HomeMy WebLinkAboutPermit Electrical 2014-3-4 SPRINGFIELD- 225 Fifth St •
1i �°- CITY OF SPRINGFIELD Springfield,OR 97477
,v `� Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00476
www.springfield-ar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 03/04/2014 EXPIRES: 08/31/2014
STATUS DATE: 03/04/2014 APPLIED: 03/04/2014
SITE ADDRESS: 665 HAYDEN BRIDGE PL,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703262101300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace main breaker
OWNER: JMR INVESTMENTS LLC Phone Number:
ADDRESS: 2206 IRONWOOD ST
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor FULL SERVICE ELECTRIC INC GCB 198359 11/19/2014 541-998-2299
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
construction.
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Owner or Contractor Signature Date .
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ATTENTION: Oregon law requires you to j1lTICE: "'`
•
•follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
• 0090. You may obtain copies of the rules by DOMMENCED OR IS ABANDONED FOR ::;!; •:i
calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number
Cente is 1-8g00-332-234 .Utility ification
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Springfield Building Permit 3/4/2014 2:19:04PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
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hyr......, 225 Fdth Sl
c OREGON
TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
81 1-S P R2014-00476
www.springtield-or.gov 665 HAYDEN BRIDGE PL permitcenter @springtield-or.gov
RECEIPT NO: 2014000489 RECORD NO: 811-SPR2014-00476 DATE:03/04/2014
;DESCRIPTION'„ , : - : ACCOUNT_CODE/TRANS CODE_ _,.a�,..__AMOUNTDUE,L.
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68
Technology fee(5%of permit total) - 100-00000-425605 2099 4.45
TOTAL DUE: 104.13
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(_`:PAYMENT TYPE PAYOR cASHFER:ccARPENrER t" • COMMENTS_ . ' AMOUNT PAID
_ ,, ___..• __I
Check FULL SERVICE ELECTRIC INC 104.13
1167
TOTAL PAID: 104.13
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Electrical Permit Application DEPARTMENT USE ONLY
fip'gtt., •4 2-i pf .a +€etrpiS; E�"t �-! �.s.." ,. SPRINGFIELD
I�Y�OF SPRINGFIELD, OREGON . perm;/ 5J6( - y7�
2'5 Filth Si,eet•Spt mgliicld.OR 97.177♦P11(541)7263753•1 \\(541)726-3689 OREGON
Date: 5/q//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. Bost Total
cost
CATEGORY OF CONSTRUCTION
Residential, per unit,service included:
IM Residential ❑Government ❑ Commercial
JOB SITE INFORMATION AND LOCATION 1,000 sq. ft. or less el) $147.50
Each additional 500 sq. 0.or portion
Job site address: 665 N.^-pi en 13c',ae LAY thereof _ $ 27.50 $
City: Jyc Aflci€k State: Ot. ZIP: 1)4>7 Limited energy(2) • $ 35.00 $
Reference: u f0yz.6zI • Taxlot:O/700 Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
-�QServices or feeders: installation. alteration. relocation
OAR- lVA i r (,fe4(-cf 7
200 amps or less(2) j $ 89.00 $ "y�1
PROPERTY OWNER 201 to Ono amps(2) $ 104.50 $
Name: ''l I —1 401 10 600 amps(2) $174.00 $
!/_ J P11Z �n�e5�1°I��}
-1�� 601 to 1,000 amps(2) $225.50 $
Address: VZp 6 }c vn L-)0
Over 1,000 amps or volts(2) $516.00 $
Cityke,,,, 1=`,,AL Slate: Or, ZIP:1)4o) .
Phone: - - Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders: installation. alteration. relocation
4-his installation is being made on residential or farm properly 200 mops or less(2) S 69.00 .5
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 10 600 amps(2) $138.50 $
Signature: • Over 600 amps or 1,000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: new, alteration, extension per panel
Business name: Fwll 5t4V.Lt etcd,r'.0 n L a Fee (Or bench circuits with purchase of a service or feeder fee: •
Address: p,D, 13,.,,< W Each branch circuit 5 6.50 Tr
City:I,,,aL\--„n ( ,Ay State: Or. I ZIP: 1)4 48 b. Fee for branch circuits■vithoui purchase of a service or feeder t'ee:
Phone:\-y1-8—_19`l Fax: - - First branch circuit(2) $ 60.50 $
E-mail: ,^ cp @-cc-11 icn LLe-c\cc4(..Cn a" c 6957 Each uddilional branch circuit $ 6.50 S
W') 1
CCB license no.: ' BCD license no.: J aliscellanenus fees:service=of_feeder not included
Signing supervisor's license no.: 5K05 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: 0 Each sign or outline lighting(2) S 69.00 $
6 5 �� Signal circuit or a limited-energy panel. $ 80.00 $
Signature of signing supervisor: 1 54,,a alteration.or extension(2)
���— Each additional inspection: (I) $80.00 $
APPLICANT USE
(A) Ewer suhtwal of above ices
(Minimum Pernli( Fee$80.00) $i2 e---
(B) Enter 12%surcharge(.12 x IAI) $ id I-
(C) Technology Fee(5 90 ofIAi) $ gKtS
440-2584-1(4/01/2013/C0m) TOTAL fees and surcharges(A through C): Skiy t5