HomeMy WebLinkAboutPermit Electrical 2014-4-2 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD
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Springfeld,OR97477
[ Lito Phone: 541-726-3753
`4=4 OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00678
'www.spnngfeld-or.gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/02/2014 EXPIRES: 09/29/2014
STATUS DATE: 04/02/2014 • APPLIED: 03/31/2014
SITE ADDRESS: 434 33RD ST,Springfield, OR 97478 . SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702312404300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Wire DHP .
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OWNER: CAMPBELL DAVID M&LILA Phone Number:
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ADDRESS: 434 N 33RD ST
SPRINGFIELD OR 97478
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CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JB ELECTRIC INC CCB 104929 03/14/2016 541-687-5770
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.
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Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
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in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
tp-
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Springfield Building Permit 4/2/2014 10:30:58AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
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TRANSACTION RECEIPT Spdngfield,OR 97477
OREGON 541-726-3753
811-SPR2014-00678
• www.springfield-cr.gov 434 33RD ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000715
RECORD NO: 811SPR2014-00678 DATE:04/02/20. 14
DESCRIPTION_e_Ti e et. FI VICM E ea ACCO1NTCODELRANS CODE ta-- liAMOUNT DU
Eu
g
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: 93.60
11P-En ENTe]TYBE PAYOR' . cAsrEa'' s"oN ei IthMMEN_-�TS AMOUNTfiAID,;
Credit Card JB ELECTRIC INC 93.60
740087
TOTAL PAID: 93.60
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r
03/30/2014 04: 19 5413028296 JBELECTRIC PAGE 01/01
i;teLtrJtai rermit Application DEPAarMENT:USE ONLY
9PDINGrIFID SrM1OA"^�('�el,
CITY O]F SPRINGFIPLD OREGON' ,, , le
225 Fifth Streets5 rin O S v Permit no.:�22ol tf— po67 r°i
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P Wield,OR 77477,PH(54I)>26J753*FAX(54t)726-36•9
Date: 347/ `/
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This permit is issued under OAR 918-309-0000.Permits are n untransferable.Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
. ,'i': r .Iut1Cd1, Gb,giStOtII:WT, "pR.O.V4L* li k'', y1wN v{t,)1 rri dKEE' $CngD,IJL +3t="N;)i�"ri kk i^:+
Zoning approval verified?
Q Yes '�*
❑No i'.Osn icrt-lDl`rti9te upia]ts`p`�t'i.fifeili+�'fii '�e ���P` ti;:" ..' ',lie
'04 EGbikri-0 ;itONSTRUCtION r ',i,. ,?. ,i , n'. , .,. .b ., '`•••i I Lxct1'.1 `rb`s-
esidential ❑Government Residential,per unit,service included:
Li Commercial
UOB,SITZ, Ntref rt,NOiJ;?IiND` ':41C° ItiNOt; , 1 I 1,000 sq. ft-or less(4) $147.50 $
Job site address: 7 r .33114-51-- Each additional 500 sq.ft.or portion
thereof - S 27.50 $
City: li 464. I State: OK I ZIP —
Reference Limited energy(2)
$ 35.00 $
I Taxlot Each manufactured home or modular -
D y2 9`r'w''ogoom'ribt gtCJw wo•0- y,-.r r Af 7� trtyy.., dwelling service or feeder(2) $ 69.00 $
-__MkIZ- Vu -b Cr � � Services or feeders: Installation, alteration, relocation
"r 200 amps or less(2)
$ 60.00 $
_r ° y „ r'pkbr,. �T y t W1l EIi tY! ,- U,liI. 201 to 400 amps(2)
$ 104.50 $
Name: '4/2 e,,,g���pe,ti� 401 to 600 amps(2) $174.00 $
Address: /„'J-,/ 601 to 1,000 amps(2) $225.50. $
City: 1 State: I ZIP: Over 1,000 amps or vole(2) $516.00 $
Phone: - - I 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)
owned by me or a member of my - $ 69.00 $
property is not intended for sale, exchange, lease, r rent. OAR 201 to 400 amps(2) g x6.00 $
479.5400)and 479.560(1). 401 to 600 amps(2)
$138.50 $
Signaturey� y�Wy��.,y��y ,�y�ty y Over 600 amps or 1,000 volts,see services or feeders section above
" �'a4�-t1q rWool.,f,',I rvv-0osp 1 at7f poloN::u{ rf ,�ri'.;'2i(111' a Branch circuits:new alteration, extension per panel -
Business name: .c.,1 yea (< . a.Fee for branch circuits with purchase of a service or feeder fec:
Address: S - 64. i 1 1 t Each branch circuit $ 6.50 1 $
jl ZIP: al:7 02- b.Fee for branch circuits without purchase of a service or feeder fcc:
yar : I Fax: / a,_ en First branch circuit(2) / $ 60.50 $
nag APP7
M? - e '& .f C -'Can-v Each additional branch circuit
CCB license no.: /1990.9 BCD license no.: 32-61,e Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: g 5 Each pump or irrigation circle(2) $ 69.00 5
Print name of signing superv' .r: „o9 ,a. ,.. Each sign or outline lighting(2) $ 69.00 $
1
Signature of signing supervisV Signal circuit or alimited-energy panel,
- ,,ion,or extension(2) $ 80.00 $
Each additional inspection:(1) $80.00
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12x[A]) • $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $ Cl 3
440-2584-i(4/01/2013/C0M)