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HomeMy WebLinkAboutPermit Electrical 2013-10-16 ,SPRINGFIELD - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 C‘.. Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02309 www.springfeld-or.gov permitcentertidspringfield-or.gov PROJECT STATUS: Issued ISSUED: 10/16/2013 EXPIRES: 04/14/2014 STATUS DATE: 10/16/2013 APPLIED: 10/16/2013 • • • SITE ADDRESS: 5107 E ST,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702332403100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Extendeding Cirucit for additoinal plugs OWNER: BOSSHARDT GLENN P&ANNETTE K Phone Number: • ADDRESS: 5107 E ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER COB 000000 08/01/2025 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. • Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Pt(3TICE: Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Nuiu: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-bu0-332-2344): . Springfield Building Permit 10/16/201 12:54:44PM Page 1 of 1 • • SPRINGFIELD `" - CITY OF SPRINGFIELD 225 Fifth St • o EGOS TRANSACTION RECEIPT SpringfiHd,OR97477 541-726-3753 811-SPR2013-02309 www.springfield-or.gov 5107 E ST permitcenter©springfield-or.gov RECEIPT NO: 2013002291 RECORD NO:811-SPR2013.02309 DATE: 10/16/2013 c7: yea ^1,`+ t ` } ,� �,"AGCOUNTCODE/TRANSFCODE AMOUNTPDUEI` Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 19.50 Branch circuits without service or feeder-1st circuit 224-00000-426102 1004 60.50 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: 93.60 P„AYMENT4170, , rPA I Er9RiERMAToN " ZCOMMERSS ,` AMOUNT¢P;AID;. `1 ';,nor:-i t=i 1,*:' Credit Card BOSSHARDT GLENN P&ANNETTE I 93.60 062951 TOTAL PAID: 93.60 Electrical Permit Application DEPARTMENT'USE ONLY _:: CIT 50E SPRTNGFIELFD OREGON hrjtk w; Permit no,:9 / ( 20( 3 (7Z30f 225 Fifth Streets Springfield,OR 97477*PH(541)726-3753•FAX(541)726-3689 .. 0//1/ 3''t Date: i 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. ` .1(NLIOei%L CG()VERNMENT: APPROVAL x };s F " `,, ''s`t`' t `at,i FEE: SCHEDULEI,;,.' =,4:_M2 Zoning approval verified? ❑ Yes ❑No to Post Total l. -Numb r w inspections per item 0, I�'i Qtys i;ea ,' s °cost,T aTI CATEGORY),OF,kCONSTRUCTI0N ; y,ft.t : Residential,per unit,service included: ❑ Residential ❑Government ❑Commercial 1,000 sq. ft. or less(4) $147.50 $ JOBISITE;JNFORMATION -AND410CATION t L2iti;" Job site address: ` / Each additional 500 sq.ft.or portion S//0 7 YA7-r;$ thereof . $ 27.50 $ City: 5, v t ? State: di ZIP:971.0 U Limited energy(2) $ 35.00 $ Reference: Taxlot Each manufactured home or modular $ 69.00 $ c. ;7 rtEit pESCRIPTION'?QF,:WORK , i r'"�ti_o; ',r,�„„,1, dwelling service or feeder(2) / /.770 Jn �f 7/0 6 Cf try 27 G y r eC,---1 Services or feeders: installation, alteration,relocation 200 amps or less(2) $ 89.00 $ ; ;" ,i„s;li .PROEl ERTlr IDYYN E RaMicalafala 201 to 400 amps(2) $ 104.50 $ Name: 401 to 600 amps(2) $174.00 $ 4'i - A i A Address: .57 ( ) e S 601 to 1,000 amps(2) $225.50 $ City: y./h 7/9‘i State: Q ZIP't 00 Over 1,000 amps or volts(2) $516.00 $ Phone:A.- 70 'jig/f f Fax: -4Y/777 Reconnect only(2) $ 69.00 $ / Temporary services or feeders: installation, alteration, relocation E-mail: at/ l k �fA.p2'/ L 0-� 200 amps or less(2) This insta�ti n 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 479.5400)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature:Sy.; - i / Over 600 amps or 1,000 volts,see services or feeders section above ,ltONTRACTOR#INSTALL'AT,ION , lta: rit','H Branch circuits:new, alteration, extension per panel • Business name: a.Fee for branch circuits with purchase of a service or feeder fee: Address: 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,: 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 $ "'* l 'AP,PEr ArrAILISEn„ '"a*' s x9270 (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges (A through C): $ 73 440-2584-J(4/01/2013/COM)