HomeMy WebLinkAboutPermit Electrical 2014-1-13 •
SPRINGFIELD --- 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
GREG°" Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00086
www.springfield-or.gov perm itcentergspringfield-or.gov
PROJECT STATUS: Issued ISSUED: 01113/2014 EXPIRES: 07/12/2014
STATUS DATE: 01/13/2014 APPLIED: 01/13/2014
SITE ADDRESS: 1370 5TH ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703263101900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 200A service
OWNER: GREEN DAVID A 8 SHARRON E Phone Number:
ADDRESS: 1370 N 5TH ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor BOB FISHER ELECTRIC INC CCB 96275 01/25/2014 541-689-7973
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
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.
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility +OTICE: " "'`' ' .
Notification Center. Those rules are set forth THIS PERMIT SHALL. EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT :s:
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR .; ''`,
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 1/13/2014 2:49:50PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
=f q .__ 225 Fifth St
ra,; ; TRANSACTION RECEIPT Springfield,OR 97477
-:: ` OREGON 541-726-3753
811-SPR2014-00086
www.springtield-or.gov 1370 5TH ST permitcenter @springfield-ocgov
RECEIPT NO: 2014000074 RECORD NO: 811-SPR2014-00086 DATE:01/13/2014
?DESCRIPTION__________ __ ____ - _ . __. - _ __ACCOUNTCODE/TRANS_CODE:_ _ AMOUNT-DUE '
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68
Technology fee(5%of permit total) 100-00000-425605 2099 4.45
TOTAL DUE: 104.13
„PAYMENT TYPE - PAYOR - CASHIER:CCARPENTER' . , - COMMENTS_;,- ' -` AMOUNT!._AID_ - ..1
Cash BOB FISHER ELECTRIC INC '104.13
TOTAL PAID: 104.13
Electrical Permit Application DEPARTMENT.USE ONLY
$PRINGGIELO -'
1C GCITYOF SPRINGIEP ORE -t
tt-,r .,, _ •o a. Si . ' '
_ Permit no.:57(1-`79/Z2F
x .,_
225 Fifth Street♦Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689
!
/
Date: //j 3/7 y
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.
t-, . „ .LOCAL, GOVERNMENT:APPROVAL° 3 , , „ ' ° t„ , € s ' ,;EEJSCHEOULE 4„ u_ r , v; !
Zoning approval verified? ❑ Yes h �'`cr a t, s,� +'x ` rl r "-..x,;Cost n'',Totl
❑No .Number of mspecbons per:dem O_ 4"Qty a .w cost, .'
' 4`" .CATEGORY,OF„t ONSTRUCTION , o} ly; 'y, „ -" "`:tc'w
Residential, per unit,service included:
12-Residential ❑ Government ❑Commercial
,�:, 1,000 sq.ft. or less(4) $147.50 $
r.d JOB+SITEaINF-O.RMATION AND; OCATIpON;i w; ,
Job site address: / 3?O late" Each additional 500 sq.ft.or portion thereof $ 27.50 $
City: GeV/ fi rz@ State:Uh_- ZIP: Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular
.: 3 4 , zl�„ r dwelling service or feeder(2) $ 69.00 $
ag? '1DESCRIP_„TION' OF. WORK', TM c ,r , vim;;.
Services or feeders: installation, alteration,relocation
/g. 5-nct IVew mop t1f�
200 amps or less(2) / $ 89.00 �{
.' et,Z.' f,`,}"F` ?P.,ROPERTY; OWNERr,°; II 201 to 400 amps(2) ( $ 104.50 $$�� `
Name: nu v d- G. l e..r,_ 401 to 600 amps(2) $174.00 $
Address: /17 70 5-117- 601 to 1,000 amps(2) $225.50 $
City: 02!l/�jn p \ ` State: ZIP: Over 1,000 amps or volts(2). $516.00 $
Phone: -/_ - 7,` ' - Fax: - - Reconnect only(2) $ 69.00 $
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) $ 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
_ .
, , ;+�*�GONTR///A777C;TOR?rINSTAL'LATION , =°,'�,�c �' Branch circuits: new alteration, extension per panel
-Business name: /�o t f f S ken/ 2e7y` ',_ a. Fee for branch circuits with purchase of a service or feeder fee:
Address: /50 �l /-{c S h jel\A/ Each branch circuit $ 6.50 $
City: g I c7 tp y I State: 01,6. . ZIP: _ b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: 5-N ) - i713 7cj73 Fax:- - - First branch circuit(2) $ 60.50 $
E-mail: // - Each additional branch circuit $ 6.50 $
CCB license no.: Sly/15 BCD license no.: ' -35u.„ Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: -3 /75-5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: 6 9 6,w .D (2--;S 14, Each sign or outline lighting(2) $ 69.00 - $
Signal circuit or a limited-energy panel, •
Signature of signing supervisor: L. —� .. � alteration,or extension(2) $ 80.00 $
Each additional inspection:(1) $80.00 $
"_a zl S; 'o ';itAPP,LICANT k-Oti l ;; Xw” °'Ca+ F:
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[A]) - $ 474
(C)Technology Fee(5%of[A]) $ [ %
TOTAL fees and surcharges (A through C): $/G! g I?
440-2584-J(4/012013/C0M) •