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Permit Electrical 2013-12-20
SPRINGI-IELD - 225 Fifth St t CITY OF SPRINGFIELD Springfield,OR 97477 en 4 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02710 wvrw.springfield-or.gov permitcenter©spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 12/20/2013 EXPIRES: 06/18/2014 STATUS DATE: 12/20/2013 APPLIED: 12/19/2013 SITE ADDRESS: 3221 MAIN ST 6,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702313105500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Branch circuit fire repairs(4) OWNER: EASTBURN JAMES L&CLAUDIA J Phone Number: ADDRESS: PO BOX 310 SPRINGFIELD OR 97477 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 II 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 r 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 1„ , Y.,, 9 „n: to ATTENTION: O: . :,- ,,, ., .ty 'ioi;CN ;;, ads . .S , ..t �,rth IohCc2 r 1 iiYgb:Ottsr i 'lo UdC � .� pFl r ��J Y'*''Y2L��Uut 'rl G tJy t`. . � r kmaa.,:.; r• X1 !DI II � I�fV11fi SMALL EXPIRE IF THE WORK fldSil� t f R�1 �:Ih^ ... j l{ NIZ D UNDER THIS PERMIT IS NOT t•e kt€F -tiNN--84 e CC)4i•.lMENOW® ®R IS ABANDONED FOR ANY I Da BAY PERIOD. Springfield Building Permit 12/20/201 10.48.52AM Page 1 of 1 Electrical Permit Application DEPARTMENT USE ONLY - SYftiNGfIfLO y� Sni i , ®hear Permit no.: }� 3 — 920 4� 225 Fifth Street•Spigfeld,OR 97477•1'tl(541)72G3753•FAS(541)7263689 -Jr'm OREGON / —/ 1 /5 Date: 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? III Yes ❑No Cost Total Number of inspections per item( Qty ea. cost CATEGORY OF CONSTRUCTION - Residential,per unit,service included: ❑ Residential ❑Government ❑Commercial JOB SITE INFOR AA•p7,,,TION AND LOCTN 000,y h orless(I) $14756 S 3 2 0 I MO it Each additional 500 sq. 0.or portion $ 27.50 S .lob site address: (1 thereof Cit . n � State: 0 (1 ZIP: 7 LH 7 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69,00 $ DESCRIPTION OF WORK dwelling serviced feeder(2) ripJ 0 1 ,/ y(i do���_ Services or feeders: inslrtllnnan alteration.lielocatiou 11 N 1' 200 amps or less(2) S 89.00 $ --" PROP 'TY 0 ER 201 to 400 amps(2) $ 104.50 $ Name: C a - a._ UVri 401 to 600 amps(2) $174.00 $ Address: G S j Or m 601 to 1.000 amps(2) $225.50 $ City: I fin �� �� ZIP - __.-_ y� Over I.00(l amps of volts(2) 5516.00 5 �� '.,�1L Reconnect only(2) S 69.00 5 Phone: - -! =a I Fax: - - -._.__.. E-mail: Temporary services or feeders: installation. alteration, relocalion 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 479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: Over 601)amps or 1.000 volts.see services or feeders section above CON?ACTOR IN TAL PION Branch circuits: new alwroliou evlension per panel Business I me: V ' q 0 1 a. Fee for branch circuits with purchase ofa service or leader fee: Address: N WM , Each branch circuit 1..-.._ ( 5 6.50 $ City: a - fV) crenc17 3 , b. Fee for branch circuits without purchase of a service or feeder fee: Phone. - 1-7 , ! SrIIMF 514 First branch circuit(2) $ 60.50 $ E-mail. Each additional branch circuit $ 6.50 $ Miscellaneous fees service oi Jeeder no included CCB license no.: �� BCD license no.:�����C .._. Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supuwsor. Each sign or outline lighting(2) $ 69.00 $ �� �� Signal circuit or a him ed energy panel, $ 80.00 $ Signature of signing super vis _ �_ c alteration.or extension(2) Each additional inspection:(I) $80.00 $ APPLICANT USE (A) Enter subtotal of above fees $r�%—. ---'''777 (Minimum Permit Fee S80.00) 3 77 (B) Enter l2%surcharge(.12 x[A]) 5 9 {°O (C)Technology Fee(5%of[A]) $ (.100 440-25844(4/0112013/COM) TOTAL. fees and surcharges(A through C): $ J .�