HomeMy WebLinkAboutPermit Electrical 2014-3-6 •
•
SPRINGFIELD" - 225 Fifth St
"' CITY OF SPRINGFIELD Springfield,OR 97477
"'. t Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00491
www.springfield-or.gov permitcenter @springfield-ocgov
PROJECT STATUS: Issued ISSUED: 03/06/2014 EXPIRES: 09/0212014
STATUS DATE: 03/06/2014 APPLIED: 03/06/2014
SITE ADDRESS: 5794 HIGHBANKS,SPRINGFIELD,OR SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702270000901 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Repair mast I add 100amp panel in barn. UGB portion of split lot adjacent to 58th and
Highbanks.Barn in SPFD UGB.
OWNER: RAMLO DORLA M - Phone Number:-
•
ADDRESS: 5794 HIGH BANKS RD
SPRINGFIELD OR 97478 .
• CONTRACTOR INFORMATION M
-
Contractor Type Contractor Name . Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER COB 000000 08/01/2025
_ INSPECTIONS REQUIRED
Inspections
4200 Reconnect Service
4220 Electrical-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_ �
- �:...-.75 o2 - 6 -. 0/1.7
Owner or Contractor Signature Date
00.0
O °
\ y
• on\a t te9
Ew�R Ote9bhe tecat
00".• dped toes ag52'00 °
� NN0( ao os a 0R\
RE \ZSI to\\owow s Centel%chou9sthe e nn
CtN `� NS
ri t N NoR�952-0°A rim e te � ca01
1
S PE R �NBND� \n pp °bN° hN c
Von " ' cot. 0dtly
c1\ � EO \s 0090.00g0' t g 23g4 .
0 p N °aWtn9 hOte0-352"
\131\ � � At be
oOentet om o Op
•
•
•
Springfield Building Permit 3/6/2014 11:44:40AM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
hr•y TRANSACTION RECEIPT Spnngfield.an 97477
OREGON 541-726-3753
811-SPR2014-00491
www.spnngfieldor.gov 5794 HIGHBANKS permitcenter @spnngfieldocgov
RECEIPT NO: 2014000503 RECORD NO:811-SPR2014-00491 DATE:03/06/2014
hl X71:Aio � � z 2_'02:7, e A_- r Ri ; k-.Et: .r t
_`ACCOUNT CODEJiRANSCODE`4..-=W�'"AMOUNT=DUE',
Service reconnect only
224-00000-426102 1004 69.00
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 18.96
Technology fee(5%of permit total) 100-00000-425605 2099 7.90
TOTAL DUE: 184.86
PAYMENT P.AYORcNiER osowLSav ___ .,COMMENSc n
Credit Card scoff ramlo 184.86
06539p
TOTAL PAID: 184.86
•
n
Electrical Permit Application DEPARTMENT USE ONLY
47r SP0I N G FI EU>
f n ,9. ;4, Permit no.:
225 Fifth Street$Spriagfleld.OR 974 77•1'il(541)726-3753•FAS(54I)726-3689 ' ; ',,OREGON 3/�0�V
Date:
This permit is issued under OAR 918-309-0000. Permits are nontrn able. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL t to ' FEE SCHEDULE
Zoo in g approval verified? ❑ Yes ❑ No7 Nul .er of inspections per item O IQty Cea ost I Total
cost
CATEGORY OF CONSTRUCTION •
Residential 1 El Government ❑Commer lal Residential, per unit,service included:
�
JOB SITE INFORMATION 'ND OCAT ON 1.000 sq. ft. or less(4) $147.50
-- a ii, Each additional 500 sq. 0. or portion $ 27.50 $
Job site address: C1 / S 11 thereof
City: scif i State: ZIP.7y�7 8 y(2
Limited energy $ 35.00 $
Reference: 1 70Z Z7CC 1 Taxlot.QQ /Q f Each manufactured home or modular 69.00 $
DESCRIPTION OF WORK dwelling service or feeder(2) $
2CVattt . wain r / Ab 1\ f Q n A 3by Services feeders: incralluli< t aherarinu, relocation —��
(/ 200 amps or less(2) /00�' / S 89.00 $ /
PROPERTY OWNER 201 to 400 amps(2) S 104.50 S
Name: '� __//// C7 401 to 600 amps(2) 5174.00 $
�.L'n7T"' gi/7[.
60110 1,000 amps(2) $225.50 $
Address:.?y4, //ia.././2 4,es Z
City: c 6, • -9.D Stale:(Ore_ ZIP:97y7 0" 1,000;unpsorvolts(2) $516.00
Phone' - - Reconnect only(2) R01),,t e / $ 69.00 $
!( ?O"y3-3(9 Fax:
11 �� / Temporary services or feeders: insrnllcuion, alteration. relocation
I -mall: Aor�Seo 7f a in P' fro_19- .�C 0,,21.
This installation 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 4(10 amps(2) $ 96.00 $
properly is not intended for sale, exchange, lease. or rent. OAR
479.540(1)and 47 11 0(1). 401 to 600 amps(2) $138.50 $
Signature: rae, ,c, ife"7 ,.t Over 600 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: neat alteration, extension per panel
Business name: Ow eft� a. Pee for branch circuits with purchase ofa service or feeder Ice:
Address: . Each branch circuit S 6.50 $
City: State: ZIP: b. Pee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: BCD license no.: 111isccllancinns l'ees:.service or feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 5 ,
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 5
Signature of si nin ' supervisor: Signal circuit or alimited-energy panel, $ 80.00 $
g b P alteration.or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal Fee above fees
(Minimum Si 5
inin b
nun Permit r Pee$80.00)
(B) Enter 12%surcharge(.12 x IA)) $ /C.J'
(C)Technology Fee(5%of lAl) $ 7 9°
410-2584-1(4/0 1/20 131COht) TOTAL fees and surcharges(A through C): 784136