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Home My WebLink AboutPermit Electrical 2014-3-21 SPRINGFIELD 225 Fifth St /1 , ..„.— ` CITY OF SPRINGFIELD Springfield,OR97477 t Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00592 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/21/2014 EXPIRES: 09/17/2014 STATUS DATE: 03/21/2014 APPLIED: 03/20/2014 • SITE ADDRESS: 2470 G ST 1,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703361106700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install new 200amp service,repair and replace circuits/wiring in the home OWNER: BASARABA DANIEL Phone Number: ADDRESS: 1233 KENRAY LOOP SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 'Electrical Contractor HAROLD S MADISON INC •CCB 168164 01/20/2016 541-688-3648 INSPECTIONS REQUIRED 11 Inspections 4220 Electrical-Service • 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work is complete. 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. . 3/Z I//V Owner or Contractor Signature Date ATTENTION: Oregon law requires you to fo low rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are setforth in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling •the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 3/21/2014 9:41:42AM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD at4 as�s... 225 Fifth St . ``ORE GON TRANSACTION RECEIPT Springfield,OR 97477 r 541-726-3753 811-S PR2014-00592 www.springfield-or.goy 2470 G ST 1 permitcenter@springfield-or.gov RECEIPT NO: 2014000606 RECORD NO: 811-SPR2014-00592 DATE:03/21/2014 ';DESCRIPTION __ _;___ _- _._ _ ::.___ _ __ ___ ..A000UNT_CODE/TRANS_CODE _.;.;-_:_-. AMOUNT,DUE-:_ . Residence wiring 1,000 sq.ft. or less 224-00000-426102 1004 147.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.70 Technology fee(5%of permit total) 100-00000-425605 2099 7.38 TOTAL DUE: 172.58 LPAYMENT TYPE - PAYOR CASHIER:CCARPENTER . COMMENTS i - • AMOUNT PAID- - - Check HAROLD&MADISON INC 172.58 • 5080 TOTAL PAID: 172.58 • • • • Elecirical Permit Application DEPARTMENT USE ONLY OF,SP GFIELD fO EGO I - 00 S 9Z Permit no.:S f:; r 225 Fifth Steet•Springleld,OR 9 7477♦PII(54I)7263753,F X(541)726-3689 "t` � -' OREGON Date: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if wort: 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 () Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: XI Residential ❑ Government ❑ Commercial — JOB SITE INFORMATION AND LOCATION 1,000 sq. a. or Icss pl) $147.50 $ Each additional 500 sq. ft. or portion Job site address: a c( yo 1)7_ 0-, S {+'o r {- thereof $ 27.50 $ Cilyapr',1})t lam( State:Ott ZIP:9-T cf 777- Limited energy(2)— $ 35.00 .$ Reference: ) 70 3 3 6 I f Taxlot.: D 6 70 O Each manufactured home or modular dwelling service or feeder(2) $ 69.00 $ DESCRIPTION OF WORK Services or feeders: it slallatiorr. alteration. relocation —r9_ /Pe (a« a t�C w: W?,.r`' 1 f 200 amps or less(2) $ 89.00 $ I. o PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ Name: /-(c.ra(cC UL(es.ice 401 to 600 amps(2) $174.00 .$ Address: 2..°S O (Zero Lean 14 • , (3( od 601 l0 1,000 amps(2) $225.50 $ Over 1,000 amps or volts(2) $516.00 $ City: £.- �y-.-C Safe:6 Z ZIP: Phone:SU(- qyK - p —V Fax: . - Reconnect only(2) $ 69.00 [;-mail:Ilk-rock II �t.. - Temporary services or feeders: installation. a/erarian. relocation b✓, -� eo.t$W.,.-c_ CO— This installation is heirs t ade on residential or farm properly 200 coups or less(2) S 69.00 $ owned by me or a member of my immediate family. This 201 to 40(1 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease. or rent. OAR 479.540(1) and 479.560 I). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1.000 volts.see services or feeders section ahove CONTRACTOR INSTALLATION Branch circuits: rem alteration, extension per panel Business name: a. Fee for branch circuits with purchase of a service or feeder fee: Address: • Each branch circuit $ 6.50 $ City: State: I ZIP: b. Fee for haunch circuits tvithout 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.: BCI) license no.: Miscellaneous fees:.service or.feeder nor 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) S 69.00 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 80.00 $ g I alteration.or extension(2) Each additional inspection: (I) $80.00 $ APPLICANT USE (A) Enter subtotal of above lees (Minimum Permit Fee$80.00) $ f� (B)Enter 12%surcharge(.12 x IAJ) $ iy' ,r., (C)Technology Pee(5%of lAl) � � 410-2584-J(4/01/2013/COMI) TOTAL fees and surcharges(A through C): u(�5 T 1,er / O\ . p . �" Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD ,L CITY OF SPRINGFIELD, OREGON Permit no.: S/ff—ot &?L . 225 Fifth Street•Springtiield.OR 97477•PII(541)726-3753• Ax(541)726-3689 OR Date: �t 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. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No Number of inspections per item() Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION yr Residential,per unit,service included: Residential I ❑Government El Commercial S`o JOB SITE INFORMATION AND LOCATION 1,000 sq. Li.or less(4) / $147.50 $/y,i Each additional 500 sq. H.or portion .g y7,50 $ Job site address: ,2•/;c3 I(Z O. 5''Cr es--4 thereof Citys(.,/,, (!?.,(e( State:01$— ZIP: 9-ff'{7'X Limited energy(2) $ 35.00 $ Reference: 3-20 3 a C a Taxlot.:&&j 760 Each manufactured home or modular $ 69.00 $ r (IDESCRIPTION OF WORK dwelling service or feeder(2) 1 n)1. (` h • .• -ZOO A ... D Sett v i Services or feeders:installation,alteration elocution 4 200 amps or less(2) $ 89.00 $ PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $ � Name: e.s 401 to 600 amps(2) $174.00 $ (�o�to(E� /y"l. . Address: 20 S p 6 oo'&a„._,C.1 J l Loc.- 601 to 1,000 amps(2) $225.50 $ City:< ,. State:( 'j2— ZIP:7 c 4Dc Over 1,000 amps or volts(2) $516.00 $ Phones 1-[5t(_ --/o -;3 Fax: - - Reconnect only(2) $ 69.00 $ sj I Temporary services or feeders:installation, alteration, relocation E-mail: 4,_,,,(c(e_ „t,5 co_s. 'j_4 ,44_ , to ,.-. 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 479540(1)and 479.560(1 "'/ C 401 to 600 amps(2) $138.50 $ Signature: t Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits:new,alteration,extension per panel Business name: Re ( // a. Fee for branch circuits with purchase of a service or feeder fee: y y�0 (GS s f- T+' t L Address: 2(1-5 _) -2..eC 4.1-e_ Each branch circuit $ 6.50 $ City:€,.,.5y.cc •I State:0-(L ZIP:"7 Yo t b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.50 $ E-mail: j.1.cp a P.e. pater_ lE-c_ C.;c - C'ot•-■ Each additional branch circuit $ 6.50 $ CCB license no.: d- 9 Z I BCD license no.:I/,C H S I Miscellaneous fees:service or feeder not included Signing supervisor's license no.: ,5110 CS Each pump or irrigation circle(2) ' $ 69.00 $ Print name of signing supervisor: J e,r'e my la Each sign or outline lighting(2) $ 69.00 $ / y Signature of signing supervisor: I Signal circuit or a limited-energy panel. $ 80.00 $ 3 g S P -, alteration,or extension(2) • Each additional inspection:(I) , : $80.00 $ APPLICANT USE ' -• �l (A) Enter subtotal of above fees $ I .1°" (Minimum Permit Fee$80.00) ��,,pp . • (B)Enter 12%surcharge(.12 x[A]) $ i7/- • . (C)Technology Fee(5%of IAj) . . $" i TB • 440-2584-1(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ 171 Sirs