HomeMy WebLinkAboutPermit Electrical 2013-10-11 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,0R97477
Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02281
www.spnngfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued • ISSUED: 10/11/2013 EXPIRES: 04/09/2014
STATUS DATE: 10/11/2013 APPLIED: 10/11/2013
SITE ADDRESS: 1169 36TH ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702304302401 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Service change to 320 Amps •
OWNER: MONDAY JOINT REVOCABLE TRUST Phone Number:
ADDRESS: 1169 36TH ST
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SPRINGFIELD OR 97478
OWNER: MONDAY MELVIN G&ROSA LEE Phone Number:
ADDRESS: 1169 36TH ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type . Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor WALTER J CANNON CCB 76304 09/09/2015 541-747-0959
INSPECTIONS REQUIRED 11
Inspections •
4210 Service Change
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 t - front of the prop- ,and the approved set of plans will remain on the site at all times during
construction. I i j •
1�'�LI1 L,A top I7 J
Owner oACo12.tifft J igettuy Jn I w requ es you to Date •
follow rules adopted the Or.gon Utility
Notification Center. Thos rules re set forth
in OAR 952-001-0010thick: •AR 952-001- NOTICE:
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0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR DI
ANY 180 DAY PERIOD.
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Springfield Building Permit 10/11/201 8:59:17AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR 97477
fGON 541-726-3753
811-SPR2013-02281
www.spnngfield-cr.gov 1169 36TH ST permitcenter@spdngfield-or gov
RECEIPT NO: 2013002266 RECORD NO:811-SPR2013-02281 DATE: 10/11/2013
0' ' tea:",vaa-Z.-47 ?� _ , :''� ACCOUNT.CODE/TRANS CODE `'" _ AMOUNT DUE„,;
Services 200 amps or less 224-00000-426102 1004 178.00
Services 201 to 400 amps 224-00000-426102 1004 104.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 33.90
Technology fee(5%of permit total) 100-00000-425605 2099 14.13
TOTAL DUE: 330.53
PAYMENT IYP.E P.AYOR' '" CASHIER:.uunasor COMMENTS AMOUNSe?AID
Check WALTER J CANNON - 330.53
25880 •
TOTAL PAID: 330.53
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Electrical Permit Application DEPARTMENT USE ONLY
n,nyae °-Y,:-4 Si'1tf"CAAELO
Ci. OF SPRINGFIE@ IVORECQ '
nx ,. k%ss. r a-rts aC'._ _,,„ .� gI Permit no.:0/7 Zvl3 02.2g(
2251 fifth SI,tet•Spi ml,ucld,OR 97477♦1'11Ua1)72637i3•11\(541)726-3689 oaeeon
Date: /0
This permit is issued under OAR 9)8-309-0000. Permits are nontransferable. Permits expire if work is not started within ISO
clays of issuance or if work is suspended for 180 days.
. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? 101 Yes ❑ No Number of inspections per item ( ) Qty. Cost Total
ea. cost
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
El/Residential ❑Government ❑ Commercial
JOB SITE INFORMATIONAND LOCATION .000 sq. ft.or less(-I) $147.50 $
�l(09 3 to--1-\\ C � tech additional 500 sq. ft.or portion $ 27.50 $
.lob site address: _ thereof •
City: �j— State:OR ZIP: �� (�� Limited energy(2) $ 35.00 5
Reference: 'l'axlot.: Each manufactured home or modular $ 69.00 $
DES RIPTION OF WORK dwelling service or feeder(Z)
ALP C * 3),D n In ^ Services or feeders: instrdluriou,alteration,relocation
TY r 200 amps or less(2) Z $ 89.00 $ r
PROPE-TY OWNER 201 to 400 amps(2) t 5104.50 5/o
Name: Li 1 A . .I 4U l0 600 amps(2) _ 5174.00 $
Address: 5A-rd 0 • 601 to 1.000 amps(2) $225.50 $
City: A State: r t 71 P: r' Over 1,000 amps or volts(2) $516.00 5
`/a3 Reconnect only(2) 5 69.00 5•Phone: Fax: - -
G-mail:
Temporary services or feeders: ii.v<dlation.alteration,relocation
This installation is being made on residential or farm properly 200 amps or less(2) $ 69.00 $
owned by me or a member of my immediate family.This 201 to 41)0 amps(2) $ 96.00 $
property is not intended for sale,exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 101 to 6(10 amps(2) $138.50 $__
Signature: Over 6011 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits:new alteration, extension per panel
Business name: C NyaM r,� M y a. Fee for branch circuits with purchase of a service or feeder fee:
Address: ,/,� t Each branch circuit I 5 6.50 $
•City: ( j j 3Th StateO R ZI P:979 d /— fib. Fee for branch circuits without purchase of a service or feeder fee:
_ - - First branch circuit(2) $ 60.50 $
Phone: 1 -7�/7�9 J 1 Fax: r _
E-mail: 4(Q,d\_ Each additional branch circuit —���� _.....__ $ 6.50 $
CCB license no.:_D-3D BCD license noS Miscellaneous fees:service 01 feedm nor included
Signing supervisor's license no.: 3..7-79---Xj AN or Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: AL ii, or ,C nl vWd'w Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy o (2 p net. $ 80.00 s
Signature of signing supervisor:
_IL..V l► ahrrafion.or extension(2) •
Each additional inspection:(I) $80.00 $ __
APPLICANT USE
(A) I ntet subtotal or above tees pp^�
• (Minimum Permit Fee$80.00) $Z8' .,* )
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(H)Enter 12%surcharge(.12 x IA]) $ 33r 4 4/ w
(CI Technology Fee(5%of[A]) $ j9,j 3
TOTAI..fees and surcharges(A Through C : �
440-zse4-lwtauzol3tconl) ( ) _
. 3t9