HomeMy WebLinkAboutPermit Electrical 2014-2-21 SPRINGFIELD
�,-. 225 Fifth St
-''t - CITY OF SPRINGFIELD Springfield,OR 97477
.Irk Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00384
www.springfield-or.gov permitcenter @spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/21/2014 EXPIRES: 08/20/2014
STATUS DATE: 02/21/2014 APPLIED: ` 02/21/2014
SITE ADDRESS: 464 W M ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703274410100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Reconnect due storm damage
OWNER: BARKER STEVEN V Phone Number:
ADDRESS: 464 W M 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
INSPECTIONS REQUIRED D
Inspections
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4200 Reconnect Service
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. L_
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S
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hAAP (a�1Jl- Z / . 1 / 14
Owner or Contractor Signature Date
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK . follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. These rules are set forth
in OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR
0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 2/21/2014 8:46:33AM Page 1 of 1
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SPRINGFIELD'� - - CITY OF SPRINGFIELD
� 225 Fifth St
TRANSACTION RECEIPT Spdngfield.OR 97477
� "� 541-726-3753
• OREGON 811-SPR2014-00384
www.springfield-cr.gov 464 W M ST permitcenter @spdngfield-or.gov
RECEIPT NO: 2014000372 RECORD NO: 611SPR2014-00384 - DATE: 02/21/2014
. - , - NS R-
l�x.�o1��;,fl�Col�t' ',�,'' -" _., ,`u �°'���z,,, v '`ACCOUNTCODERRANSCODE__ �eac,.;_:AMOUNTdDUE '�?c
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
frA A I T TxYP,E .., PAYOR. .gcASHIEa:: �nasof - COMMENTS) :, AMOUNTdPAID
Credit Card BARKER STEVEN V 93.60
- 145533
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY
spa»-'M s'ptyG-" 4, 3&•z; SYRINGFIELO
C O °SMIN = Il✓MI\UREGO 1 r -`-a-4 Permit no e(( - ?."1,-( —005(1
225 Fifth SUcet•Springfietd Oft 97477,PIf(541)726-3753.1 X(54t)726-3689 '� _ + .oaEGON
Date: Z /Z 7 // t
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? 0 Yes ❑ No Number of inspections per item () Qty. C To
ea ost cost tal
CATEGORY OF CONSTRUCTION
Residential, per unit,service included:
jj?'Residential ❑ Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 000 sq. ft. or less PI) $147.50 $
Each additional 500 sq. fl. or portion $ 27.50 $
Job site address: 1 (<� thereof
CilySpr a$ • _ State: 6 ZIP: •' 9•71 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK - dwelling service or feeder(2)
g q _ Services or feeders: installation. alteration.relocation
"+ �� - s — 200 amps or less(2) $ 89.00 $
On CU PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: Sri-tv 401 to 600 amps(2) $174.00 $
Address: t�� I" t rt.,-�- 601 to 1,000 amps(2) $225.60 $
/? Over 1,0(10 amps or volts(2) $516.00 $
City: ``�f ib! pJ pi �1 State: or ZIP: 9 7i(7'
Pltonee% V I'ax: - - Reconnect only(2) n $ 69,00 $
5i l zps- y
Temporary services or feeders: installation. alteration. relocation
F--mail:
'1-his installation is being made on residential or farm property 2(10 amps or less(2) S 69.00 $
owned by me or a member of my immediate family. This 201 to-100 amps(2) $ 96.00 $
property is not intended for sale,exchange, lease. or rent. OAR —
479.540(1)and r4—�79.560(1) 401 to 6(1(0 amps(2) $138.50 $
Signature: � �/�/// Over 600 amps or 1.000 volts,see services or feeders section above
CONTRACT INSTALLATION Branch circuits: new alteration. extension per panel
Business name: a. Pee for hranch circuits with purchase of a service or feeder lee:
Address: Each branch circuit $ 6.50 $
City: Late: ZIP: b. Fee for branch circuits without purchase ofa service or feeder fee.
Phone: - - Fax: - - first branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 S
CCB license no.: BCD license no.: Miscellaneous fees:.service of;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 $
Signal circuit or a limited-energy panel, $ 80.00 $
Signature of signing supervisor: alteration,or extension(2)
Each additional inspection:(I) $80.00 $ - -�
APPLICANT USE •
(A) Enter subtotal'n fabuve fees
(Minimum Permit Fee$80.00)
(131 Enter 12%surcharge(.12 x IA I) $
(C)Technology Fee(5%of IAI) $
440-2584-1 wl01/20 11rcoNq TOTAL fees and surcharges(A through C): 5.73