HomeMy WebLinkAboutPermit Electrical 2013-12-23 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
o4- Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
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PERMIT NO: 811SPR2013-02725
www.springfield-or.gov permitcenterQspnngfeld-ocgov
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PROJECT STATUS: Issued ISSUED: 12/23/2013 EXPIRES: 06/21/2014
STATUS DATE: 12/23/2013 APPLIED: 12/23/2013
SITE ADDRESS: 2066 G ST,Springfield,OR 97477 SCOPE: Heating System
ASSESOR'S PARCEL NO: 1703361205500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Heat pump and furnace
OWNER: ALVAREZ ALEJANDRO ABARCA Phone Number:
ADDRESS: 2066 G ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor OWNER CCB 000000 08/01/2025
Electrical Contractor OWNER CCB 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 emplo ho are in compliance with ORS 701.005 will be used on this project. I further agree •
to ensure that all required inspe :-" •ue -• -t-the proper time, that each address is readable from the street, that the
permit card is lo ated - ".• • - property, and the approved set of plans will remain on the site at all times during
constructi
/ - 5 3
Owner or Contractor Signature Date •
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth . MnTICE.
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
Springfield Building Permit 12/23/207 1:36:43PM Page 1 of 1 •
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SPRINGFIELD --. CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfelef OR 97477
tie, , 541-726-3753
e OREGON 811-SPR2013-02725
www.spnngfield-or.gov 2066 G ST " pennitcenter @springfield-ar.gov
RECEIPT NO: 2013002728 RECORD NO:811SPR2013-02725 DATE: 12/23/2013
bESCRIPTION „a= - emu:+ _ TT
t��''�'"Y�.='.ACCOUNTiCODE/TRANS'CODE N-C-T L— • Ilo e
Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00
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 6.50
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
TOTAL DUE: 93.60
PAYMENTTaYPE?'.. �WAY,ORt"1Y.cnsrirgi: utr aigeOMMENTS , ;;IAMOURIONID.'z
Cash ALVAREZ ALEJANDRO ABARCA 93.60
TOTAL PAID: 93.60
Electrical Permit Application ,,. , btoARTmENT:usEoNLy 7:-,:spnrNarIELo
I
.:5CIIPle.t.OFSPRINGETELLIVOREGON55. ,„..,.‘ 7-.--“:- :-w.m4.-:'
49%1-tYtitYiti,ii. .141,0 77,1,at:,,i-'77-r-4n41.?1t4itteCtSir4-111-tielattalISZSit&t:41,44::: r‘t- ‘ ";- Permit 11°•:_5/3 - a 11 z sr
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689
Date: I 01 /7
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.
;:ciiili4L1:00 CCG OVERN M E NTTA PP R OVA GYAIWA:inf-,t ?::?,...::`,:anW,..c.,-",..A9FEE,:,.3:3CHEDULEtk'Maritett34M.FA
Zoning approval verified? 111 Yes n No , ,■9117, 1s4ctr; # aLOGnigt4;VTOtaTc%
tc/,9,1109r-14!wfstr!,..:Pcril!ETS-)it:c 9!),/ttcwisi.4k; V
',:;5W:g.CATEGOI3n0FAC.ONSTRUCTIOCalmpa ---- --------' ------''.----7"----
Residential,per unit,service included:
dResidential li Government n Commercial
1,000 sq.ft. or less(4) $147.50 $
!A:1;r.nUOB f,SITE:r.1 N F.0 RMATION;AND)'''110,CATICINI;:iht.C:Wci;
_ Each additional 500 sq.ft or portion
Job site address:26C s 1-- thereof - $ 27.50 $
City: Cy r;rIcci-: e Id State: 0 a_ ZIP: q 7 q 77 Limited energy(2) $ 35.00 $
Reference: 1 70 33 ic, ( 7_ Taxiot.: a sso 0 Each manufactured home or modular
$ 69.00 $
Wr1.*11(1144SMIDESCRIPTI 0 N'...',C)EMO RFON6XaVaM dwelling service or feeder(2)
- Services or feeders: installation, alteration,relocation
2 13.1r6•- e-Y S
200 amps or less(2) $ 89.00 $
flaigiallatcq§:P ROPERWALOWNERMAINAMICS 201 to 400 amps(2) $ 104.50 $
Name: 4 [ft, c.„ Ay° 6, CA_
A6 ,,, •C 401 to 600 amps(2) $174.00 $
el
Address: 70 CC 0 5 4.. 601 to 1,000 amps(2) $225.50 $
State:0a, ZIP:
City: Fu 1
Over 1,000 amps or volts(2) $516.00 $
2 ene 1,7 q?..72
Phone:51-f(5-7q' 1560.S Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders: installation, alteration, relocation
200 amps or less(2)
This installation is being made on residential or farm property I $ 69.00 , $
owned by me or a member of my immediate farriily. 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). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
.RWPIa1sfilicON;TneTp INSTALLATION ,i1,:',.:W;i:00X1L-A Branch circuits:new alteration, extension per panel
Business name: 0 toest cr",_ a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit $ 6.50 $
City: State: ZIP: b.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 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor:
Signal circuit or a limited-energy panel,
$ 80.00 $
alteration,or extension(2)
Each additional inspection:(1) $80.00 $
flat„„L. 411,slara-PleEltratTia§ESKitererAl
(A) Enter subtotal of above fees
$
(Minimum Permit Fee$80.00) go
(B)Enter 12%surcharge(.12 x[A]) $ FiC)
(C)Technology Fee(5%of[A]) $ 11
TOTAL fees and surcharges(A through C): S F3 (5
440-2584-1(4/01/2013/COM)