HomeMy WebLinkAboutPermit Electrical 2013-9-5 SPRINGFIELD 225 Fifth St
`' CITY OF SPRINGFIELD Springfeld,OR97477
.C\C� Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01997
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/05/2013 EXPIRES: 03/03/2014
STATUS DATE: 09/05/2013 APPLIED: 09/05/2013 •
SITE ADDRESS: 205 22ND ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703361302500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 3 branch circuits
OWNER: NILES ALISCIA M&TAYLOR JASON P Phone Number:
ADDRESS: 205 22ND ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Il
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor MAG ELECTRIC INC CCB 149834 12/13/2013 541-461-0387
L 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 the property, and the approved set of plans will remain on the site at all times during
construction.
own:. • r ntractor Signature ' Date
f' - I nn;Tres you to •
NOTICE: ao.. ,:e y by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK ... . . „tm Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in 0/Art 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. number the center. (Note: the telephone
umber for the Oregon Utility Notification
Center is 1-800-332-2344).
•
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Springfield Building Permit 9/5/2013 10:26:21AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
.a. 225 Fifth St elt-iic EGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-S PR2013-01997
www.springfield-or.gov 205 22ND ST permitcenter @springfield-or.gov
RECEIPT NO: 2013001963 RECORD NO:811-SPR2013-01997 DATE:09/05/2013
(DESCRIPTION ,,_,,,ACC,OUNTCODE/TRANS CODE ,, , ,;'' AMOUNT DUE I
Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00
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: 9160
LPAYMENT TYPE - ' PAYOR_u,cnswER:CCARPENTER- ; '_COMMENTS „ 3.;:IL , '''' • AMOUNT PAID
Credit Card MAG ELECTRIC INC 93.60
320449
TOTAL PAID: 93.60
•
Electrical Permit Application .-:.- bEoARTmENT,usEoNL*.SPflINGFIELfl
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225 Fifth Street•Springfield,OR 97477•PB(541)726-3753•FAX(540726-3689
Date: 9/7( -3
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.
,..q„cciliE0 A LCGOV,E kN M E NTIA RP,ROO liYatil;S:,y. c±:1,2c'ES-iigi,;:atr,?:;;ME EL, S.cill EQUEElaWM-git:i1/4A:y.-52cA
Zoning approval verified? t-17:442,7f7,-.75:fRe,>tja.'jr:CrQzf; .,-
0 Yes 0 No ,;:Ntiiiiheiaf iiisifidaio-ritileilitiiirl Qty.,yt,,Cost---,tf:v:t-Totat,
-7,,--;.;:c1fEarql 64;
,C4,•:Mre.a0ATEOCIOY0FiCoNsTRUQT,i0N1Wit:
Residential,per unit,service included:
csidential 0 Government 0 Commercial
1,000 sq. ft or less(4) $147.50 $
-,::■. 1";:;;;UOBT;ISITEMNFOAMATIONE'%Ni:ti; ; itATICOWZ::::
Each additional 500 sq. ft.or portion
Job site address: ..V., thereof - $ 27.50 $
City: 4ittrarel Statea,c7 ZIP: Limited energy(2) $ 35.00 $
Reference: , (103 r‘,/3 Taxlot025-00 Each manufactured home or modular
$ 69.00 $
-'40R;VID ES c R 1 Kriti NI°F,WO RK4::-,t::(#,WU:CPT;3 dwelling service or feeder(2)
Services or feeders: installation,alteration,relocation
200 amps or less(2) $ 89.00 $
'W"iTSA);FiiVai413,-kORERTAO-W IN ERMA:3 rn‘l-N 201 to 400 amps(2) $ 104.50 $
Name: 401 to 600 amps(2) $174.00 $
Address: 601 to 1,000 amps(2) $225.50 $
City: I State: I ZIP: Over 1,000 amps or volts(2) $516.00 $
Phore//137 9/34/ I Fax - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders: installation, alteration, relocation
200 amps or less(2)
This installation is being made on residential or farm property $ 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 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
4 .,,TCONTOCT.OFGINUALLATIONVENtiraVekia Branch circuits:new alteration, extension per panel
Business namearlaia4 Jeteettp a.Fee for branch circuits with purchase of a service or feeder fee:
Address5 ,4nany X44 her"\ Each branch circuit $ 6.50 $
City: 440,e9.4;‘t StateyX ZIP:97 Via9 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone5V /45,1-7 Fag/' ç / 5/6602 First branch circuit(2) / $ 60.50 $
E-mail:Ci/07,Wa4-teta );)C0/0C /14./i/ , Each additional branch circuit Ir $ 6.50 $
CCB license no./94121:5<-7 BCD<-7 BCD license no /7(2 . i Miscellaneous fees:service or feeder not included
Each pump or irrigation circle(2) $ 69.00 $
Signing supervisor's license no.: /7/75C2
Print name of signing supervisor:77/0,-,z/ fi /6. „/ Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisit(
4
...
Signal circuit or a limited-energy panel,
alteration,or extension(2)
$ 80.00 $
Each additional inspection:(1)
$80.00 $
g:Z44-gktEalarlcrKritaSEMIPaiEfagzi
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) $ 40 t2
(C)Technology Fee(5%of[A]) $ ye°
TOTAL fees and surcharges (A through C): $ 03 C•21.—
440-2584-J(4/01/2013/COM)