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Home My WebLink AboutPermit Electrical 2013-8-22 • • SPRINGFIELD-_..., 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 .�Le "t Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01880 www.springfeld-ar.gov permitcenter @springfeld-ar.gov PROJECT STATUS: Issued ISSUED: 08/22/2013 EXPIRES: 02/17/2014 STATUS DATE: 08/22/2013 APPLIED: 08/22/2013 SITE ADDRESS: 503 5TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703352407400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bathroom outlets and two heaters OWNER: HARLEY JOCELYN G Phone Number: ADDRESS: 503 5TH ST • . SPRINGFIELD OR 97477 OWNER: HULINGS KREG K Phone Number: ADDRESS: 503 5TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ' Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 BUILDERS ELECTRIC INC CCB 4296 12/10/2013 541-485-0922 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 a he front of the property, and the approved set of plans will remain on the site at all times during construction. • 40r„�� #r _/ ... f/02j/o2d0 Own: . r on r�r Signatur' 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.,Fro COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Cer-ier is 1-S00-332-2344). Springfield Building Permit 8/22/2013 10:53:35AM Page 1 of 1 . SPRINGFIELD CITY OF SPRINGFIELD 1,k225 Fifth St ‘OREGON TRANSACTION RECEIPT Spdngfield,OR97477 541-726-3753 811-SPR2013-01880 www.springfield-or.gov 503 5TH ST permitcenter @springfield-or.gov RECEIPT NO: 2013001835 RECORD NO:811SPR2013-01880 DATE:08/22/2013 fie] .'I�7 cleIhR S 'x.= LC-'g'R.,K... r' rV 4.- Lt∎:.aA000UNT>CODE/TRANSCODE =t2F >-=AMOUNT DUE1`"1 Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 6.50 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 13.00 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 P.AYMETRTYPE BAYOR CASHIFR ALARSON COMMENTS - AMOUN:11, AID Credit Card HULINGS KREG K 93.60 07692C TOTAL PAID: 93.60 AUG-22-2013 10:18 Builders Electric P.01/01 Electrical Permit A t r lication DEPARTMENT USE ONLY CITY OF SPRINGFIELD, OREGON - 46,.... Permit no.: R//Zc9l 3 of 08 0 225 Filth StrM•sprtag11dd,OR 91477•PR(541)72637534 FAX(511)7263659 Date: 0 42/ / 3 This permit is issued under OAR 918309-0000.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 Numbeirot(napeedons•pernte () •:Qty. • . CATEGORY OF..CONSTRUCTION . . Residential,per unit,service included: X Residential I 0 Government I 0 Commercial 1,000 sq.R.or less(4) 5134.00 S JOB SITE INFORMATION.AND LOCATION Each additional 500 sq.ft or portion Job site address: SD D 2j TH'sr _ thereof $ 28.00 $ Cityfj iukne--r_D I State: 0 J2 I ZIP:97977 Limited energy(2) $ 32.00 $ Reference: I Taxlot: Each manufactured home or modular S 63.00 S dwelling service or feeder(2) Services r� DESCRIPTION OF. WORK i- p C. r b R. Z. x,6N Act._ ue ee—•`S or faders:installation,alteration relocation 200 amps or less(2) $ 81.00 S PROPERTY OWNER . 201 to 400 amps(2) $ 85.00 S Name: ttP-4, (-guff i ru{a 5 40f to 600 amps(2) $168.00 S Address:SO 3 3 C 5{-- 601 to 1,000 amps(2) 5205.00 S City:l ^,‘hit t`e�� I State: c , I ZIP:17i/7.7 Over 1,000 amps or volts(2) 5489.00 $ Phone:i-13 3 gI I Fax: - - Reconnect only(2) S 63.00 S E-mail: Temporary cervices or feeders:installation alteration,relocation rfl his being �°t'",n�1 � ' 200 amps or less(2) s 63,00 $ This insta.11atn is being made on residential or farm property owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale,exchange,lease,or rent.OAR 479.540(1)r479.560( 401 to 600 amps(2) $128.00 f Signature/ Over 600 amps or 1,000 volts,see services or feeders section about NSTALLATION • Brands areas:new,alteration,extension per panel Business name:"gV h L_. Pa.s FtaTe-te_ a.Fee for branch circuits with purchase of a service or feeder fee: Address: /q - $440040 N Each branch circuit I I $ 8.00 j $ City: g7J 6164.1 e- I State: OQ I ZIP:17t?OL b.Fee for branch circuits withou t purchase of a service or feeder fa: Phone:by/-1. -p922 I Fax: - - First branch circuit(2) 1 S 55.00 $ E-mail: Each additional branch circuit y $ 8.00 S CCB license no.:tfflb I BCD license no.: Miscellaneous fees:service orjeeder not included Signing supervisor's license no.: '32.90-$ Each pump or irrigation circle(2) S $3.00 $ Print name of signing supervisor: Few,t e/1 lti), re.we: Each sign or outline lighting(2) $ 6x.00 S Signature of signing supervisor: ,( Signal circuit or a extension(2) panel, $ 82,00 $ rgtant gn D (,.��C�- alteration,or extension(2) Each additional inspection:(1) $86.00 $ r "0.1 -PRlICAPIliUtre: ."'.•, ✓,, ., . (A) Enter subtotal of above fees S (Minimum Permit Fee$58.00) (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(6%of[A)) $ � TOTAL fees and surcharges(A through C): 5 92f o, 440.25844(9/08/COM) TOTAL P.01 . 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 • 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. %1q ,7/11,0 q- Print Nam eygt Permit pplicant . VVV_o� Vo2a2/026/ 3 e of Per it Appl��nt Da dio Permit#: /o F Address: a n7/ : 3itims:;. in ; "4".7"5:-...: Issued by: Date: 859 This Copy for Permit Offices