HomeMy WebLinkAboutPermit Electrical 2014-2-24 SPRINGFIELD 225 Fifth St •
'' CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
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his,
` `OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00404
www.springfield-or.gov permitcenter @springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 02/24/2014 EXPIRES: 08123/2014
STATUS DATE: 02/24/2014 APPLIED: 02/24/2014
SITE ADDRESS: 5940 MAIN ST,Springfield,OR 97478 • SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702343200800 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Service mast repair
OWNER: HORTON DON M&LAUREN E Phone Number: •
ADDRESS: 780 S 57TH ST
SPRINGFIELD OR 97478 .
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
DMH ELECTRIC CO (C)Electrical Conn 20-458C 07/01/2014 541-937-3721
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.
•
an
tractor Signature Date '
. .ATTENTION: Oregon law requires you to
•NOTICE: follow rules adopted by the Oregon Utility
Notificationenter. Those rules are set forth
THIS PERMIT SHAD-EXPIRE IF THE WORK 'C
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).
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Springfield Building Permit 2/24/2014 2:08:50PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
.t.t ; 225 Fifth St
;,� TRANSACTION RECEIPT Springfield,OR97477
�N 541-726-3753
OREGON 811-SPR2014-00404
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www.springfield-or.gov 5940 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000398 RECORD NO:811-SPR2014-00404 DATE:02/24/2014•[DESCRIPTION' • :• - - ACCOUNTCODE/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•PAYMENT TYPE `" PAYOR- CASHIER:CCARPENTER_ `___ - COMMENTS _ '" AMOUNT PAID 1
Check DMH ELECTRIC CO 93.60
1601
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY
` }- ,, - -_ :AX 9c SPRINGFIELD
C[TYQF SPRINGFIE jO G.0N' 4 t
1 Permit no.: 5-/-(7— �Q4.
225 Fifth Street•Springfield,OR97 477•P11(541)7263753•FAX(541)726-3689 zxa{' OHEGON r�� 9
Date: 7 I 2-1.1 //
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 wort: 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:
El Residential ❑ Government ❑ Commercial
JOB SITE INFORMATION AND LOCATION
1.000 sq. ft, or less(4) $147.50 $
Each additional 500 sq. 0. or portion $ 27.50 $ '
Job site address: .5-47 "(o �o,,,in thereof
City: S! ,,, I. '.jJ State:02 ZIP:g1 1/4(1ei Limited energy(2) $ 35.00 $
Reference: Ta.dot.: Each manufactured home or modular $ 69.00 S
DESCRIPTION OF WORK duelling service or feeder(2)
� Services or feeders: installation.alteration.relocation
L1_Y.ornntC:C $esArl(It- r'tt �rm.cto .'
cit.' 200 amps or less(2) 5 89.00 5
6� sio
PROPERTY OWNER 201 to 400 amps(2) $ 104.50
Aar 10 600 amps(2) 5174.00 $
T
Name: ,.yon Aar a
Address: 70o , 'o SL rn B - 601 to 1,000 amps(2) $225.50 $
City: ,,, tin W State: o ZI P:g797g Over 1.000 amps or volts(2) $516.00 5
Phone: f 5'F)-doC7 Fax: - Reconnect only(2) $ 69.00 $
Temporary services or feeders: installation. alteration. relocation
E-mail:
_.-.._.........._— 200 amps or less(2) 69.00 $
This installation is being made on residential or farm property
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 479560(1). 401 to(i00 amps(2) $138.50 $
Sin than' L vbL v Over 600 amps or 1.000 volts. see services or feeders section above
TRACTOR INS ALLATION Branch circuits: new. alteration, extension per panel
Business name M/re,------ a, Fee for branch circuits with purchase ofa service or feeder I'ec:
Address: Each branch circuit $ 6.50 $
City: State: rZIP: b. Pee for blanch circuits without purchase ofa service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 60.50
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E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 247 5 4 Each pump or irrigation circle(2) $ 69.00 I $
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 of above fees. pD
(Minimum I'eruul Pee$8(1.1111)
(B) Enter 12%surcharge(.12 NIA]) $ •�-.77
(C)Teeltn ologv.Fee(526 of IA It $ -0`o
440-2584-J(4/Ot/2013/CO\p 'TOTAL fees and surcharges(A through C): Sqq(JU