The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2014-2-27 • SPRINGFIELD 225 Fifth St _ CITY OF SPRINGFIELD Springfield,OR 97477 ( St Phone: 541-726-3753 t`.. )`: OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00444 www.springfield-or.gov permitcenter @springtield-or.gov PROJECT STATUS: Issued ISSUED: 02/27/2014 EXPIRES: 08/26/2014 STATUS DATE: 02/27/2014 . APPLIED: 02/27/2014 SITE ADDRESS: 2150 LAURA ST,SPC#42,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703271004700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Run sevice entrance underground OWNER: MOUNTAIN TRUST Phone Number: ADDRESS: 2154 LAW LN EUGENE OR 97401 • L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections ' 4225 Service or Feeder 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 cons .. ion. & jr /✓� j./ 7 �-1 / -/ Owner or Contractor Signature // Date • tO Oregon law requireson 11Cl ty . .:E: AnENTION. fed by the Oregon PERMIT SHALL EXPIRE IF THE WORK follow rules ad°p rules are 52.0 forth Those Notification 0010thr°— h OAR952 001- `}RIZED UNDER THIS PERMIT IS NOT InOARg52-001- obtain copies of therhoney rviENCED OR IS ABANDONED FOR• Oo90. You may Note: the telep ' 180 DAY PERIOD. - calling the center. (Note: Notification egon numbefCentee Is Springfield 800-332"2344). Springfield Building Permit • 2/27/2014 1:13:02PM Page 1 of 1 • SPRINGFIELD— CITY OF SPRINGFIELD 225 Fifth St <� TRANSACTION RECEIPT Springfield,OR 97477 I`' � OREGON 541-726-3753 811-S P R2014-00444 www.springfield-or.gov 2150 LAURA ST. SPC 42 permitcenter @springfield-or.gov RECEIPT NO: - 2014000452 RECORD NO: 811-SPR2014-00444 DATE:02/27/2014 (DESCRIPTION_,,. _ _ ___-ACCOUNT CODEJTRANSCODEy ' AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 Ea manufactured or modular dwelling, service,feeder 224-00000-426102 1032 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:cC RPENTER COMMENTS AMOUNT PAID`- - •CreditCard ANNA WALKER 93.60 898271 TOTAL PAID: 93.60 • • • Electrical Permit Application DEPARTMENT USE ONLY ; '. OSP , GFiB tr Fy GON s SYR(INGFLu Permit no.: r / /— gilt/ ` S , 225 Fifth Sired♦Spa mgheld.OR 97477♦ '111541)726-3753• t\(541)726-3689 r "OREGON �--7 / Date: 2 /2 /12 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if fvork 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 Q ty. Ceo Total cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: Residential ❑Government ❑ Commercial — JOB SITE INFORMATION AND LOCATION 1.000 sq. ft. or less(4) $147.50 $- Each additional 500 sq ft or portion Job site address: g/50 Laura S+ //N thereof $ 27.50 $ Cityf6ortASP ea State:C) ZIP: g7T 7 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular DESCRIPTION OF WORK dwelling service or feeder(2) / $ 69.00 5 �e r n) er ( ,.I ec lrf c Services or feeders: installation. alteration. relocation rw/ (� I y` 200 amps or less(2) $ 89.00 5 PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: gil 11 ara S - Jl� 401 to 600 amps(2) $174.00 $ Address: O Q j) , '7 ? 601 to 1,000 amps(2) $225.50 $ City:6 rt Slit State: ZI P:97t�7 1)Over 1.00mops or volts(2) $516.00 Phone:9/'-40400 - )77& Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation. alteration. relocation 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 t Inte ided for sale, exchange, lease, or rent. OAR 479.540(I)and 47 .560(1). / 401 to 600 amps(2) $138.50 $ I Over 600 amps or 1,000 volts,see services or feeders section above Signature: i/ I ', P CONTRACTOR INST. fji ATION Branch circuits: new. alteration, extension per panel Business name: 9A,//1.41-2,_ a. Fee Mr branch circuits with purchase of a service or feeder fee: • Address: Each branch circuit $ 6.50 $ City: State: 1 ZIP: h. Fee for branch circuits)vithout purchase of a 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.: Rliscelbmenus fees:service on_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 SignaUU'e of sigmung su ervisor: . s 80.00 $ P alteration.or extension(2) Each additional inspection: (I) $80.00 $ APPLICANT USE (A) Enter subtotal of above fees $ p') (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x IA I) $ ,/ (C)Technology Fee(5%ofIA1) $ �).--- 440-2584-1(4/01/2013/CON) TOTAL fees and surcharges (A through C): �- 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 CCa# Expiration Date iI will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or C I will be performing work on property I own, a residence that I reside in, or a residence that I will • t 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. Pnn ..... of Permit Applicant n of Signau Permit Applicant Date Permit S /% ' Gly7 oF__ • S (4/f-vc+'t/l— �^ • Address: �/ O --,..4 X74' 77 �� S Prue ri->= . w k • Issued by: C— Date: 2/2 y/ This Copy for Permit Offices