HomeMy WebLinkAboutPermit Electrical 2013-9-30 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
yi.� Phone: 541-726-3753• OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02186
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 0913012013 EXPIRES: 03/29/2014
STATUS DATE: 09/30/2013 APPLIED: 09/30/2013
SITE ADDRESS: 3699 RIVER HEIGHTS DR,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702301204500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Temp pwr
OWNER: BREEDEN BROS INC Phone Number:
ADDRESS: 366 E 40TH AVE STE 250
EUGENE OR 97405
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor BREEDEN BROS INC COB 27 12/04/2014 541-686-9431
Electrical Contractor BREEDEN BROS INC CCB 27 12/04/2014 541-686-9431
L 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 card is located at the front of the property, and the approved set of plans will remain on the site at all times during
constr�uctiion. /
�(C l e 4` 3a f K3
wner or C tractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility !OTICE:
in OfAR 952- 0110010th ougheOAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK .
obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332 2344).
Springfield Building Permit 9/30/2013 10:52:40AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD 22 Fifth TRANSACTION RECEIPT SpSingfeldpR 97477
541-726-3753
OREGON 811-SPR2013-02186
www.springfield-or.gay 3699 RIVER HEIGHTS DR permitcenter@springfield-or.gov
RECEIPT NO: 2013002167 RECORD NO:811-SPR2013-02186 DATE:09/30/2013
(DESCRIPTION - ACCOUNT_CODE/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
>_PAYMENTTYPE - PAYOR " CASHIER:CCARPENTER; _ COMMENTS-...-___ -AMOUNT PAID - _ J
Credit Card BREEDEN BROS INC 93.60
00500B
TOTAL PAID: 93.60
•
•
Electrical Permit Application DEPARTMENT USE ONLY
yyx .z, l.1v -T l� "- -. SYNINGfIELD—� �—/�
CITYOFSP NGFIE ;®:ItEI:.® �t Permit no.: rSl3 2l0 �°
225 Fifth Stect+Springteld,Ott 97477,11(54 11726-3753 4FA\(54t)726-3689 r rA `OREGON
Date: ‘ I-g0(i 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.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Number of inspections per item ( ) Qty. Cost Total
ea. cost
CATEGORY OF CONSTRUCTION
J Residential,per unit,service included:
L� Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION
1.000 sq. 1.or less(4) $147.50 S
Each additional 500 sq. ft.or ponioo S 27.50 S
Joh site address: 3659 tZIVEP NE15HTsae- thereof
• City: 5 p¢INyt eL9 State: 0C ZIP:97177 ? Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00
DESCRIPTION OF WORK dwelling service or feeder('?)
Services or feeders: amsadlation, alteration.relocation
1 MPOeAe`/ ELEGTR%CAL
—
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(21 $ 104.50 S
Name: Bj2EFD ..N HOMES 401 m 600 amps(2) $174.00 —S __-----
Address:—%6 2'. 16 AuE , Ste, 250 601 to 1,000 amps(2) $225.50 S
City:EuPZ'1-),E State: 02 ZIP_017100_5 Geer I,000 tulips or volts(2) $516.00 5
S ] $b_g43) Reconnect only(2) $ 69.00 $
Phone: Fax: - -
___ 9..-_�
'temporary services or feeders: installation.alteration, relocation
1:i-mail: _KA_Tei tJA Bets) I.10/Yps. CDM
This installation is being made on residential or farm property 200 amps or less 12) $ 69.00 $ VI
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 471.560(1) 401 to6t10 amps(2) $138.50 $
Signature: Over 601)amps or 1.000 volts.see services or feeders section above
C NTRACTO INSTALLATION f3rmtch circuits: new. ahercrrion. extension per panel
Business name /VLF-- a. Fee for branch circuits with purchase ofe service or feeder fee:
Address: Each branch circuit i I n50 $
City: State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) 5 60.50 5
E-mail: Each additional branch circuit 5 6.50 $
CCB license no.: 2—) 1 13C license no.: N1iseetloreous fees:service m:/ceder gat included
Signing supervisor's license no.: Each point)or irrigation circle(2) $ 69.00 S
Print name of sighing supervisor: Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-cncrgv panel. $ 80.00 s
Signature of signing supervisor: alteration.or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) b
(l3) linter 12%surchmge(.12 x(A]) $9g.
(C)Technology Fee(5%of[Al) 5 Li 6D,
440-2584-J(4/01/2013/C'Orx1) TOTAL fees and surcharges(A through C): $ 93