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HomeMy WebLinkAboutPermit Electrical 2013-12-20 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02721 www.springfeldor.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 12/20/2013 EXPIRES: 06/18/2014 STATUS DATE: 12/20/2013 APPLIED: 12/20/2013 SITE ADDRESS: 7134 A ST,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702353101104 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Circuit for ductless heatpump OWNER: ALBER CHADRICK P Phone Number: ADDRESS: 7134 A ST • SPRINGFIELD OR 97478 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone OWNER COB 000000 08/01/2025 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 re uired insp tions are requested at the proper time,that each address is readable from the street, that the permit rd boat at the on oft p perty, and the approved set of plans will remain on the site at all times during cons cti R/901 / Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to • " follow rules adopted by the Oregon Utility DTI�E; WORK Notification Center. Those rules are set forth {S PERMIT SHAEE MIS PERMIT IS NOT • in OAR 952-001-0010 through OAR 952-001- JTHOPtIZED UNDER OR 0090. You may obtain copies of the rules by OR IS ABANDONED F calling the center. (Note: the telephone ),�MENCE� PERIOD. number for the Oregon Utility Notification " 180 DA Center is 1-800-332-2344). • • Springfield Building Permit - 12/20/201 11:07:56AM Page 1 of 1 SPRINGFIELD-axis, CITY OF SPRINGFIELD 225 Fifth St LLO E�oN TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2013-02721 www.springfieldor.gov 7134 A ST permitcenter©spdngfield-orgov RECEIPT NO: 2013002719 RECORD NO:811-SPR2013.02721 DATE:12/20/2013 - . ;0 � � _'«,_u� _�� ...• _. `oTf�j CODE/TRANS CODE ', . _L3=AMOUNTEgg 'z Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 19.50 Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50 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 1.,_ TOTAL DUE: 93.60 P,AYMENT!ITtYPE, P,AYOR cnswER:oeowLSer COMMENTS. AM(NAVAID • Credit Card ALBER CHADRICK P 93.60 216926 TOTAL PAID: 93.60 • • • • • • Electrical Permit A pplica tion DEPARTMENT USE ONLY : y5 y SPRINGFIELD G �SPRING+ DOREGO V 9 3 Z-7 1/ r x ? +' , „. . m ar, t .:,, Permit no.: 225 Filth Street♦Srrin field.OR 97477•P11(54t726-3753. \\ 041)7 263689 ` sON EGO Date: /G C_'� //3 This permit is issued tinder 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 7eotaost l CATEGORY OF CONSTRUCTION ca. c Residential,per unit,service included: tie Residential ❑Government ❑Commercial JOB SITE INFORMATION AND LOCATION 000 sq. U.or less(4) $147.50 $ • Each additional 500 sq. ft.or portion Job site address: ---1y 1,S thereof $ 27.50 S City: 3 pe;nc-1ie1 G . state:OR ZIP:1-1 X 4.7 Limited energy(2) _ $ 35.00 $ : Reference: i 7ey3 S3 I Taxlot.O/ J L( Each manufactured home or modular dwelling service or feeder(2) $ 69.00 $ DESCRIPTION OF WORK POC*- e-55 kec T- r.�t ),/: Services or feeders: installation, altered on,relocation 1 _ 200 amps or less(2) $ 89.00 $ PROPERTY OWNER 201 to 400 amps(2) S 104.50 $ Name: C.,,"/"IC"CX P A\be C 401 to 600 amps(2) $174.00 $ Address: -71 3 4 A S I 601 to 1.000 amps(2) $225.50 $ r ' Over 1 000 amps of volts(2) $516.00 $ City: `J C i n C tL�U� Slate:Q ZIP: �Le�p O ..._.._. __-__ .......-.-_.._ - . Phone:S40 9 6q 63 Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: install((inn. alteration, relocorinn This installation is cing made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me -a emb •or mind i. e family. This 201 to 400 amps 12) $ 96.00 $ property is t t i code f r sal excl ., lease, or rent. OAR 479.540(1),nd 79.56 1). o� 401 to 600 amps(2) $138.50 $ �XSignatm'e: ' Over 600 amps or 1.000 volts,see services or fecdets section above CONTRACTO I ALLATION --___, ._,.- 1311111411 circuits: ne u.alteration, exteasimr per panel Business name: a. Fee for branch circuits wiih purchase of a service or feeder fee: Address: Each branch circuit I $ 6.50 $ City: State: ZIP: h. Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - _.First bninch circuit(2) ) I $ 60.50 $ E-mail: Each additionail branch circuit $ 6.50 $ CCB license no.: BCD license no.: fviiseelinncous fees:service Or.jeer/er nor inciur/ed Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Each sign or outline lighting(2) $ 6200 S Si^name of si min supervisor: Signal circuit or a limited-energy panel. $ g0.0o $ E S p alteration.or extension(_1 ------- -_----_ Each additional inspection: (I) $80.00 S APPLICANT USE y? � (A) Enter subtotal ofal 9-fees 513 ) (Minimum Pern ' Ree$80.00) (B)Enter 12%sun arge(.12 x[A]) $ (C)Technology Fee(5%,of IA I) $ V 4-10-2584-1(4/01/2013/COM) TOTAL fees and surcharges(A through C): $