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Home My WebLink AboutPermit Electrical 2013-10-25 • SPRINGFIELD 225 Fifth St • a;3 iii CITY OF SPRINGFIELD Springfield,OR 97477 ''- OREGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02387 e' www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 10/25/2013 EXPIRES: 04/23/2014 STATUS DATE: 10/25/2013 • APPLIED: 10/25/2013 • SITE ADDRESS: 2273 ROSE BLOSSOM DR,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703261103207 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace 200a panel and 5 branc circuits _ OWNER: MELOY CHRISTOPHER A&KATHRYN R M Phone Number: ADDRESS: 2273 ROSE BLOSSOM DR • SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER GCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 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. , • • Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth NOTICE: in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 00c9a0l.l i nYgo may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT number for the OregontUtil ty Notification COMMENCED OR IS ABANDONED FOR Center is 1-800.332-2344). ANY 180 DAY PERIOD. Springfield Building Permit 10/25/201 2:34:01PM Page 1 of 1 • • SPRINGFIELD`-- , CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2013-02387 • www.springfield-or.gov 2273 ROSE BLOSSOM DR permitcenter @springfield-or.gov RECEIPT NO: 2013002360 RECORD NO: 811SPR2013-02387 DATE: 10/25/2013 DESCRIPTION "± a 'i;tri -. t'ACCOUNT'CODE/TRANS'CODE:: ' Mtn IoM : Branch circuits with service or feeder each circuit 224-00000-426102 1004 32.50 Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 14.58 Technology fee(5%of permit total) 100-00000-425605 2099 6.08 TOTAL DUE: 142.16 -P.AYMENTEi YPE WP.AY.OR caswER:aaP,eNTeR. COMMENTS AMOUNTkpelp Credit Card MELOY CHRISTOPHER A&KATHRY 142.16 045305 M TOTAL PAID: 142.16 • • • • Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Chris 1414107/ Print Name of Permit Ap p/nt c :v to/.s /3 Signature of Permit Applicant Date Permit#: 5/3- 2377 or 2213 Ao s c f5W5 •=%^' • Address: 'fit m;A11g;:, vkm�4:r, 5fra« ,/4ncz-n ?7,-E77 Issued by: 3—Bate: /, ZS//3 :59 This Copy for Permit Offices Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD C/� 7 CITY OF SPRINGFIELD, OREGON c ' Permit no.: (l' / YI 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FA%(541)726-3689 ll IIES.OREGON /J Date: 7U/`25// •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 CATEGORY OF CONSTRUCTION ea. cost ❑Residential ❑Government I ❑Commercial Residential,per unit,service included: JOB SITE INFORMATION AND LOCATION 1,000 sq.R.or less(4) $147.50 $ 2273 Rose Blossom Dr. Each lional500 sq. li.orponion $ 27.50 $ Job site address: thereof ereof City: Springfield State: OR ZIP: 97477 Limitedenergy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ •DESCRIPTION OF WORK dwelling service or feeder(2) Replace 200A Service. Add Branch Services or feeders:installation.alteration,relocation 1 Circuits in attached Garage 2o0ainpsor less(z) $ 89.00 $�j,00 PROPERTY OWNER 201 to 400 amps(2) $ 104.60 $ i Name: Chris & Katie Meloy 401 to 600 amps(2) $174.00 $ Address: 2273 Rose Blossom Dr. 601 to 1,000 amps(2) $226.50 $ City: Springfield State: OR ZIP: 97477 Over 1,000 amps or volts(2) $516.00 $ Phone:541- 79-3044 Fax:541-988-7028 Reconnectonly(2) $ 69.00 $ E-mail: Y 9 melo f 5d@ mai 1 .com Temporary services or feeders:installation,alteration,relocation This installation is being made on residential or farm property 200 amps or less(2) $ 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-47+ 9.560(1). ,7 bv,V E R 401 to 600 amps(2) $138.50 $ Signature: C es 56c - Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATI Branch circuits:new alteration,extension per panel fff Business name: a. Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit 5 $ 6.50 $31.50 City: State: ZIP: b. Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.60 $ 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 $ ,III Signal circuit or a limited-energy panel, Signature of signing supervisor: alteration,or extension(2) $ 80.00 $ Each additional inspection:(1) $80.00 $ APPLICANT USE (A) Enter subtotal of above fees $ �a).5-0(Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x IAD - $ 19%.5g (C)Technology Fee(5%of IA)) $ 4.0 g 440-2584-1(4/01/2013/COM) TOTAL fees and surcharges(A through C): $iya,i 4,