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HomeMy WebLinkAboutPermit Electrical 2013-9-6 SPRINGFIELD 225 Fifth St • 4 ale...list CITY OF SPRINGFIELD Springfeld,OR 97477 `�� Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02012 w,w.springfield-or.gov permitce nter©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: 975 S 56TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802041109100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Temp power for New SFD Lot 5 Lauren Estates OWNER: RONALD C NELSON REVOCABLE LIVING TRUST Phone Number: ADDRESS: 806 S 57TH ST SPRINGFIELD OR 97478 . - CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone , Electrical Contractor GALCERAN CONSTRUCTION INC CCB 164708 05/17/2015 541-520-6645 General Contractor GALCERAN CONSTRUCTION INC CCB 164708 05/17/2015 541-520-6645 I, INSPECTIONS REQUIRED Inspections 4000 Temporary Power Service 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 ca is located at the front of the property, and the approved set of plans will remain on the site at all times during constru tion • Owne or ractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility zOTICE: Notification Center. Those rules are set forth j HIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies Of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 9/6/2013 9:09:03AM Page 1 of 1 • SPRINFIELD CITY OF SPRINGFIELD bcORGON TRANSACTION RECEIPT Spningfield,OR 97477 541-726-3753 811-S PR2013-02012 - www.springfield-or.gov 975 S 56TH ST permitcenter @springfield-or.gov RECEIPT NO: 2013001967 RECORD NO:811-SPR2013-02012 DATE:09/06/2013 DESCRIPTION __._ . ACCOUNTCODE/TRANS-CODE___ __ __,_:-AMOUNT DUE_ ; 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 PAYMENT TYPE __pAYOR_ CASHIER:SSARPENTER _ ___,._COMMENTS_ __ AMOUNT PAID • - - I Credit Card GALCERAN CONSTRUCTION INC 91.61- 3.60 06115C TOTAL PAID: 93.60 • • Electrical Permit Application ,,. bE0,!ARTMENTAlSE-ONLY .c-;. T4.7.,r .-:iiiin:W•WalasUiTe-41t4-1.*igiwzii.:44,Az.r: pit 14 j keITYTOESPRINGFIEED4gORECON2- - :7. sia. ' • . S/7- 20(Z 1 ts---fiN 0 -4 PerTnil no.. 225 Fifth Streets Springfield,OR 97477*N:1(541)726-3753o FAX(541)726-3689 Date: 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. •:.3": ::F.ti.SEOCALitfOOVERNMENTsAppRovAG-iwygi7:' :,-,ti:1:,'AnifilascOFEEirsc H ED ILI EE,WrilnqingWf ) - Zoning approval verified? 0 Yes E No ,,„.....w. .74.,741e.12-..N.fikAinakyi.Fir--t-e: 4acsgeoi:f---LTeitil3C rasliintilierofilpspectr nsterntm(iyitiv pty,.,il?„,-e-a-,t-.*: .,--ebs-clic! ;:lcATEGOBY,lia.FACIONSTROPTIOrtiPMAR '')'- '''''''''''''' ''''' .--' Ajj''''''-'''' ''' "" n Residential,per unit,service included: D Residential n Government 0 Commercial 1,000 sq. ft.or less(4) $147.50 $ ",:;:i-vj•::`,.10B;;;S ITEA N FORMATION EAN Di'.:',1213'CATI 0 N:'..:thILA:, Each additional 500 sq ft.or portion Job site address: 97C S 544h thereof $ 27.50 $ City: Sp iz4. 3-ii eld State: 0 (2_ ZIP: ?7 ti 7? Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular dwelling service or feeder(2) • $ 69.00 $ ::-.` "lit:57,4-04,4X,IDESCRIPTIONIOFEWORKtV4,Ata;, Services or feeders: installation, alteration, relocation rtnif P 0 VA-4- 200 amps or less(2) $ 89.00 $ •";;01,7CiRill,Wil4P130 RE R7,41.-OWN EFtini-V.I.,::•:irin 201 to 400 amps(2) $ 104.50 $ Name: 12-D n G.4-162 -1-ri 401 to 600 amps(2) $174.00 $ i /2 Address: 17 y 5 5-61-A 51., — 601 to 1,000 amps(2) $225.50 $ City: 5-e• p_t,07geid State:0 0._ ZIP:77 4-(7? Over 1,000 amps or volts(2) $516.00 $ Reconnect only(2) $ 69.00 $ Phone:511/ 51.0 - 6 6 VS" Fax: - - E-mail: Temporary services or feeders: installation, alteration, relocation 200 amps or less(2) / $ 69.00 $en CC This installation is being made on residential or farm property owned by o a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is ot. te ded for sale, exchange, lease, or rent. OAR 479.5400)a .560(1). 401 to 600 amps(2) $138.50 $ Signature: — Over 600 amps or 1,000 volts,see services or feeders section above TRA:CT,ORtINSTALLATIOW4?..]P:'3/444* Branch circuits:new alteration, extension per panel Business name: 41 te2 Co n..r i-o-c-ic Ahoy-, a Fee for branch circuits with purchase of a service or feeder fee: Address: 5.4”..-_e_ 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.:/6 '7/701 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 $ .1„tataMCPP/01:-SR-Kgrqtra.Mdfax,erelit (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ • (B)Enter 12%surcharge(.12 x[A]) - $ r (C)Technology Fee(5%of[A]) $ zifit-2 TOTAL fees and surcharges(A through C): $ W-ei-2 440-2584-J(4/01/2013/COM)