HomeMy WebLinkAboutPermit Electrical 2013-12-13 SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfield.OR 97477
Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax. 541-726-3676
PERMIT NO: 811-SPR2013-02668
www.springfield-or gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 12/13/2013 EXPIRES: 06/11/2014
STATUS DATE: 12/13/2013 APPLIED: 12/13/2013
SITE ADDRESS: 1048 S 34TH PL,Springfield, OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1802062402100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Rewire House after fire damage
OWNER: WAGNER GLENN C&LANA R Phone Number:
ADDRESS: 1205 CLEARWATER LN
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Eectncal Contractor WILLIAM A GRAY JR CC° 21351 C4;28/2014 541-485-3954
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.
_.,e,_:e,3, 2
/,2—A.3/ 3
Owner or Contractor Signature Date
1 a'm r� I I 's. you t0
ATTE71TIntl: OSnnn1 If '�r3 l kl'ity i'OTICE:
;;Mow rules ad-�'. : �')'
_,: ,- n T l forth T:IIS PERf�91T SHALL EXPIRE 1F THE WORK
;,� T I-iORIZED UNDER THIS PERMIT 1S NOT
C C I E N C E D OR IS ABANDONED FOR
,;l' 180 DAY PERIOD.
Spnngfield Building Permit 12113/201 9:57:24AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
_______alimiii
225 Fifth St
< O. TRANSACTION RECEIPT Springfield.OR 97477
OREGON 541-726-3753
811-SPR2013-02668
www spnngfieldor gov 1048 S 34TH PL permdcenter @spnngfield-or gov
RECEIPT NO: 2013002659 RECORD NO:811-SPR2013-02668 DATE: 12/13/2013
.
Each added 500 sq. ft. or portion 224-00000-426102 1004 27.50
Residence wiring 1.000 sq ft. or less 224-00000-426102 1004 147.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 21.00
Technology fee(5%of permit total) 100-00000-425605 2099 8.75
TOTAL DUE: 204.75
Check Tom G.WIRFS Enterprises. INC. 204.75
9454
TOTAL PAID: 204.75
Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
CITY OF SPRINGFIELD, OREGON Permit no.: E3Ik'?c,13—o24
225 Fifth Street•Springfield,OR 97477•PH(54I)726.3753•FAX(541)726-3689 OREGON
Date: / 2/34.3
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
e
Zoning approval verified? ❑ Yes ❑ No Number of inspections per item() Qty. Cost Total
CATEGORY OF CONSTRUCTION t ea. cost
❑ Residential ❑Government ID Commercial Residential,per unit,service included: 5'0
JOB SITE INFORMATION AND LOCATION 1,000 sq.fl.or less(4) / $147.50 S / 7.
Each additional 500 sq.fi.or portion ���
Job site address: f t-f g 6' . g<7/ pL thereof / $ 27.50 S �7-
City`cpr`/L -(214,1 Stated22 ZIP:q 7C/77 Limited energy(2) $ 35.00 S
Refereftce: Taxlot.: Each manufactured home or modular $ 69.00 $
. DESCRIPTION OF WORK dwelling service or feeder(2)
i, 4/__-S� � � /� 'Services or feeders:installation,alteration,relocation
z1 KP 200 amps or less(2) S 89.00 $
j PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: ,C.Q n et, ,Co -6.0 1--- 401 to 600 amps(2) 5174.00 S
Address:/off Q� Cezaez,��:IC 4,4.4_.... 601 to 1,000 amps(2) 5225.50 S
City 2 State:Vc--, I ZIP: 97 ,-7 N Over 1,000 amps or volts(2) 5516.00 $
Phone: - - I Fax: - - Reconnect only(2) $ 69.00 S
E-mail: 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) $ 98.00 $
property is not intended for sale,exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits:nett, alteration, extension per panel
Business name: r t f t5 /,r c_7". . a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 5 77 S ,R r 4 E 4 . ) - Each branch circuit I 5 6.50 I $
City: Z ,� of I State: 0 V I ZIP: '7/0 Z b.Fee for branch circuits without purchase of a service or feeder fee: .
Phone: S.17I/- S d / 5 050 Fax: '7/ 3 L/5/3 55 First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.60 $
CCB license no.: g/ )s r I BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 7 go 5 Each pump or irrigation circle(2) S 59.00 S
Print name of signing supervisor: T3,' // Cr,,- 4. 7 Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel
Signature of signing supervise 4/2 , $ 80.00 $
�i� alteration,or extension(2)
Each additional inspection:(1) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $ /75..
(B)Enter 12%surcharge(.12 x[A]) S / ea—,.J
(C)Technology Fee(5%of[A]) $ e `75
440.2584-J(4/U1/2013/C0M) TOTAL fees and surcharges(A through C): $ 004/, 7s