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Home My WebLink AboutPermit Electrical 2014-3-28 • SPRINGFIELD j to 225 Fifth St CITY OF SPRINGFIELD Springfeld,OR 97477 Phone: 541-726-3753 - iikiortacoN Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00657 www.springfield-or.gov i permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/28/2014 EXPIRES: 09/24/2014 STATUS DATE: 03/28/2014 APPLIED: 03/28/2014 SITE ADDRESS: 5776 MINERAL WAY,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802033301900 TYPE OF STRUCTURE: Residential • • PROJECT DESCRIPTION: 4 outlets in garage OWNER: TILLMAN SHERRY Phone Number: ADDRESS: 5776 MINERAL WAY SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor.Name Lic Type Lic No Lic Exp - Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED ' m Inspections . 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. 3l24ly Owner or Co actor Signature . Date • • • ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth • THIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). . Springfield Building Permit 3/28/2014 8:52:39AM Page 1 of 1 • SPRINGFIELD --, CITY OF SPRINGFIELD 225 Fifth St � � TRANSACTION RECEIPT Spnngfield,OR 97477 � ( `fie 541-726-3753 OREGON 811-SPR2014-00657 www.spnngfieldor.gov 5776 MINERAL WAY permitcenter@spdngfieldor.gov RECEIPT NO: 2014000673 RECORD NO: 811SPR2014-00657 DATE:03/28/2014 Ie141e1:71:n caS E t Y:S2Fg 3 iri? •41.L+.`_. Sc ACCOUNT CODE/TRANS CODE i --"AMOUNTDUETTA 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 - 19.50 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 igiiii.._..a.,....._.._ _._.__,.....m,. ..,,�. ,... r:PAYMENT�TeYP.E ...,_.PAYOR- 'cnsNieR:,�urisoR � COMMENTS ' .r ` AMOUNTOPAIU Credit Card TILLMAN SHERRY 93.60 38721P TOTAL PAID: 93.60 • • Electrical Permit Application DEPARTMENT USE ONLY 1 q SPRINGFIELD CITY,OF S'PRINGFI(E4LD,.®REG4®N k r 4 ,.. Perna(no.:W JZ — OOGS 225 Fi fth Sit eet*Springfield.OR 97477*111(541)726-3753HAX(541)7263689 . t o EGOM • Date: ��o v /1 1-( 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 El No Number of inspections per item O Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: Wesiclential ❑Government ❑Commercial JOB SITE INFORMATION AND LOCATION 000 sq. 0.or less(4) $147so $ / ^ Each additional 500 sq.ft.or portion $ 27.50 $ ; Job site address: 5� - f-(v jA I nPa I LUG l/ thereof City: ('InU lIft 4 State: OR, ZIP:97f 7si Limited energy(2) V g (_) $ 35.00 $ ( Reference: Taxlot.: Each manufactured home or modular DESCRIPTION OF WORK dwelling service or feeder(2) $ 69.00 $ I .N skry II i n LI a 1 J'k D.i,1,f ( �IeC, I (1 Services or feeders:installation,alteration,relocation j +v �Nf : , J 'Q// ' W1 ( 200 amps or less(2) $ 89.00 $ I P-OPER' OWNER 201 to 400 amps(2) $ 104.50 $ Name: 61 I 1 rnn � 401 to 600 amps(2) • $174.00 $ - ? V 601 to 1.000 amps(2) $225.50 $ J Address: � 1 �� • 1 i� � r�4C-�' Way 3 r eel, L� l�f1,0 Over 1.000 amps or volts(2) $516.00 $ City: 1111 r1 Q(/ State: ZIPI 1 O t Phone: - (Q r - j Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders:installation.alteration,relocation This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 S property is riot intended for sale,exchange, lease,or tent.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 CONTRACTOR INSTALLATION Branch circuits:new migration,extension per panel Business name: a.Fee for branch circuits with purchase of a service or feeder fee: l Address: Each branch circuit $ 6.50 $ City: tate: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - - First branch circuit(2) $ 60.50 $ 0r7a I I hone: Fas: (-) E-mail: Each additional branch circuit 3 S 6.50 $N 4i i CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included Signing supervi r's license no.: Each pump or irrigation circle(2) $ 69.00 $ Print name signing supervisor: Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy panel. $ 80.00 $ I Signatt of signing supervisor: alteration.or extension(2) Each additional inspection:(1) $80.00 $ APPLICANT USE I (A) Enter subtotal of above fees ,$ G�J10� - . (Minimum Permit Fee$80.00) �(J (B)Enter 12%surcharge(.12 x[Al) $ Toll (C)Technology Fee 5%of IAD $ it e-€1- TOTAL fees and surchar es(A through C): $ 02� 44o-z584-)(4lovzol3/COhq g ( g )