HomeMy WebLinkAboutPermit Electrical 2013-9-6 •
. SPRINGFIELD 225 Fifth St
_- CITY OF SPRINGFIELD Springfield,OR97477
Neff' Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02018
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/06/2013 EXPIRES: 03/04/2014
STATUS DATE: 09/06/2013 APPLIED: 09/06/2013
SITE ADDRESS: 1483 DELROSE AVE,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703243305900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Temp Power to property
OWNER: DUTTON KEIVAN J &REBECCA R Phone Number:
ADDRESS: 1493 DELROSE AVE
SPRINGFIELD OR 97477
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CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone •
Electrical Contractor OWNER CCB 000000 08/01/2025
L INSPECTIONS REQUIRED
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Inspections
4000 Temporary Power Service
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.
ictodA til91 ewe
wner or Contractor S'i ature Date
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ATTENTION: Oregon.law requires you to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-530-332-2344).
Springfield Building Permit 9/6/2013 1:49:18PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD •
-._.. 225 Fifth St
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TRANSACTION RECEIPT Springfield,OR97477
OREGON
541-726-3753
811-SPR2013-02018
www.springfieldar.gov 1483 DELROSE AVE permitcenter @springfield-or.gov
RECEIPT NO: 2013001981 RECORD NO:811-SPR2013-02018 DATE:09/06/2013
DESCRIPTION -` `E? }Lem<`lii:'insti , .>,""ar y&4C ¶!ACCOUN!TP CODE/TRANS-CODE " ilia-,.a4i'; o e Ia 6V•
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00
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
Temp services 200 amps or less 224-00000-426102 1003 69.00
TOTAL DUE: 93.60
P.AYMENT�W.P6 -. PAYOR I casefEMLAI SON COMMENTS. AMOUNTPAID
Cash DUTTON KEIVAN J &REBECCA R 93.60
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT.:USE ONLY
$PNINGPIELO ✓� _
ITYvO.SPRINGITEL=D;,OREO-01.• . 1 . ( Zor
s'3a civ::.) ..v, —w� 1ysins ?: '&i_ riip kir..e3trr * 1 Pemtit no.:gl 3 OlGf v
225 Fifth Street.Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689 // �
Date: r?(�( ( z/
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCALt,GOVERNMENfAPPROVAL 4 t . la . {<'" c;i
• .�'" � r.� „s .4��s 1',r.�$"�,[F,,EE,„SCHEDULE ., , •:�'��.`_�x _:'tM,.,:+
Zoning a Sp p roval verified? ❑ Yes ❑No '"'r"° "
` ' ggt.W Y ` `? ` Cost •1\umber of inspections!per item O Qty r. o, u
t,«. l ; ea cos"_ =CATEGORY OF:CONSTRUCTION 4
Residential,per unit,service included:
'Residential ❑Government ❑Commercial
JOB.jSITE;'.INFORMATION AN D,;LOCATION,;.M $ 000 sq. ft.or less(4) $147.50 $
q [� A Each additional 500 sq. ft.or portion
Job site address:
q g Delr04o A Oc thereof S 27.50 $
City: S ph rijC k 4 State: a(2 ZIP: ° 7217 7 Limited energy(2) $ 35.00 $
Reference: J” Taxlot.: Each manufactured home or modular $ 69.00 $
,‘; ' ,;, , _ 5:?IDESCRIETION"OFt WORK' z, ;] 'x kr' dwelling service or feeder(2)
i ;owe I _ �rD^_, Services or feeders: installation, alteration,relocation
l��}1 POCa r TV !\K 200 amps or less(2) $ 89.00 $
.m;a .�*a c,,,,"t ' 'r{+ . ,PROP(E�RT_Y.l, OWNER ;x;- ,y . ;['h ,s4Q 201 to 400 amps(2) $ 104.50 $
Name: cg,e� J��^ e-to c_ca,_ Lw-F4- 401 to 600 amps(2) $174.00 $
Address: )IA q.5 be l(cY3 . d - - 601 to 1,000 amps(2) $225.50 $
City: I‘.n34 e S State: p2, ZIP:R7477
Over 1,000 amps or volts(2) $516.00 $
�/ Reconnect only(2) $ 69.00 $
Phone. Yi-59.1- x76-2_ Fax: - -
E-mail:c.0-{.dy( beck 0 yravf; . c-�-y� Temporary services or feeders: installation, alteration, relocation
This installation is being made on resitdential 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
479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $
Signature:pje,GC✓X ,.�y l _ Over 600 amps or 1,000 volts,see services or feeders section above
+3= -ifliginec NTR.ACTOR INSTALLATION t'f ,t,-4 Branch circuits:new alteration,extension per panel
Business name: a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 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 $
Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 80.00 $
alteration,or extension(2)
Each additional inspection:(1) $80.00 $
klq' tca.t,4 :(t SAPP,LICANL,USEL 8
(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): $ 7 3 e°
440-2584-1(4/01/2013/COM)