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Home My WebLink AboutPermit Electrical 2014-2-20 • SPRINGFIELD 225 Fifth St AI ..�; CITY OF SPRINGFIELD Springfield,OR 97477 f,tjr' Phone: 541-726-3753 ,,. OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00375 . www.apringfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 02/20/2014 EXPIRES: 08/19/2014 . STATUS DATE: 02/20/2014 APPLIED: 02/20/2014 SITE ADDRESS: 455 23RD ST,Springfield,OR 97477 SCOPE: Electrical Only • ASSESOR'S PARCEL NO: 1703361407900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: E-Bathroom/laundry remodel OWNER: CREATIVE REAL ESTATE SOLUTIONS LLC Phone Number: ADDRESS: 505 SW MILL VIEW WAY STE 250 BEND OR 97702 L CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08101/2025 Mechanical Contractor OWNER CCB 000000 08101/2025 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 wh.,are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections ar- -quested at the proper time, that each address is readable from the street,that the permit card is located at the front o - property, and the approved set of plans will remain on the site at all times during construction. L Owner •ontractor Signature Da,- c,r-;Ei 1T10N: Oregon IaWt requires you to IL',ova rules adopted by the Oregon Utility WORK h OAR 952-tretb;- NI; ru:ll Co der. Those rules are set f [3OTICE' obtain copies of the ruley in OAR 952-001-0010 ihrou ho THIS PERMIT SHAEE TIPS PERMIT IS NOT 0090. You may Note: the telep AUTHORIZED UND S ABANDONED FOR calling the center. ( Notification COMMENCED OR numberOfenter he is01e800 331212344). ANY 180 DAY PERIOD. Springfield Building Permit 2/20/2014 9:50:00AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD -t{. :»n......6.. t 225 Fifth St etE • TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 811-SPR2014-00375 www.springfield-or.gov 455 23RD ST ' permitcenter @springfield-or.gov RECEIPT NO: 2014000360 RECORD NO:811-SPR2014-00375 DATE:02/20/2014 ,DESCRIPTION - • _ --_ACCOUNT CODE/TRANS CODE ^AMOUNT DUEL J Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00 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 L PAYMENT TYPELPAYOR CASHIER:CCARPENTER • COMMENTS AMOUNT PAID - [ I Credit Card GLENDA BROWN 93.60 00203c TOTAL PAID: 93.60 • • • • • • • Electrical Permit Application DEPARTMENT USE ONLY . B T:^ -.. $ _.,y v. A i t'f 1 I N G E CI S O SPRILYGF�IELD OREGON ' , ;�y_ �7) like Permit no.: > ' fib' z: �''t'4`ia.. � . _ a 225 Fifth Slrecl$Springneld,Olt 97477•P11(541)726-3753•FAX(54t)726-3689 - -".OREGON Date: 2/2-6/iV 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? ❑ Yes ❑ No Number of inspections per item () Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential, per unit,service included: K2-Residential ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION 1.600 sq. ft. or less(1) 5147.50 Each additional 500 sq, ft. or.portion $ 27.50 $ Job site address: '�j76 Pb thereof City r/rJg-Phew State:or` ZIP: l7. Limited energy(2) $ 35.00 $ Refercnce: ao Taxlot.: Each manufactured home or modular $ 69.00 $ DESCRIPTION OF WORK dwelling service or feeder(2) // /[//�-- Services or feeders: installation, alteration. relocation -�/ l_�� 200 or amps c less 7 (-) $ 89.00 5 PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: / en e2, ,-,0U > 401 to 600 amps(2) 5174.00 $ Address: ' ‘ to-4 �0/� 601 to 1,000 amps(2) $225.50 City: a,f cnierc Slale:Oe ZIP: Over 1,000 amps or volts(2) 5516.00 5 Phone: � ,57y-was Fax:5 //- .9P--ai67 Reconnect only(2) 5 69.00 $ To Temporary services or feeders: installation, alteration, relocation E-mail: 7! 2/c-zz toWff/ e AS1:nJFL-- This instal ton 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 s' -, exchange, lease, or rent. OAR 479540(I) and 47 560 . 401 to 600 amps(2) 5138.50 $ Signature: Over 600 amps or 1.000 volts.see services or feeders section above t "TRACTOR INSTALLATION Branch circuits: neu, alteration, extension per panel i Business nt le: -r�rt/e71/4- - _ a. Fee for branch circuits with purchase of a service or feeder Ice Address: Each branch circuit • 4r' 5 6.50 $ City: State: ZIP: b. Fee for branch circuits without purchas jof a service or feeder fee: Phone: - - Fax: - - - First branch circuit(2) $ 60.50 5 E-mail: Each additional branch circuit 5 6.50 5 CCB license no.: BCD license no.: Miscellaneous fees:service of_feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) 1 $ 69.00 5 Print name of signing supervisor: Each sign or outline lighting(2) 5 69.00 $ Signal circuit or a limited-energy panel. s 80.00 $ Signature of signing supervisor: alteration;or extension(2) Each additional inspection: (I) / $80.00 $ /4, _ APPLICANT USE /' l (A) Enter subtotal of above fees (Minimum Permit Pee$80.011) (13)Enter 12%surcharge(.12 x IAII S (81- (C)Technology Fee(5%of IAl) $ le 440-2584-114/(1Ii2013iCONI) TOTAL fees and surcharges(A through C): $6 i . 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. or 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 CCB 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. • rVaP — e _ Print Name of"e pplica. Signay - of Permit Applicant Date • Permit#: /`(r 195 of SS � Address: [I 23 (> fitargit 7—q Pt- q to • • Issued by: Date: Z/ 2C)/y 1g59 • This Copy for Permit Offices •