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HomeMy WebLinkAboutPermit Electrical 2014-3-12 • • SPRINGFIELD - - 225 Fifth St CITY OF SPRINGFIELD • Springfield,OR 97477 3; Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00525 • '4ww.springfield-or.gov permitcenter@sprfngfield-ar.gov PROJECT STATUS: Issued ISSUED: 03/12/2014 EXPIRES: 09/08/2014 STATUS DATE: 03/12/2014 • APPLIED: 03/12/2014 SITE ADDRESS: 1218 1ST ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703263300524 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New service OWNER: NOBLE STEPHANIE I M&CHRISTOPHER L • Phone Number: ADDRESS: 1218 1ST ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor PHANTOM INC COB 109864 01/14/2015 541-688-2549 _ INSPECTIONS REQUIRED Inspections 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 c d is located at the front of the property, and the approved set of plans will remain on the site at all times during constr ion. Owner or Contractor Signature r Date • wires you to ENTION: Ore9on law req on Utility tedbytheOsar w rules adop 140TICE: ORK h oAR g52-oo1 IRE W THEW NOT;cation Center. Those rules are set fort THIS PERMIT SHA�1-�` q BIS PER R g52 001 obtain coP°$ of the rules by �, You may Note: the telenh0ne AUTHORIZED UNDIS ABANDONED FOR Ong the center- (NOW:•Uttllty Not+fication COMMENCED OR • Inter for the Oreg ANY 180 DAY PERIOD. Center is 1 ,.„.„,_332.2344). • • • Springfield Building Permit 3/12/2014 11:02:46AM Page 1 of I • • ' SPRINGFIELD - - CITY OF SPRINGFIELD TRANSACTION RECEIPT Sphngfield,OR 97477 ''�""'� 225 Fifth h St OREGON 5N 41-726-3753 1 . 811-SPR2014-00525 www.spririgfield-or.gov 1218 1ST ST permitcenter@springfield-ar.gov RECEIPT NO: 2014000537 RECORD NO:811-SPR2014-00525 DATE:03/12/2014 I,gig:Jfd9lo7:L'a '+i:„-��+a,.='E` K; _� �_� �- ;.t'JACCOUNTdCODEIPRANS:CODE '.r.`?`mi:(AMOUNT'DUE:',' 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 P,AYMENTTYP.E P-AYOR 6ASHIER: RSON COM-TETI AMOUNTiPAID Check PHANTOM INC 104.13 2563 TOTAL PAID: 104.13 • . An folk Noti' in 0 009 c DI • Electrical Permit Application DEPARTMENT USE ONLY SPNINGFIELG r ='tea" -�+ M x.m ^rv,rr g�.fi.J�'-"°'T ar 1�#��Frxpk ua K5'pYi7` 'd�� ,4 CITY OF"SPRINGFIELD; OREGON.4:6. s -,, ?, Permit no.J/��'db 5 Z S m a'G:=- 43 'ru;:�.,D t+'^ ..."_�._:'3YYes4 « _- 3., 225 Fifth Street*Springfield,OR 97477*PH(541)726-3753*FAX(541)726-3689 Date: 3/ 7 Z L/ 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. OCAL:GOVERNMENT`'ARP ROVAL `" t- •Tr- ,t'+' ;FEE I.,SC HEDULE„4", Et,; x.,: Zoning approval verified? ❑ Yes ❑ No Number of inspections per.,item.( , Qty Cost Total- CATEGORY,_OF,.`CONSTRUCT,ION ;- ' Residential, per unit,service included: ip Residential ❑Government ❑Commercial r .. E .���„�. 1,000 sq. ft.or less(4) $134.00 $ F „40McSITE INFORMATIOWAND_LOCATION // / Each additional 500 sq. ft. or portion Job site address: /e: n �ax,. r //�� thereof _, $ 25.00 $ City.. ly c0/J�/ // 3 0 7 ZIP:97h/7 Limited energy(2) $ 32.00 $ Refer ce: j 3 �b 3 3 Taxlot.0b Sr2 y Each manufactured home or modular $ 63.00 $ /// DESCRIPTION OF WORK' .,'. dwelling service or feeder(2) / 0 J S .u) /aQ_t C� Services or feeders: installation, alteration, r ocation 200 amps or less(2) • $ 81.00 $ 'PROPERTY OWNER 201 to 400 amps(2) $ 95.00 $ Name: (/W! 5 /we_ 401 to 600 amps(2) $158.00 $ Address: r, 601 to 1,000 amps(2) $205.00 $ City: /t � State: ZIP: Over 1,000 amps or volts(2) $469.00 $ Phone: - Fax: - - Reconnect only(2) $ 63.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 63.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.5400)and 479.560(1). 401 to 600 amps(2) $126.00 $ 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:/ q C A 4 1 A . ( �/ -,��� a. Fee for branch circuits with purchase of a service or feeder fee: Address: #a v2 S 7c)/7 Each branch circuit $ 6.00 $ City:4{ tZ f^& State: die ZIP?71#2 2— b. Fee for branch circuits without purchase of a service or feeder fee: Phone: Fax: 7/4/9 First branch circuit(2) $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no./O9F&V BCD license no.:, 79-e--' Miscellaneous fees:service or feeder not included Signing supervisor's license no.: ��-_-5- Each pump or irrigation circle(2) $ 63.00 $ Print name of signing supervisor:, g/nie/j, 2ZS7(ea'6��. Each sign or outline lighting(2) $ 63.00 $ Signature of signing supervisor: �-C:-�.---C. Signal circuit or alimited-energy panel, $ 63.00 $ g g P �ivv+ alteration,or extension(2) Each additional inspection: (I) $58.00 $ ,: d>ggllll2 , hd?N APPLICANrUSE tx .;a` i} ' . 1 (A) Enter subtotal of above fees $ �� (Minimum Permit Fee$58.00) O (B)Enter 12%surcharge(.12 x [A]) $ I O (8 (C)Technology Fee(5%of[A]) $f 4 4S— TOTAL fees and surcharges(A through C): $/O if II 440-2584-J(9/08/COM)