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HomeMy WebLinkAboutPermit Electrical 2013-12-18 ti SPRINGFIELD 225 Fifth St c CITY OF SPRINGFIELD Springheld,OR 97477 = l Phone: 541-726-3753 ''.OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02701 www.springfield-or.gov permitce nter @sprin gfield-or.gov PROJECT STATUS: Issued ISSUED: 12/18/2013 EXPIRES: 06/16/2014 STATUS DATE: 12/18/2013 APPLIED: 12/18/2013 SITE ADDRESS: 706 OAKDALE AVE,Springfield,OR 97477 SCOPE: Electrical Only . ASSESOR'S PARCEL NO: 1703223110500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Rewire of upstairs bathroom due to fire OWNER: JOYCE D SUMMERS REV LVG TR Phone Number: ADDRESS: 2647 VALLEY FORGE DR EUGENE OR 97408 CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No - Lic Exp Phone Electrical Contractor BURRELL BROS ENTERPRISES INC CCB 136446 06/20/2015 541-747-2724 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 per it card is located at the front of the property, and the approved set of plans will remain on the site at all times during cons uction. 9 li lb ►ILI / -ic'-j3 Owne or Contractor Signature Date ATTENTION: Oregon law requires you to • ted by the Oregon Utility NOTICE: follow rules Center. THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set fort in OAR 952 001 0013 through OAR 952 oot- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by calling the center. (Note. the telephone COMMENCED OR IS ABANDONED FOR number for the Oreg on Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332 2344)• • Springfield Building Permit 12/18/201 1:50:05PM Page 1 of 1 SPRINGFIELD - - CITY OF SPRINGFIELD 225 Fifth St EGO TRANSACTION RECEIPT SpringfleI OR 97477 541-726-3753 811-S PR2013-02701 www.springfield-or.gov 706 OAKDALE AVE permitcenter©springfield-or.gov RECEIPT NO: 2013002701 RECORD NO: 811-SPR2013-02701 DATE: 12/18/2013 DESCRIPTION " ACCOUNVCODE/TRANS CODE AMOUNT,DUE__' Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 -6.50 Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 13.00 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 _PA YMENT TYPE :PAYOR CASHIER:CCARPE_NTeR COMMENTS __ • . AMOUNT PAID Credit Card Joshua J. Burrell 93.60 055776 TOTAL PAID: 93.60 • • • • Electrical Permit Application DEPARTMENT USE ONLY r) CIE ,OF� YSPR NGEIELD, oREGO y9�.. Permit no.:di( Zvi3 0270 225 Fifth Strect•Springfleld,OR 97477H'11(541)726 3753•FA\( 41)726 3689 N OREGON Date: / 7765V p /i 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 Zoning approval verified? ❑ Yes ❑No Number of inspections per item( ) Qty'.I Cost Total I per ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: XResidential ❑Government ❑Commercial JOB SITE INFORMATION AND LOCATION 1.000 sq. Ii.or less(4) $147.50 $ 7� w I A kda/�/1y Each additional 500 sq. ft.or portion S 27.50 S job site address: / thereof - City: OP fir?, - ' A State: l/✓l ZIP: 97Y77 _Limited energy(2) $ 35,00 $ Reference: 'I axlot.: Each manufactured home or modular $ 69.00 $ II DESCRIPTION OF WORK dwelling service or feeder(2) l^ n DESCRIPTION ri l!// Services or feeders: installation.alteration.relocation /✓/ J IN 200 amps or less(2) $ 89.00 $ PROPE- Y OWNER 201 to 400 amps(2) $ 104.50 $ Name: V ( 1 Li m./7S 401 to 600,imps(2) $174.00 $ Address: Jan=i mow 6✓ 601 to 1,000 amps(2) $225.50 $ City: ,... State: ZIP: Over I,000 amps or volts(2) $516.00 S Phone: V- Fax: - _ Reconnect only(2) $ 69.00 S E-mail: Temporary services or feeders: insinl(ation.♦hessian, relocation This installation is being ode on residential or farm property 200 amps or less 12) m $ 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 rem. OAR 479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1.000 volts,see services or feeders section above CO NTJACTOR INSTA i ATION ____ ___ Branch circuits:new alteration.exieusioa per panel Business na e: lqY Jr fa f) a. Fee for branch circuits with purchase of a service or feeder fee: Address: p d stir Each blanch circuit 1 $ 6.50 $ City': �--11G�®/'��]�/���� ZIP: rt 7 g b. Pee lisr branch circuits without purchase of a service or feeder fee: Phone: / ,t-pli 1`S we 4 51 First branch circuit(2) / $ 60.50 S E-mail: ! c r• D Each additional branch circuit $ 6.50 $ h r ,as . , i �r,o a r c � CCB license no.:13(i / , B ''�///lic���e'''nseno.: i Q-r; Miscellaneou.sfees:service o,'leedernotincluded Signing supervisor's license nit.: I 7 . J Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervise': I I ' Each sign or outline lighting(2) $ 69.00 $ ''Ii�/ ''�. Signal on.or xta sinned-energy panel, $ 80.00 $ Signature of signing nape alteration,or extension l2) II Each additional inspection:(I) $80.00 $ APPLICANT USE (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B) Enter 12%,surcharge(.12 x[A]) $ (C)Technology Fee(5%of[AD $ 60 T0TA1,fees and surcharges(A through C): $73 -� 44o-z5s4-)(4/0u2013lconn E.'z( )�