HomeMy WebLinkAboutPermit Electrical 2013-8-28 •
SPRINGFIELD 225 Fifth St
hWCITY OF SPRINGFIELD Springfeld,OR 97477
l '�' Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2013-01939
www.spnngfieltlar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/28/2013 EXPIRES: 02/23/2014
STATUS DATE: 08/28/2013 APPLIED: 08/28/2013
SITE ADDRESS: '5335 DAISY ST,SPC#62,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702330001301 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Meter Base Repair
OWNER: ABUNDIS IRMA Y Phone Number:
ADDRESS: 5335 DAISY ST SPACE•55
SPRINGFIELD OR 97478
. CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electncal Contractor BURRELL BROS ENTERPRISES INC CCB 136446 08/20/2015 541-747-2724
INSPECTIONS REQUIRED
•
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
6� � �` 111
ATTENTION: Oregon law requires you to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF'fhE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR 952-001-0010 through OAR rules 001-
COMMENCED OR IS ABANDONED FOR
0090. You may obtain copies of the rules by ANY 180 DAY PERIOD.
calling the center. (Note: the telephone
•
number for the Oregon Unlit/ Notification
Genf pr is - •
Springfield Building Permit 8/28/2013 10:45:23AM I Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Frith St
( r. TRANSACTION RECEIPT Spnngfield,OR 97477
541-726-3753
OREGON 811-SPR2013-01939
www.spnngfieldbcgov 5335 DAISY ST. SPC 62 permitcenter@spnngfield-or.gov
RECEIPT NO: 2013001907 RECORD NO:811-SPR2013-01939 DATE:08/28/2013
laf -3el•71:iit n kNil 1.2k, ''s?$;"., %g. I L, -- -2;—1ACCOUNT.CODEITRANS!CODE/ _asp 4-AMOUNT DUE':
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
".P-AYMENTsTYPE!;i°.L 'PAYOR:g cpsHleix3 aRSSON -F�, COMMENTS''I"` :;.c.., ur'a t r..CAMOUNT PAID;-.p..,-,vyi; ntf. = _
Credit Card BURRELL BROS ENTERPRISES INC 104.13
045109
TOTAL PAID: 104.13
•
Electrical Permit Application sPa b DEPARTMENT USE ONLY i`,
wr.'_..J3i i e 2 4' - 7'd ..,: :::6;:k. =•m7 "4:" l ;;F: nt.`G i n i
CITYOF SPRING LD ;OREG3
P
.R :- a it r es _ 1��,3�.?, - 3. emit no.: a(\ 20 C3 Olt? (
225 Fifth Street•Spnngfield,OR 97477.P11(541)726-3753•FAX(541)726-3689
Date: Cd /Z7/
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.
44 3tLOCAL CGOVERNMENT RP,RO,VALkA Y,J y 4 ax t FEEr SCHEDOlit .igt.3 .IK
Zoning approval verified? ❑ Yes ❑No .," `' }cif t 't 7.T '1" f `:,Cost , Total
*` eNumber thspeettonxpertdem (:), Qty 'l a ,y cost,x.
CCATEGORYI2OF.„CONSTRUCTION ;.t1; P . -
Residential,per unit,service included:
]Residential ❑ Government ❑ Commercial
/- : 1,000 sq. ft. or less(4) $147.50 $
s.( °, .JOB=,iSITE;: NFORMATIQN=AND;LOCATION*,i �`
/�q �f Each additional 500 sq. ft.or portion
Job site address: 5 3 3 5- 0 P 1)Sy 7 thereof - $ 27.50 $
City: State: J ZIP: Limited energy(2) $ 35.00 $
Reference: I Taxlot.: Each manufactured home or modular $ 69.00 $
as ,;. �a` v r�i ,: dwelling service or feeder(2)
-; �"SDESCl21PTION°^OF` OR�j r ,a x z`
fib 1 rn eiw y I?), 4// sj o/96�✓ Services or feeders: installation,alteration,relocation
tJ/� ten J no/96,y 200 amps or less(2) $ 89.00 $
mfrs f,PROPERTY4t E „{%?,, V e 1.,: 20I to 400 amps(2) $ 104.50 $
Name: V? Y V/ QI �/ 401 to 600 amps(2) $174.00 $
Address: 5 3 3� .e2 ` 601 to 1,000 amps(2) $225.50 $
I
City: State( I ZIP: Over 1,000 amps or volts(2) $516.00 $
Phone: - - 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 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 479.5600). 401 to 600 amps(2) I $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
;.SM'elcIleZCON111 r CTOR"INST'• `LATj N ,/ eyl'7: lt%5)" ,',`f Branch circuits:new alteration, extension per panel
Business n • e: /� Y tit 1/r�//ll / 0� a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 0 4$ "4 1.12 - Each branch circuit $ 6.50 $
City: ,fin7/� lirriia ZIP' r,A b.Fee for branch circuits without purchase of a service or feeder fee:
E
Phone: - `PlEMrM K First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: VW/ BCD license no.:e_�ff E Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: nal. Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: cas Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor-,.111,,'l0��ll,,rl,,,,, Signal circuit or extension panel, $ 80.00 $
_ slteranon or extension(2)
' •Each additional inspection:(1) $80.00 $
Caif a' :, "farm L[CANtaSE f gt1I"1IR u
(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): $ bO'-f
440-2584-1(4/012013/C0M)