HomeMy WebLinkAboutPermit Electrical 2013-7-22 SPRINGFIELD-.... 225 Fifth St
` <-- CITY OF SPRINGFIELD Springfield,OR 97477
1\`
OREGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01653
www.sprtngfield-or.gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/22/2013 EXPIRES: .01/17/2014
STATUS DATE: 07/22/2013 APPLIED: 07/22/2013
SITE ADDRESS: 1820 G ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703362111701 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Sub panel and 7 circuits
OWNER: HEISLER DAVID E Phone Number:
ADDRESS: PO BOX 1985
EUGENE OR 97440
CONTRACTOR INFORMATION
•
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
L. INSPECTIONS REQUIRED
•
Inspections
•
4225 Service or Feeder
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. 2/2.11?
Owner or Contractor Signature • Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001- NOTICE:
0090. You may obtain copies of the rules by
calling the center. (Note: the telepl; ) THIS PERMIT SHALL EXPIRE IF THE WORK
number for the Oregon Utility Notification +UTHORIZED UNDER THIS PERMIT IS NOT
C
•
enter is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR ,.,T _•
.,,JY 180 DAY PERIOD.
Springfield Building Permit 7/22/2013 8:49:00AM - Page 1 of 1
SPRINGFIELD- CITY OF SPRINGFIELD
225 Fifth St
, TRANSACTION RECEIPT Spnngfeld,OR 97477
101. -b------ � 541-726-3753
'OREGON 811-SPR2013-01653
www.springfield-or.gov 1820 G ST permitcenter@springfield-or.gov •
RECEIPT NO: 2013001592 RECORD NO:811-SPR2013-01653 DATE:07/22/2013
Le] agillrea[o11( !;};_ rst t kt:12 0.-4:; M.ACCOUNT•CODE/TRANS CODE t s_argAMOUNT o r;.
Branch circuits with service or feeder each circuit 224-00000-426102 1004 45.50
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 16.14
Technology fee(5%of permit total) 100-00000-425605 2099 6.73
TOTAL DUE: 157.37
BAYMENTfT;Y,RE P..AY.OR -cAS8ET„JLARSaR COMMENTS AMOUNTOP,AID
Check HEISLER DAVID E 157.37
4354 •
• TOTAL PAID: 157.37
•
•
. . . ., ... ... _ . ,-. ... _, .... .
- Electrical Permit Application :: - DOARTMENtiUSEONLY: :*';'_;SPRINGFiELD
rw;ikreak,:".ccrarluKtrc-',;: e.rasAcw,ccry-ter..-..7.7r.kecaewer-wa t
treITPORSPRINGFIELDwOREGON-741 , Permit no.: 9 3 -/6 C-3
pe.:ith:4;4i,,,ssa,,,.::=.:.,-,;=„.,4:7. ....kchvii,g24;:tig.ra.-.4,41,i-rni etis. b
225 Fifth Street•Springtield,OR 97477*P1.1(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.
;q:tt,::NZNifoOAIA:60V,ERNMENINAP,,PROvioiy-denW .5M-W.kaeRVIVFEEi.t'SCHEDULEA4UittSAM4.Y:"Wb
Zoning approval verified? 0 Yes D No &i.i'llitit*ISTWitCni "-"A -V at4-Z1::At C8$6?,:.7;:.- 061-•
IPM-Ir'21:TWC,Stilrs'UrntETS,(40 rgtr;Lifil-eir&i,1C-tetiSit:
RM:.;?lier,t.TAICATE601300,FSC.0 N SIM)CTIONOtailt - ----- 4"''' '---' - " ''''' •-2' ----- - 6'''
Residential, per unit,service included:
Residential 0 Government 0 Commercial
1,000 sq. ft. or less(4) $147.50 $
20,VJOBTISITE;;;INFO_FtrWATIO.NANDNECOTIONV,VA•
Each additional 500 sq ft.or portion
Job site address: / 8-2,0 G SH-A-ext thereof - $ 27.50 $
City: Sp c--n.‘\ta State:Ge.. ZIP:qi/-1 77 Limited energy(2) $ 35.00 $
Reference: /76.2 32/ Taxlot.:77 7j/ Each manufactured home or modular
$ 69.00 $
W4:7‘S'YeNtrAID(SCRIPAITIONkbEij.wORKW,4WFV.:UM dwelling service or feeder(2)
Services or feeders: installation,alteration,relocation
G Ckweest C ; VI 5-L't+0 S4 41 ILA
200 amps or less(2) $ 89.00
atiatiMMikPPRoRERTAbwNERaf,MWATARI 201 to 400 amps(2) $ 104.50 $
401 to 600 amps(2) $174.00 $
Name: Doti i v3 /-)--e 1 . Levu
Address: PeD g6-71/4 /9 601 to 1,000 amps(2) $225.50 $
City: EA-81/4-4. State:C..)g. ZIP:CO 4 0 Over L000 amps or volts(2) $516.00 $
Phone: SLk‘ - k-k .S. 5 te410 Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders: installation, alteration, relocation
200 amps or less(2)
This installation is being made on residential or farm property 4-',..- $ 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(4. 401 to 600 amps(2) $138.50 $
Signature: \,iN 1 --2 ---------- -A . Over 600 amps or 1,000 volts,see services or feeders section above
MattlaKebNiERA:Cir.OR'51INSTALLATIONW:AVMIca Branch circuits:new alteration, extension per panel
Business name: S_Rli CYZ.n/A-7Cfr"\-- a. Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit '7 $ 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 $
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:(1) $80.00 $
:i1;111ka- ratAtfiIineAltiluSERelit31112W
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) $ (4 /4/
(C)Technology Fee(5%of[A]) $ o 77
TOTAL fees and surcharges (A through C): $
440-2584-J(4/01/2013/COM)