HomeMy WebLinkAboutPermit Electrical 2013-10-9 SPRINGFIELD 225 Fifth St
` - CITY OF SPRINGFIELD Springfield,OR 97477
rcit..415 z= Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02266
wv w.springfield-or.gov permitcenter@spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/09/2013 EXPIRES: 04/07/2014
STATUS DATE: 10/09/2013 APPLIED: 10/09/2013
SITE ADDRESS: 1233 M ST,Springfield,OR 97477 SCOPE: Electrical Only
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ASSESOR'S PARCEL NO: 1703264404200 TYPE OF.STRUCTURE: Residential
PROJECT DESCRIPTION: Add Sub Panel-6 circuts
OWNER: MORIN VERONIKA Phone Number:
ADDRESS: PO BOX 415
NOTI OR 97461
CONTRACTOR INFORMATION
Contractor Type Contractor Name • Lic Type Lic No Lic Exp Phone
Electrical Contractor LYNNS ELECTRIC CO CCB • 102316 10/14/2015 541-726-7895
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INSPECTIONS REQUIRED
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Inspections
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4225 Service or Feeder
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.
6PCP AAAVal12--Owner or ractor /
Signature Date
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK
follow rules enter, Those osere rules are set Center, Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 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. calling the center. (Note: the telephone
• number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 10/9/2013 1:10:36PM Page 1 of 1
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PRINGFIELD CITY OF SPRINGFIELD
�+� 225 Fifth St
E�aN TRANSACTION RECEIPT 5pnn fielld7O3 97477
• 811-SPR2013-02266
www.springfield-or.gov 1233 M ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002250 RECORD NO: 811SPR2013-02266 DATE: 10/09/2013
5.74_14041— [ .: �- _2,:4-=x. rEi x '`.' j_ :Cir. :i: ACCOUNT-CODE/FRANS:CODE- 1 r' `;'"AMOUNT DUE IL-
Branch circuits with service or feeder each circuit 224-00000-426102 1004 39.00
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 15.36
Technology fee(5%of permit total) 100-00000-425605 2099 6.40
TOTAL DUE: 149.76
bilAYMENT7YPE a PAYOR .ASTA ] AEI ,; COMMENTSW3 t 11 AMOUNTPAID,'- ,;,
Credit Card LYNNS ELECTRIC CO 149.76
63564H
TOTAL PAID: 149.76
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Electrical Permit Application DEPARTMENT USE ONLY
z'aa . :{4! fl —;, a a W sva INGFIELO
CITY OF SPRINGFIELD,'DREG ON n permit no Si ( 7vl oZZ,G
ate c
225 Fifth SirceI•Springfeld.OR 97477•1'11(541)726-3753•F AX(541)726-3689
oaeeory
Date: (0/9//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
c:t. cost
CATEGORY OF CONSTRUCTION _ Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial
S
JOB SITE INFORMATION AND LOCATION LOOP sq. It.oi less(4) $147.50
Each additional 500 sq. 0.or portion S 27.50 S
Job site address: /2'j 41 , 51". thereof
City: Sp At �f/ State: 0 2_ ZIP: 97977 Limited energy(2) S 35.00 S
Reference: (f faxlot.: Each manufactured home or modular - $ 69.00 $
DESCRIPTION OF WORK ^ dwelling service or feeder(2)
5/ o7f ( y S:v. , Services feeders:installation, nUeralion.relocation
✓ — 200 amps or less(2) 1 S 89.00 $ _
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: ,, n.,.nnn low requires you to 401 to 600 amps(2) $174.00 $
O' I Cr"1"' _.- r the Oregon u Ely 601 to 1.000 amps(2) 5225.50 $
Addr ss: ,dcc adopted b} _, forth
i ."., e Over 1,000 amps or volts(2) $516.00 S
Giimtification Center. l no)N,i.is of
951 ZQ i'
Phiine`�AR X52-VU I-Uv i`�"-•'0-eEa.'t tharules by Reconnect only(2) $ 69.00 $
„Main coq
( 1_t i. -i.,J 1':_' 'I'cm pewary services or feeders: insinuation.oUcrnlion, 1elocunan
L-Idac_.! nn the center. (Note' the rete4 e-at On
This inst�lhiion;is'tieiii=)made'on le5i'd�{eniial or term property 200 amps or less(2) $ 69.00 $
1 r:, ,J t 'ri i-E
owned by mz�ot,atlnetitbzt:-o�m§-inmt ilia c/Tamily. This 201 to 400 amps(2) $ 96.00 $
property is not intended for sale, exchange, lease.or rent.OAR
479.540(I)and 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 0011 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: new,, alteration. extension per panel
Business name: Ly,veJ S F/f ,L a. Fee for branch circuits with purchase era service or tbedcr fee:
Address: p$ I4- ,' Each In circuit (p $ 6.50 $ '39
City: .�I (,aunt eState: De. ZIP:9 7y 38 h. Fee for branch circuits without purchase of a service or feeder fee:
Phone:sn/ �Z�-7py�ax'9//75C- 7 -Z First branch circuit(2) $ 60.50 $
Email: hf*awe jecilia,,t/SA) iGix1 Each additional branch circuit $ 6.50 $
CCB license no.: fat /4 BCD license no.: ZG-/P•L O'Iiscellanenus fees:.service nr:/cede,'not included•
Signing supervisor's license no.: 2,3571-5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: L en.) MOORt
Each sign or outline lighting(2) $ 69.00 $
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Signature of signing supervisor: Signal circuit or alimited-energy panel. $ 80.00 $
I alteration.or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE
(} { (A) Enter subtotal of above fees
$
'ATICE: (Minimum Permit Fee$80.00)
THIS PERMIT SHALL EXPIRE IF THE WORK (B)Enter 12%surcharge(.12 x[A]) $
AUTHORIZED UNDER THIS PERMIT IS NOT (C) technology Fee(6%of[Al) $
too-25x:, ,l(4idil, StizE OF IS ABANDDNED FOR To-fAL fees and surcharges(A through C): $ /ftrke
ANY 180 DAY PERIOD.