HomeMy WebLinkAboutPermit Electrical 2014-3-27 SPRINGFIELD 225 Fifth St
'' y'- CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00639
www.springfield-or.goy porn tcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 03/27/2014 EXPIRES: 09/23/2014
STATUS DATE: 03/2712014 APPLIED: 03/27/2014 .
SITE ADDRESS: 281 S 71ST ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702353405804 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Install 7.5 KW generator
' OWNER: LACLUYSE DAVID Phone Number:
ADDRESS: 281 S 71ST ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No • Lic Exp Phone
Electrical Contractor MCDIARMID CONTROLS INC CCB 77023 10/24/2014 541-726-1677
INSPECTIONS REQUIRED
•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. - -7 7/7
Ail-r..."\r„._/
Ow r o ntractor Signature Date
ATTENTION: Oregon law requires ypu to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rulesosetforth AUTHORIZED UNDER THIS PERMIT IS NOT
ar
in OAR 952-001-0010 obtan c pees ofthe ides by COMMENCED OR IS ABANDONED FOR
0090. You may ANY 180 DAY PERIOD.•
calling the center. (ontUtil ty Notification
number for the Oreg
Center is 1-800-332-2344).
Springfield Building Permit 3/27/2014 8:44:46AM Page 1 of 1 .
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SPRINGFIELD CITY OF SPRINGFIELD
+� FIE 225 Fifth 51
,Y. OREGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-S P R2014-00639
www.springlield-or.gov 281 S 71ST ST permitcenter @springfield-or.gov -
RECEIPT NO: 2014000660 RECORD NO:811-SPR2014-00639 DATE:03/27/2014
_DESCRIPTION___ _ __ _ _, _. .. __ _ ACCOUNTCODE/TRANS CODE._., .___li ,AMOUNT.DUE_-.
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.02
Technology fee(5%of permit total) 100-00000-425605 2099 5.43
_..__ TOTAL DUE: 126.95
ILL PAYMENT TYPE. PAYOR CASHIER:JLARSON . ... COMMENTS ' ' ''AMOUNT PAID "'
Credit Card Terry McDiarmid 126.95
809397
TOTAL PAID: 126.95
•
.
Electrical Permit Application svw,xas,au DEPARTMENT USE ONLY
CITY OF SPRINGFIELD, OREGON isk
eit permit no.67(2eyl4 O '63f
225 Fifth Street•Springfield,OR 97477.PH(541)726-3753•FAX(StQ726-3689
Date: 77/Z 7 // c/
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 O Qty. Cost Total
CATEGORY OF CONSTRUCTION �• cost
Residential,per unit,service included:
Residential ❑Government ❑Commercial
1,000 sq.ft.or less(4) $134.00 $
JOB SITE INFORMATION AND LOCATION
Each additional 500 sq.ft.or portion
Job site address: 8/ S. 7/ sr thereof $ 26.00 $
City;9"Ai �/cfD State:a< ZIP:97 4/49 Limited energy(2) $ 32.00 $
Reference: - p Taxlot.: Each manufactured home or modular $ 63.00 $
DESCRIPTION OF WORK dwelling service or feeder(2)
) T �/ Services or feeders:installation,alteration,relocation
�bl JJ-f/ /1
7 7 0 2-c.„,c--emOVv
G 200 amps or less(2) / $ 81.00. $ 6/
PROPERTY OWNER 201 to 400 amps(2) $ 95.00 '$
Name: Da_iii An_r-1 u: y s C 401 to 600 amps(2) $158.00 $
Address: ,38y S 7/ sr :•J-� 601 to 1,000 amps(2) $205.00 $
City �� State:Qf` I ZIP: 7y7 Over 1,000 amps or volts(2) $469.00 $
Ci
Py '
-Phone:5/�/ 42(0_g7/3 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) $ 83.00 $
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 479.5600). 401 to 600 amps(2) $126.00 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
CONTRACTOR INSTALLATION LLLATION /i Branch circuits:new,alteration,extension per panel
Business name: it CO/4. .cti rq/ ( 'e& jY rA/ S a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 6.7 /4.i (• S Each branch circuit $ 6.00 $ / g •
City: gar�.0 � 'State:OkC. I ZIP:97 945- b.Fee for branch circuits without purchase of a service or feeder fee:
Phone:wj�`/(7/- /...24,-
M77 I Fax:n - - First branch circuit(2) $ 55.00 $
E-mail: Tyvdi40 MC-19/G1rr4'D9Co 4v D(f'- Ca k, Each additional branch circuit $ 6.00 $
CCB license no.: 771)a3 BCD license no.:..,2(2-..- /37' Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: S6o2i/S Each pump or irrigation circle(2) $ 63.00 $
Print name of signing supervisor:7Ey S/4( r� �. , -/1 Each sign or outline lighting(2) $ 63.00 $
Signature of signing supervisor: - C �� Signal circuit or a limited energy panel, $ 63.00 $
/L,_ E. .�.' alteration,or extension(2)
/ Each additional inspection:(I) $58.00 $
APPLICANT USE
(A) Enter subtotal of above fees $
(Minimum Permit Fee$58.00)
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(6%of[A]) $
TOTAL fees and surcharges(A through C): $ /Z(95_
440-2584-1(9/08/COM)