HomeMy WebLinkAboutPermit Electrical 2014-2-11 '1'- 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-SPR2014-00242
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/11/2014 EXPIRES: 08/10/2014
STATUS DATE: 02/11/2014 APPLIED: 02/06/2014
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SITE ADDRESS: 1361 S ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703252301802 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: E-Washer/dryer relocate,with new water/sewer and feeder extensions
OWNER: HURD ZACHARY JUSTIN Phone Number:
ADDRESS: 1361 S ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 - 08/01/2025
Mechanical Contractor OWNER CCB 000000 08/01/2025
Plumbing 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 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.
4-0 - Z,-k l — 1�1
Owner o Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
NOTICE: 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 0090. You may obtain copies of the rules by
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
ANY 180 DAY PERIOD. number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 2/11/2014 11:14:50AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield,OR97477
S 541-726-3753
OREGON 811-SPR2014-00242
www.springfield-or.gov 1361 S ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000271 RECORD NO: 811-SPR2014-00242 DATE:02/11/2014
!DESCRIPTION__.____- _ _, _ .-.-_ -_ _ :. . : - . .._ACCOUNTCODE/TRANS CODE:,-_,• •!:,`-_.AMOUNT DUE
Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00
Permit Fee Adjustment-Tech Fee 100-00000-425605 2099 -0.01
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.01
TOTAL DUE: 93.60
,{-PAYMENT TYPE PAYOR;, CASHIER:CCARPENTER . COMMENTS:' - AMOUNT PAID a' j
Credit Card HURD ZACHARY JUSTIN 93.60
234880
TOTAL PAID: 93.60
•
•
Electrical Permit Application DEPARTMENT USE ONLY
���yf�y� rte.�7�ff f� ���. r SPRINGFIELD /�
a U U al MlL4SL4l4V Vu W LI EIE,ORT,CG �JLN,
B_L'ORIGON v Petmit no.: �� / ��� ;
225 Fifth Street•Springleld,OR 97477•PFI(541)126-3753•FA%(541)726-3689 /
Date: 2/6 / [ c/
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? 'gYes ❑No Number of inspections per item() Qty. Cost Total f
ea. cost
CATEGORY OF CONSTRUCTION Residential,per unit,service included:
is Residential ❑Government I ❑Commercial
o0o
JOB SITE INFORMATION AND LOCATION sq. a.or less(4) $147.50 $
Each additional 500 sq. 0.or portion $ 27.50 $
Job site address: \3\p\ rj �k- thereof tt
City: - v \rc \ \c\ 0,_State: . ZIP: di1t-1-11 Limited energy(2) $ 35.00 $
Reference: J Taxlot.: Each manufactured home or modular $ 69.00 $
dwelling service or feeder(2)
,,1
DESCRIPTION
! O\F, WORK 1
V-e(r((1-1LY(� OY Uf'('Y\0 X 1 "1��(� Services or feeders:installation,alteration,relocation
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 S
401 to 600 amps(2) $174.00 S t
Name: ra�(^i'l -4k1\y-rk I
Address:
2,VD\ c, c. 601 to 1,000 amps(2) $225.50 S
"� I
City: c_��O\ 1 QX�I I �,._ I C_l y-�—I Over 1,000 amps or volts(2) $516.00 $
Ci \.1CL\ (-` State: ZIP: i
Phone., Fax: - - Reconnect only(2) $ 69.00 S
Temporary services or feeders:installation.alteration.relocation
E-mail: 76,Gk\nUY('-\ 27 Ctcl.COM
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,exch nee,lease,or rent.OAR
479.5400)an 479.560(1). 401 to 600 amps(2) $138.50 $ I
Signature:A • 1, Over 600 amps or 1.000 volts.see services or feeders section above
C91(ITRACTOR INS ALLATION Branch circuits:new,alteration,extension per panel ,
Business name: �O 2_0k A 1■ftitr a.Fee for branch circuits with purchase of a service or feeder fee:
I
Address: Each branch circuit $ 6.50 I $
City: I State: I ZIP: h.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) ( $ 60.50 $Vf),w '
E-mail: Each additional branch circuit I $ 6.50 $ ' 0
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 olsi signing supervisor: Signal circuit or a limited-energy panel. $ 80 00 $
g g P alteration,or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE I
(A) Enter subtotal of above fees $ I
(Mininuun Permit Fee$80.00)
t
(B)Enter 12%surcharge(.12 x[A)) $
I
(C)Technology Fee(5%of[A)) $
440-2584-J(41012013/CONI) • TOTAL fees and surcharges(A through C): $ •
Eft s«- 2(/
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