HomeMy WebLinkAboutPermit Electrical 2013-11-26 •
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SPRINGFIELD • 225 Fifth St
• CITY OF SPRINGFIELD springfield,OR 97477
1l.„4; Phone:541-726-3753 - . "
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02579
www.springfield-cr.gov permitcenter @springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 11/26/2013 EXPIRES: 05/25/2014
STATUS DATE: 11/26/2013 APPLIED: 11/26/2013
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SITE ADDRESS: 3955 S E ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702314403900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New Shop Service and 3 circuits
OWNER: SHELDON CARY 84 MARGARET D Phone Number: 7 Lj(o'— 6F5—C-9
ADDRESS: 3955 S E ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 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.
` �714;ga f 00 . H_ ow_ _ moo/�
Owner or Corciractor Signature Date
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NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 90 -001-0 Center. 0 through gh OAR set forth
0 -
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 11/26/201 1:33:38PM Page 1 of 1
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SPRINGFIELD — CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT - Spnngfield,OR 97477
541-726-3753
OREGON 811-SPR2013-02579
www.springeeld-or.gav 3955 S E ST pennilcenter @springfield-or.gov
RECEIPT NO: 2013002569 RECORD NO:811-SPR2013.02579 DATE: 11/26/2013
B CR P.TION Watir ::- s;-1..th ,-,,T.L.s.t3. . ACCOUNT CODE/TRANS o a ;: r"` 1 AMo UNT DUET
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less - 224-00000-426102 1004 89.00
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State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.02
Technology fee(5%of permit total) 100-00000-425605 2099 5.43
TOTAL DUE: 126.95
P.AYMENTral E „P.A ZI WENTS - .. - - AMOUNTIRAID
Credit Card SHELDON CARY&MARGARET D 126.95
026972
TOTAL PAID: 126.95 •
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Electrical Permit Application
DEPARTMENT USE ONLY
CT, , F SPRIKoriirog RG0? a SYfla L0 0?.A.t. --,,,,_
. Yr ar .", . -E , s. .„ Permit no ✓//f 7Q7 3 7
7qq
225 Fifth Si'eet+Sp m)field,OR97 477+ l0'41)7263753♦F x\(c41)7263(89 OREGON
Date: ///Z G/ 3
'Phis permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
clays of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? 0 Yes ❑ No Number of inspections per item ( ) Qty. Cost Total
rl. oust
CATEGORY OF CONSTRUCTION
Residential,per unit,service included:
'aResiclent ial ❑Government ['Commercial
JOB SITE INFORMATION AND LOCATION 000 x1. ft.or less f4) $147.50 $
big Each additional 500 sq. ft.or portion •
Job site address: j�s5 Oe uG`7 St thereof $ 27.50 S
City: ZpII4 State: Ove ZIP: Q71178/ Limited energy(2) $ 35.00 $
Reference: t l Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
C r 0 Services or feeders: installation.alteration.relocation
,llJlrin� A) h in
200 amps or less(2) $ 89.00 $ 84„00
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 S
1 fv(ar aY t 401 to 600 amps 7 $174.00 S Name: LA cw e{�el o l
__
Address: 5-5 cOp usEh r}` ,s-I. 601 to 1.000 amps(2) $225.50 S
City: S�-r(c( State: (_/ -e ZIP: 2is y 78 Over 1,000 amps or volts(2) $616.00 S
Phone:Jill_7•16, - 14150 Fax: - -
Reconnect only(2) $ 69.00 S
L-mail: Temporary services or feeders: installation. alteration, relocation
This installation is being made no residential or farm property 200 amps or less(2) S 69.00
owned by me or a member of my immediate fainily.This 201 to 400 amps(2) $ 96.00 $
property is not intended for sale,exchange. lease,or rent. OAR
479.540(1)and 479.5600). /(� 'n �1 / 401106(10 amps(2) $138.50 $
Signature: //( mi#fJf /6- F-? PS Over 600 amps or 1.000 volts.see services or feeders section above
COIN.TKNCTOR INSTALLATION Branch circuits:new alteration,extension per panel
Business name: V a. Fee for branch circuits with purchase of a service or feeder fee:
Address: - Each branch circuit IJ $ 6.50 $lef,50
City: State: ZIP: h. 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 $
CCI3 license no.: BCD license no.: Miscellaneous fees:.service orjeeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 5
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $
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Signal circuit or a limited-energy panel. $ 80.00 $
Signature of signing supervisor: alteration.or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees S
(Minion in Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[A]) $
• (C)Technology Fee(5%of[A]) $ �a
440-2584-)19/0 1120 1 3/CO:vll TOTAL fees and surcharges(A through C): S/ 1--5—