HomeMy WebLinkAboutPermit Electrical 2014-4-2 •
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I. SPRINGFIELD 225 Fifth St
` CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
-OREGON Building l Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
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PERMIT NO: 811-SPR2014-00581
www.springfieldor.gov - permitcenter @sphngfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/02/2014 EXPIRES: 09/29/2014
STATUS DATE: 04/02/2014 APPLIED: 03/19/2014 • .
SITE ADDRESS: 853 67TH PL,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702341100300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: E-new single family residence
OWNER: MIKE BLANKENSHIP CORP Phone Number:
ADDRESS: 8063 THURSTON RD
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
GERARD ELECTRIC (C)Electrical Cont 20-284C 07/01/2014 541-741-2596
General Contractor BLANKENSHIP CORP CCB 78966 01/09/2016 541-746-0194
INSPECTIONS REQUIRED
Inspections
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4000 Temporary Power Service '
4225 Service or Feeder
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 loc-ted at the front of the property, and the approved set of plans will remain on the site at all times during
constructio
Si
Pil
Owner. -.n ractor Signature - Date •
ATTENTION: Oregon law requires you to
•I\NOTICE: follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK 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
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 4/2/2014 1:19:57PM Page 1 of 1
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SPRINGFIELD _ CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT • Springfield,OR 97477
541-726-3753
OREGON 811-S PR2014-00581
www.springtieldor.gav 853 67TH PL - permitcenter @springfield-or.gov
RECEIPT NO: 2014000718 RECORD NO:811SPR2014-00581 DATE:04/02/2014
Ilo1 Yt:ollaust, kkyy ?;TM ,( az4zyg ;%", mr ,I` 7`.-ACCOUNT3CODE/TRANS CODE, .:44uil": 'AMOUNTT,
Each added 500 sq.ft. or portion 224-00000-426102 1004 82.50
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 35.88
Technology fee(5%of permit total) 100-00000-425605 2099 14.95
Temp services 200 amps or less 224-00000-426102 1003 69.00
TOTAL DUE: 349.83
PAYMENT4T7PE PATOR, eArn ii trAtia • COMMENTS '"a"'"�' �1d9`0"�* P_M_OUNTITAID
Check MIKE BLANKENSHIP CORP 349.83
15341
TOTAL PAID: 349.83
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Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD fl' '
'e∎awAai zrpii.`w' +-t---^v-in•-'t° x. :gtict ro3-x n3ti t e-- ysc 0'
gigi OF SPRING ILED OREGO ` t S a� t n : gill — S r/
r ; -/ Perm
225 Fifth Street•Springfield,OR 97477,P$1(541)726-3753♦FAX(541)726-3689 —' .
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Date: J//O`
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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 A ,`
Zoning approval verified? ❑ Yes ❑No Number of ins ections er item i Gost Total °
.: _ _„� _,:i ... :.P P O ,.,f'City:. e
;?CATEGORY OF- CONSTRUCTION '.,.:,_,_ , r Residential, per unit,service included:
Eiiirgidential ❑Government ❑Commercial 1,000 sq. ft. or less(4) $147.50 $/y,�
=YJ OB,SITE. IN FORMATION,'AND_10CATION '); ?
Each additional 500 sq.ft.or portion
Job site address: grc3 ��,t A- thereof - y $ 27.50 $7e-
City: ('10F2—0y State: _ZIP: 97 ' ?1 Limited energy(2) $ 35.00 $
Reference: / . Z 34"// Taxlot.:,00 00 Each manufactured home or modular $ 69.00 $
Ti DESCRIPTION?:O F.."WORK t ,r.. dwelling service or feeder(2)
r, // Z //N"f�� I P a Services or feeders: installation,alteration,relocation
W ,LG Y7/tc f^�✓^--'— 200 amps or less(2) $ 89.00 $
R;,'>;1 c „ ,, a.r., . PROPERMOOWNER �k,:7* 201 to 400 amps(2) $ 104.50 $
Name: 0-71. IGtLt-S7h If 401 to 600 amps(2) $174.00 • $
Address: O (;7 y7,4 t5 4l' 601 to 1,000 amps(2) $225.50 $
City: S-fj) State: 6./C__ ZIP: 55'74e7J Over 1,000 amps or volts(2) $516.00 $
Phone: - - 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) t $ 69.00 $6'
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 479.5600). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
+' a" ;,.,Yiw .CONTRACTORf INSTALLATION" ,. Branch circuits:new alteration, extension per panel
Business name: e wt7,•-d) • jec (',1t,t I 1(et--i1 a Fee for branch circuits with purchase of a service or feeder fee:
Address:3y52f H-14t/dcr.S du- gc/ Each branch circuit $ 6.50 $
City:S p r,pJ G PI a t 8, State:O P`. I ZIP:fn7si 71 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone:S-4/ / 7'//-2597 Fax: - - 71/4-2S f‘ First branch circuit(2) $ 50.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.: 8 7 kis BCD license no. :2. geg. Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: „34,-,.-54/S Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: nCo,.''N ,'t L I/air— Each sign or outline lighting(2) ,, $ 69.00 $
Signature of sitming su ervisor� t \ t, - Signal circuit or a limited-energy panel, $ 80.00 $
o P - / O�w1 M"%�� alteration,or extension(2)
\�.Jh Each additional inspection:(1) $80.00 $
t^ wd',.,APPLICANT USE'. ,,,N
(A) Enter subtotal of above fees G
(Minimum Permit Fee$80.00) - $ 2 c,/
(B)Enter 12%surcharge(.12 x[A]) - $ 3 5T
(C)Technology Fee(5%of[A]) $ ///1--L.
TOTAL fees and surcharges(A through C): $ 3 iiC 8)
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440-2584-1(4/01/2013/COM)