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Home My WebLink AboutPermit Electrical 2014-2-10 SPRINGFIELD --- 225 Fifth St `` - CITY OF SPRINGFIELD Springfield,OR 97477 %i � Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00265 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 02/10/2014 EXPIRES: 08/09/2014 STATUS DATE: 02110/2014 APPLIED: 02/10/2014 SITE ADDRESS: 342 T ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703262106400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service mast repair OWNER: CHEVRIER JOHN J Phone Number: ADDRESS: 342 T ST#2 SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED II • Inspections 4200 Reconnect Service 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. ( //p// O r or Contractor Signature Date '(b17£3-3E2-008-1 si aa�ua0 uo!Weo!moN Apji 1 uo60.10 eql ao}iegwnu './TICE: euogdele egii :aloN) aaivao eql 6u!!Ieo IS PERMIT SHALL EXPIRE IF THE WORK Aq semi eqi yo Se!doo u!efgo Aaw noA '0600 JTHORIZED UNDER THIS PERMIT IS NOT -LOO-zs6 EVO enolg101.00 100-696 MHO u! .OMMENCED OR IS ABANDONED FOR LIT-101 los we saps esogl uewe3 uo!113011!loN ANY 180 DAY PERIOD. ApI!gn uoboio eqj Aq pO dope salsa Mollo} t . . . of noA sagnbel Mel uobeio :NOIIN311V • • Springfield Building Permit 2/10/2014 1:51.41PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD • hr f 225 Fifth St t�; TRANSACTION RECEIPT Springfield,OR97477 ONEGON 541-726-3753 811-SPR2014-00265 • www.springfield-or.gav 342 T ST permitcenter@springfield-or.gov RECEIPT NO: 2014000251 RECORD NO:811-SPR2014-00265 DATE:02/10/2014 [DESCRIPTION ACCOUNT CODE/TRANS CODE___ -_ __. AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 Service reconnect only 224-00000-426102 1004 69.00 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 I_ PAYMENT TYPE ' . PAYOR CASHIER:COARPENTER 7 COMMENTS AMOUNT PAID J Credit Card CHEVRIER JOHN J 93.60 021106 TOTAL PAID: 93.60 • Electrical Permit Application DEPARTMENT_USE ONLY ':; . Yom- pity t SPXINGRIELO i reFFVORSPRING141ELDZ4OREGO1 I �` -e _. Pent no.: $7q -2z S 225 Fifth Street•Springfield,OR 97477♦PH(541)726-3753•FAX(541)726-3689 Date: 21/ 0/ / U 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. a ="4t . ,s at.-OAL,;,GO-VERNMENT;APPROVAL :', "t AW.i.`":7''°,;FEE;wSCHEDULEk\-fi::cft*A:,', ;°- ` �s Zoning approval verified? Yes No '`ke '�'�' su 'sn , r ' K.fost Total=- pp ❑ ❑ Residential,per eunit, ervtee included: Qty- ,Yf'ea , -. cost.,:`. CATEGORY. OF:aCONSTRUCTION * . ded. ❑Residential ❑Government ❑Commercial 1,000 sq. ft.or less(4) $147.50 $ ,,c JOB SITE,INFORMATION=ANDsLOCATION.. ,;,�, .3 Li p %-S/ Each additional 500 sq.fr.or portion Job site address: r address: thereof - $ 27.50 $ City: /U State ZIP: 9 7Z/77 Limited energy(2) . $ 35.00 $ Referent& Taxlo[ Each manufactured home or modular $ 69.00 $ I ' a1I DESCRIP,TICSWOF :WORK`: dwelling service or feeder(2) Re 6C C n l�c/r//./c ./1 SUS / Services or feeders: installation, alteration, relocation CJ //ro,v] A:let- -7cc S U Q Fi°(Q 200 amps or less(2) $ 89.00 $ a'- ? ..r -r`+4_=4PROP_ERTY;,;OWNER , _i1.. ,n t 201 to 400 amps(2) $ 104.50 $ Name: Joti� CGS( r)e r 401 to 600 amps(2) $174.00 $ Address: 3'-f r9 ] 601 to 1,000 amps(2) $225.50 $ City: / StatOV Y ZIP:/ Lj)7 Over 1,000 amps or volts(2) $516.00 $ Phone: [7I do�I 57 SLi Fax: - - P. Reconnect only(2) / $ 69.00 4_U 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 ' tended for sal change, lease, or rent. OAR 479.5400)ar 79 560(1). � to 60 amps(2) $138.50 $ Signature C ` Over 6 O Ov amps 600 amps or 1,000 volts,see services or feeders section above P,tl d'1+.u$'.,',_._. ONTRACTOR INSTALLATION 1''r'(£:011- Branch circuits: new alteration, extension per panel Business name: 97.-1 A.-{-47----- 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.: I BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) 1 $ 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 $ ^" 'ta± 'fi �� , APPLICANTn�USE"�. w ��" � =�.r=°� „,.� ��,._ �_, � a � ,. _ ter, Y'�i (A) Enter subtotal of above fees $ �7�, (Minimum Permit Fee$80.00) U.f'� (B)Enter 12%surcharge(.12 x[A]) $ 960 (C)Technology Fee(5%of[A]) $ ad TOTAL fees and surcharges (A through-C): $ 9 Z 6 440-2584-1(4/01/2013/COM) Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date • I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. AP or • j PIS I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the COB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • i JOAxV l_AeVrlCI^ • Print Name of Permit Applicant . ure l Si of Permit Applicant Date Permit#: C/ C-7 '7�5� pF 3 yZ 70 Sr Address: a;re�r1�.vhrirr :ihn Cie� �2 574(77 Issued by: Date: -7:—/76)// This Copy for Permit Offices