HomeMy WebLinkAboutPermit Electrical 2013-8-19 SPRINGFIELD -•-
1 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01843
vmAV.springfield-or.gay permitcenter @springfield-or.goy
PROJECT STATUS: Issued ISSUED: 08/19/2013 EXPIRES: 02/14/2014
STATUS DATE: 08/19/2013 APPLIED: 08/19/2013
SITE ADDRESS: 1249 PARKER ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703264416600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 4 Circuits
OWNER: BAILEY BARBARA L Phone Number:
ADDRESS: 4226 SCOTTDALE ST
EUGENE OR 97404
CONTRACTOR INFORMATION I
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor WILLIAM A GRAY JR CCB 21351 04/28/2014 541-485-3954
INSPECTIONS REQUIRED
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 th property,and the approved set of plans will remain on the site at all times during
constr Ictio
O er or Contractor Signature Date •
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE�MIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth THIS PER
in 952-001-001 o through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090.90. You may obtain copies of the rules es by
by
calling the center. (Note: the teleph.:nc COMMENCED OR IS ABANDONED FOR
number for the Oregon Utiity Notification ANY 180_DAYPERIOD.
Center is 1-600- 32-23:4). -
•
•
Springfield Building Permit 8/19/2013 10:18:26AM Page 1 of 1
SPRINGFIELD --- CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT SpringfielQOR 97477
OREGON 541-726-3753
811-SPR2013-01843
www.springfieldor.gov 1249 PARKER ST permitcenter @spdngfleld-or.gov -
RECEIPT NO: 2013001796 RECORD NO:811 SPR2013-01843 DATE:08/19/2013
DES RP1 o " ,� r r Tom; � ;�ACCOUNT CODE/TRANS.COD '' ?e�'AMOUNr:DUE j
_.,,mot.
Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50
Branch circuits without service or feeder-each additional 224-00000-426102 1004 19.50
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
11PAY.MENT:TYPE. PAYOR casRIER:a RSON _. .COMMENTS _ _ AMOUNT'PAID f
Cash WILLIAM A GRAY JR 93.60
TOTAL PAID: 93.60
•
•
•
•
•
, Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD i
CITY OF SPRINGFIELD, OREGON Permit no.: P,// Z4.7/3 01 gl(f ttit
225 Fifth Slreet•SpringfieW,OR 97177•P6(511)7 2 6-3 7 5 3♦FAX(511)726-3689 OREGON 2
Date: U//y//3 g
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. Cost Total
ea. cost
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
all Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION I,000sq. R.or less(4) $147.50 $
U /L l'^/ Each additional 500 sq. ft.or portion
Job site address: U y Pa er St thereof $ 27.50 $
City:spr%09 4 ea State:CC. ZIP: 9'79'77 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
dwelling service or feeder(2)
DESCRIPTION OF WORK
/ Services or feeders:installation, alteration.relocation
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: TD4,LbPy,(,. Sat ft:"" 401 to 600 amps(2) $174.00 $
Address: 9 a/ 5GO/ el�L s-/- 601 to 1,000 amps(2) $225.50 $
City: Ewe/Ml, State: at ZIP:775/1V Over 1,000 amps or volts(2) $516.00 $
Phone: - - Fax: - - Reconnect only(2) $ 69.00 $ I
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) $ 96.00 $
property is not intended for sale,exchange, lease,or rent.OAR
479.5400)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:newt alteration,extension per panel
Business name: J%//$ ejecie-/ L a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 9 77 CO char-/14. b k Each branch circuit $. 6.50 $
City: 6-t16-rive State:O/ t ZIP:9'7yei & b. Fee for branch circuits without purchase of a service or feeder fee:
Phone:0 50/'-S�56 Fax: 53// -9,3— SSB First branch circuit(2) , $ 60.50 $40,31)
E-mail: Each additional branch circuit $ 6.50 $p4496
CCB license no.:e7/3 57 BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: gp O O S 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. gj/� 6--i Signal circuit Ora limited-energy r panel, $ 80.00 $
alteration,or extension 2
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) 40
(B)Enter 12%surcharge(.12 x[A]) $ g6—
(C)Technology Fee(5%of[Al) $ 'I/0
440-2584-1(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ /a 0,10