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Permit Electrical 2014-3-21
• ``SPRINGFIELD i. 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 i+y`+ Phone: 541-726-3753 s- `OaE�°" Building / Residential Permit Inspection Phone: 541-726-3769 . . Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00603 www.spnngfeldacgov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/21/2014 EXPIRES: 09/17/2014 STATUS DATE: 03/21/2014 APPLIED: 03/21/2014 SITE ADDRESS: 6002 MAIN ST,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702343200600 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 3 branch circuits OWNER: BRUNS JOSEPH S&CHRISTINA M Phone Number: ADDRESS: 934 S 56TH ST SPRINGFIELD OR 97478 .• CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER COB 000000 08/01/2025 ' INSPECTIONS REQUIRED. Inspections • 4500 Rough Electrical Rough Electric: Prior to Cover • 4999 Final Electrical I 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. Owner or Contractor Signature Date NOTICE: ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). . Springfield Building Permit 3/21/2014 2:26:29PM Page 1 of 1 SPRINGFIELD" CITY OF SPRINGFIELD a1 - 225 Fifth St TRANSACTION RECEIPT Spnngfieltl,OR 97477 1": 541-726-3753 OREGON 81 1-SPR2014-00603 wwwspringfieldbr.gov 6002 MAIN ST permitcenter @spnngfield-or.gov RECEIPT NO: 2014000615 RECORD NO:811-SPR2014-00603 DATE:03/21/2014 DESCRIPTION'rn_i">r'.t e'er i-i.x-:.,,.- sue"±C a:'''.; =T ACCOUNT CODE/TRANSTRo]o1x - 'aL AMOUNTJDUE",'.i Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 6.50 Branch circuits without service or feeder-1st circuit • 224-00000-426102 1004 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 13.00 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 cAS 8675LARSOR _ COMMENTS ,QMOUNTyPAID, Credit Card BRUNS JOSEPH S&CHRISTINA M - 93.60 04317A TOTAL PAID: 93.60 • • • • • • • • • Electrical Permit Application sPw � o DEPARTMENT!USE ONLY ., x4.i j r f y :_x .r x- '2bs .. CITYOFSPRINGFIELD 'OREG6N 4 .-� `-k* - Permit no. Z-Ci t —(CJ 225 Fifth Street•Springfeld,OR 97477•PH(540726-3753•FAX(541726-3689 Date: 27/Ti/// `/ 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. 1, mpLOCAL GOVERNMENT CAPPROVAL,- s, ;'; _t .{ ':t,.b.WIFEE SCHEDULE ,t . ; I ' "u Zoning approval verified? ❑Yes ❑No "Number ofanspeetioh per den O Qty" eas t , :cost1'tn,' is,'CATEGORY OF,,,CONSTRUCTION ah ' r5 - ' ' Residential,per unit,service included: RI Residential ❑ Government ❑Commercial 1,000 sq. ft.or less(4) $147.50 $ ,'.: , JOB SITE.'INFORMATION',AND'LOCATION',. ,,, , Each additional 500 sq ft.or portion Job site address: (coo a I \c t\ SA thereof - $ 27.50 $ City: 5prsv,y \A State: (IL ZIP: 9"\4'1 e Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ '' ° t, 1D Esc RIP-TIOW'OE*',WORK' t I ;E", t dwelling service or feeder(2) ik . O'`'`.. \ I k ck\a- Services or feeders: installation, alteration,relocation 0. "C"- c, pr, \ 200 amps or less(2) $ 89.00 $ *0 (1,oOvv■ 'C O.'.t\ONE ' =c , 4s,N V ,PROPERTYOWNER ?;'; : ;t 4 201 to 400amps(2) $ 104.50 $ Name: —Sot Iru,A5 - 401 to 600 amps(2) $174.00 $ Address: } 'Noah S� 601 to 1,000 amps(2) $225.50 $ City: C cc4.. State: 5l ZIP: tritti Over 1,000 amps or volts(2) $516.00 $ Reconnect only(2) $ 69.00 $ Phone$A\- -1- \\`4\ Faxfj41- 1`((; O A(o$ E-mail: �x o�5� Cowes Temporary services or feeders:installation, alteration, relocation )n A-v.}fv pl� 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 400 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.5400) and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above `-._,,'` cte CO TRACTOR ,INSTAL'LATION +i 'rk x<, . Branch circuits:new 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: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) I $ 60.50 $ E-mail: Each additional branch circuit 7Z .$ 6.50 $ CCB license no.: BCD license no.: Miscellaneous fees:service or 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 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 80.00 $ alteration,or extension(2) - Each additional inspection:(1) $80.00 $ tq' ,, .;' .t;;^tj APPLICANTrUSE ; Tz .aq, ='S (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges (A through C): $9.3i 440-2584-1(4/01/2013/C0M)