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HomeMy WebLinkAboutBuilding Application 2014-2-19 Electrical Permit Application , . DEPARTMENT.USE ONLY .y.: ' .44 ; t. VielT, Yik.OESSPRINGFIELD.,thitORECTOW E--;t-t—Laa-0064- • 1:7?ti •:44::: ,,if.,4e.m.„*„ ,tii„e,,,,s,th,..,,,,a, aw.,..._ 0 -,,,,,i Pemnt no 225 Fifth Streets Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 ..a .. - Date:21/ /7 V 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. ,,ALOP‘Ali.Cg011,ERNMENT:WARPR-OVAL:filiAi.;,JA:.,t it..;:mi4,. .disft.t.,VTEE:i:scHEouLEatiMiWitA4k3y4F.,ih Zoning approval verified? E Yes 0 No -.iires. ..e019.-.: ,/-.,4-.1 j(z • ',..e, ?, . - --, (iLNiritiber,Of.liiipeietionkpei=liteirii(1( nth ,,,,;....;„,„ „...,-,. .„,.. ; ..11:1 .,,J,r,,,Preart1l'i r:..].'-21).;1C.AIEGORY].;lOF,1.],tONSTRUCTloN:::V;a;?:4.';.-,1Rg, - Residential, per unit,service included: - - — 'TA Residential El Government fl Commercial - .„..„.... 1,000 sq. ft or less(4) $147.50 $ ';11;:cThri;:U013.?,ISITE,INFOOMATiON,MNri'lticATION ;c1:-:,, Each additional 500 sq. ft.or portion Job site address: 336 Yia /6 "th s r thereof - $ 27.50 $ City: S ecCip State: Ott. ZIP: 4:1) V7 7 Limited energy(2) $ 35.00 $ Reference: /76 7 7 2 ye Taxlot :0 5/0 0 Each manufactured home or modular $ 69.00 $ A.M1,1]KliiSiD ES C RI wr 1 o N 51,0FtWO RKi!.1;14],1]AsiqSM,W.k dwelling service or feeder(2) STORM CAM AC C REC.6 NNC (7 Services or feeders: installation, alteration, relocation 200 amps or less(2) $ 89.00 $ Wif.."614iliii4rAWaP 130 P.ERPOLOWN E R:S141;11iiiltia 201 to 400 amps(2) $ 104.50 $ Name: Attit91)711 irt...--- ' P-air 401 to 600 amps(2) $174.00 $ Address: y2_5- isilenraterty-7--- 601 to 1,000 amps(2) $225.50 $ City: -.v7/t- Statee-p._ ZIP: ,n2 70/ Over 1,000 amps or volts(2) $516.00 $ Phone: - - Fax: - - Reconnect only(2) I $ 69.00 $ 69 E-mail: , Temporary services or feeders: installation, alteration, relocation 200 amps or less(2) This installation is being made on residential or farm property ' $ 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 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above .?...-:,1Yim1rieciNTERAPTIQFV,UNsTAELATIoN7t.t:g14-1g Branch circuits:new alteration, extension per panel Business name: C bS'TS i 0-C Et Eci la c a. Fee for branch circuits with purchase of a service or feeder fee: Address: 3S as 3 80SchGE 1-i•N C. Each branch circuit • $ 6.50 $ _ City: SPVLO State: 0R zip:97 1(7%) b.Fee for branch circuits without purchase of a service or feeder fee: Phone: S3i- / -) Y (- / Y 9'9 Fax:s 9_1 -734- V3 0 First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: I 177)() BCD license no.:.3 b 'YOSc Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 472 7S Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Ro 6 E g K)A,6- Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisor: lap-Vi $ 80.00 $ alteration,or extension(2) Each additional inspection:(1) $80.00 $ iMitialfitaWPIPEIcAtal§CnqatICFN • (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) S (B)Enter 12%surcharge(.12 x[A]) S (C)Technology Fee(5%of[A]) $ Vflfr TOTAL fees and surcharges (A through C): $ /301,2 440-2584-1(4/01/2013/C0M) SPRINGFIELD-+—, CITY OF SPRINGFIELD +�9 225 Fifth St `C TRANSACTION RECEIPT Springheld,OR 97477• OREGON 541-726-3753 811-SPR2014-00364 www.springfield-ocgov 336 1/2 16TH ST 1 permitcenter©springfield-or.gov RECEIPT NO: 2014000346 • RECORD NO:811-SPR2014-00364 DATE:02/19/2014 [DESCRIPTION, _ ACCOUNT_CODE/TRANS CODEk 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 ._PAYMENT TYPE- PAYOR-_casJIER:CCARPENTER _: _COMMENTS., _ _- :AMOUNT_PAID _ ' J Credit Card EASTSIDE ELECTRIC INC 93.60 07748g TOTAL PAID: 93.60 • • • • • a I. . SPRINGFIELD --_. 225 Fifth St A CITY OF SPRINGFIELD Springfield,OR 97477 -"I1 Phone: 541-726-3753 - OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00364 www.springfield-or-gov • permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 02/19/2014 EXPIRES: 08/18/2014 • STATUS DATE: 02/19/2014 APPLIED: 02/19/2014 SITE ADDRESS: 336 1/2 16TH ST 1,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703362409100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repair service mast OWNER: MATOON FAMILY TRUST Phone Number: ADDRESS: 825 SHERATON DR EUGENE OR 97401 • • L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 3' 117770 10/04/2015 541-741-1499 INSPECTIONS REQUIRED . 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. Owner or Contractor Signature Date fotl T ELATION: Or. . ,. Notific rules ado eQon law re SI)TICE: ation Center, y by the requires YOU to THIS PERMIT SHALL EXPIRE IF THE WORK 0090.ARou-OO1.0010 h�OUrhesa eOSe�fo th AUTHORIZED UNDER THIS PERMIT IS NOT cain YObtain OAR 952_00 _ . COMMENCED OR IS ABANDONED FOR 9 the center. co,;o°p1es of the rules t ANY 180 DAY PERIOD. ' number for the Ore Note: the tele Y ` Center is 1-00.332 2344�tifit caho� • • Springfield Building Permit 2/19/2014 9:22:54AM Page 1 of 1 •