HomeMy WebLinkAboutPermit Electrical 2013-8-13 •
• SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
eeoN.
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01801
www.spnngfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued .ISSUED: 08/13/2013 EXPIRES: 02/08/2014
STATUS DATE: 08/13/2013 APPLIED: 08/13/2013
SITE ADDRESS: 601 EDGEMONT WAY,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703341307003 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Move Meter Base •
OWNER: YARNALL JAMES E&JACQUELINE Z Phone Number:
ADDRESS: 632 W D ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor WILLIAM LEE WILSON CCB 131536 10/04/2014 541-913-7354
INSPECTIONS REQUIRED b
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Inspections
4210 Service Change
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.
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
- follow rules adopted by the Oregon Utility
THIS NOTICE'P n OAR 952-01 0010 through OAR 952 001h
THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules 1-
AUTHORIZED UNDER THIS PERMIT
IS NOT calling the center. (Note: the teleph;,:v,
OP/IMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification
V iso DAY PERIOD. Center is 1-800-332-2344).
'Springfield Building Permit 8/13/2013 1:42:54PM Page 1 of 1
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SPRINGFIELD'-- CITY OF SPRINGFIELD
U, •u1� 225 Fifth St
TRANSACTION RECEIPT Springfield,OR97477
1 OREGON 541-726-3753
811-SPR2013-01801
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www.springfieldor.gov 601 EDGEMONT WAY • permitcenter @spdngfield-cr.gov
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RECEIPT NO: 2013001755 RECORD NO: 811SPR2013.01801 DATE:08/13/2013
DESCRIPTION rf- - r�;t. " i `_ietE ; }1 ACCOUNT'CODELTRANS+CODE=;,"i1t 4 -AMOUNT DUE ?Q?
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68
Technology fee(5%of permit total) 100-00000-425605 2099 4.45
TOTAL DUE: 104.13
PSPAY,MENTaxpE -' PAYOR caSHie"a 4inToIM , 60MMENTS,'l -r QM_OUNnp-,
Cash WILLIAM LEE WILSON 104.13
TOTAL PAID: 104.13
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" Electrical Permit Application DEPARTMENT USE ONLY .
CITY'OF SPRINGFIELD, OREGON'`. 3 _:-\v��7 Permit no.:e / \ ZoC9O( R o 1 F
225 Fifth Street•Springfietd.OR 97477.Pti(54l) ''6-3753•F X(54U726 3689 OxEGON p
Date: ( (3( 13
(
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. €
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Number of inspections per item () Qty. Cea.ost To tal
,
CATEGORY OF CONSTRUCTION cost
Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial 1
JOB SITE INFORMATION AND LOCATION
1.000 sq.II.or less(4) $147.50 S
,� �---- Each additional 500 sq. ft.or portion $ 27.50 $
Job site address: 60( lip e 01 on r _ thereof
City:r)y)hI io StateOt ZIP:9(N 7 7 Limited energy(2) $ 35.00 I $ R
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ p
DESCRIPTION OF WORK dwelling service or feeder(2) II
Services or feeders:installation,alteration,relocation
M tl e rYIETeV b SL 4-e ry. I rs)6e i
M9 200 amps or less(2) / $ 89.00 $ y
v iy 9,44-49-e.y49�
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 5
Name: P1 Li 4r A141_0 401 to 600 amps(2) $174.00 S
Address: 45Z t / ccr er 601 to 1.000 amps(2) $225.50 S
Over 1.000 amps or volts(2) $516.00 $
City: S Fee/) State:/0/L 1 ZIP: 1-7 i
Reconnect only(2) $ 69.00 $
Phone) �fG-Zz�j�' Fax: - - t
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 $ j
owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 $ I
property is not intended for sale,exchange, lease,or rent.OAR
479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $ 1
Signature: - Over 600 amps or 1,000 volts,see services or feeders section above
CONTRAFTOR INSTALLATION Branch circuits:non: alteration.extension per panel
�+ i
Business name: .1411.414-..) ma,y, l maiyoOQ'Jn' a.Fee for branch circuits with purchase of a service or feeder fee: I
Address:5�- .e-04-6.'I / . Each branch circuit - 5 6.50 $
City: ,,f99-Gt^1 State:Oft_ ZIP:el-p je ) b.Fee for branch circuits without purchase of a service or feeder fee:
Phon ma/).9 q 1 3S ii Fax: - - First branch circuit(2) S 60.50 $ [
E-mail: i Each additional branch circuit. $ 6.50 $
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CCB license no.: ) 15 BCD license o.: Miscellaneous fees:service or feeder not included I
Signing supervisor's license no.: ,rp , 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, $ 80.00 $ '
Signature of signing supervisor: alteration,or extension(2) I
Each additional inspection:(1) $80.00 $ i
APPLICANT USE `
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[Al) $ 1
1
(C)Technology Fee(5%of[A]) $
440-2534-4(4101/20131COM) TOTAL fees and surcharges(A through C): $