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Permit Electrical 2014-4-1
I SPRINGFIELD 225 Fifth St • • ' t CITY OF SPRINGFIELD Sp'ringfield,OR 97477 1c„.•-•OREGON Phone: 541-726-3753• Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00703 www.springfieldocgov .permitcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 04/01/2014 EXPIRES: 09/28/2014 STATUS DATE: 04/01/2014 APPLIED: 04/01/2014 SITE ADDRESS: 1025 56TH PL,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702331108500 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: 1 circuit in garage for conversion OWNER: LITSTER DAVID W 8 LINDA K Phone Number: ADDRESS: 1025 NO 56TH PL • 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 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. a F /4 • Owner or Contractor Signature Date • • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility • Notification Center. Those rules are set forth NOTICE: . - , 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 number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180,DAY PERIOD. • - Springfield Building Permit ' 4/1/2014 1:20:36PM Page 1 of 1 • SPRINGFIELD — CITY OF SPRINGFIELD r q 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR97477 OREGON 541-726-3753 811-SPR2014-00703 www.springfieid-or.gav 1025 56TH PL permitcentera©spnngfield-or.gov RECEIPT NO: 2014000707 RECORD NO: 811SPR2014-00703 DATE:04/01/2014 DESCRIPTION i, 7r.;u"_s attSi- +`ti asi' a fACCOUNT`CODEITRANStCODE . : 2:-11='AMOUNTMUE Balance of Minimum Electrical Permit Fees • 224-00000-426102 1004 13.00 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 6.50 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: 9160 PAY, ENTWYPEs,-W1.P.AYOR grasHieR::dunRSON - COMMENTS-�, , Check LITSTER DAVID W& LINDA K 93.60 • 11262 TOTAL PAID: 93.60 • • • • • • • • • • • L Electrical Permit Application , . DEPARTMENT USE ONLY SPRINGFIELD ,.. . C-ITz.V0P-SPRINGFIELDOREG-43N=.1ti1/4:7 I :-----ea----A• ' . az. - - Permit no.: SIK Zeal cc-oc..,7c 3 a. re 225 Fifth Streets Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: 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. sq:-Afei‘ZSE0cALc:00V,ERNMENMAPPROVALVati.t• ::*: 4,;-iiit_WW.:1;WIT.EE.tiSCHEDULE:nittet!hiNna Zoning approval verified? D Yes D No ;',N4•11.::fir5V1M--11r41M,:•''f..::=1/t:4-71.2•erttr"-Nceit,gii a'.T6tift-,) eNumberof ihspections periltence) :7,1 Qtv;1• ,,--,..4:j rg:- • •.,1•,: ! CATEGORYiliafaONSTRUCTIONT,.:;,,-..i.W.;:ffv?;: . Residential,per unit,service included: esidential El Government li Commercial 1,000 sq.ft.or less(4) $147.50 $ 1:zVN:,''..10B::!,S11-EalNEORMATIONc-ANWLOCATION:INSAF, 4_4_ -%; Each additional 500 sq.ft.or portion Job site address: / ,...- , 6-4° ,--, /-14e...2_, thereof - $ 27.50 $ City: _Sr /...„0 State: ORQ ZIP: 9 )9,Q Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular '9],f]?-2411(rat'aliDESCRIP.TIOWOFONoRKW;Antalk dwelling service or feeder(2) $ 69.00 $ Services or feeders: installation,alteration, relocation --I---;)< 1-n)lif'Th Co reef-. eki. ,, ,i- / 200 amps or less(2) $ 89.00 $ Atelf—ino gOC in) Z/ 1iikiVeRROpER1WilowNEW:INIMY*; 41:4M," 201 to 400 amps(2) ' $ 104.50 $ , Narne: 46cc-g-rkAJ- 04;74 1(Q 401 to 600 amps(2) - $174.00 $ Address:ja4 c--4) 6-64-b pi 601 to 1,000 amps(2) $225.50 $ City: 5#- ..a State 0 ee- Fax: - -ZIP9) 9 Over 1,000 amps or volts(2) $516.00 $ Phone: Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation 200 amps or less(2) This installation is being made on residential or farm property $ 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 479.540(1)and 479.564- ). hi 401 to 600 amps(2) $138.50 $ Signaturel3 ---- - IT: Over 600 amps or 1,000 volts,see services or feeders section above ]:4:IttSWSCONIERACT,ORIINSTALLATIONiirglWaa Branch circuits:new alteration, extension per panel Business name: a. Fee for branch circuits with purchase of a service or feeder fee: Addres'• 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) V.- $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license p0.: BCD license no.: Miscellaneous fees:service or feeder not included Signing survisor's lice se no.: Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: , Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy Signature of signing supervisor: panel, $ 80.00 $ alteration,or extension(2) Each additional inspection:(1) $80.00 $ itr■ tiattfie44:h1EArliAff reAriiira§tgeMiSatt-Ca (A) Enter subtotal of above fees ' $ (Minimum Permit Fee$80.00) . (B)Enter 12%surcharge(.12 x[AD - $ (C)Technology Fee(5%of[A]) ' . $ TOTAL fees and surcharges(A through C): $ 440-2584-J(4/01/2013/COM)