$'ii r-• ..e lease, or rent. OAR
479.540 . ,t 60(1). �\�� 401 to 600 amps(2) $138.50 $
Signal ie t1���=�� Over 600 amps or 1,000 volts,see services or feeders section above
,,_ .V _ _„x�_�„—�.' i 9N ) _ ,�,. ,:„'i. Branch circuits:new alteration, extension per panel
Business n."�����J a. Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 6.50 $
City: e: I ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - I Fax: - First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB tense 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 $
Signature of signing supervisor: Signal circuit or alimited-energy panel, $ 80.00 $
alteration,or extension(2)
Each additional inspection:(1) $80.00 $
t i - -r- r”' r °nf - WA"'
- _� ''W .#�APP�LICANTIUSEa ,'4sFs-`t"r,>
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) ' $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges (A through C): $ /6/.L/S----
440-2584-1(4/012013/C0M)