HomeMy WebLinkAboutPermit Electrical 2014-4-7 SPRINGFIELD ,. 225 Fifth St
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lirt CITY OF SPRINGFIELD • Springfield,OR 97477
(`es Phone: 541-726-3753
-"`OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00736
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/07/2014 EXPIRES: 10/04/2014
STATUS DATE: 04/07/2014 APPLIED: 04/07/2014 • -
SITE ADDRESS: 1120 FAIRVIEW DR,SPC#45,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703273100600 - TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Fire damage repairs
OWNER: NOVACOFF BRANDON Phone Number:
ADDRESS: 1120 FAIRVIEW DR SPACE 45
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED j
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.
itadiz Ec.)I reRot, ( /O6 /(7
Owner or Contractor 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). •
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Springfield Building Permit 4/7/2014 11:28:01AM Page 1 of 1
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SPRINGFIELD — • CITY OF SPRINGFIELD
225 Fifth St
=z „m TRANSACTION RECEIPT Spnngfield,OR97477
'i OREGON 541-726-3753
811-SPR2014-00736
www.springfield-or.gov 1120 FAIRVIEW DR. SPC 45 permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000743 RECORD NO:811-SPR2014-00736 DATE:04/07/2014
DESCRIPTION � • .: � :*tingit - a '�s��2.4 ACCOUNT CODE/TRANS CODE,MaztAMOUNT!DUE
Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00
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
'PAYMENT3TYP.E PAYOR,, cASwEa ccnRaEriTTERR "�+i doli MENTS + 4t a'"t WMOUNTEPAIO:R 4'M4
Cash MEDINA 93.60
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TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY
Ci O SiPRNG IRE, OgR
S t I Ir N G:t LU
$ i
y . 44,c,"cm„ • „ .t. . » ot. ./ass•- l Permit no.: --- 71$
r N a
225 Filth Street•Springfield,Olt 97477*101(541)7263753*1 \N(541)726-3689 OxECOry / , I 7//C/
Date: y( /
'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 ( Cost Total
I per ( y' ca. cost
CATEGORY OF CONSTRUCTION — -
Residential,per unit,service included:
❑ Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1.000 sq. It.or less(4) $147.50 $
I1 I I Each additional 500 sq. ft.or ponion
/ Job site address: ((tO V�i . lc A\R I iew OR• se(aiv thereof 5 27.50 $
City: 8 pit lyv[(�F(e , State: OD_ ZIP: c1.11..'1-"l. Limited energy(2) $ 35.00 $
Reference: ._ Taxlot.: Each manufactured home or modular
DESCRIPTION OF WORK dwtlling service or feeder(2)
$ x9.00 $
,,,�, ,� - Services or feeders: installation, alteration,relocation
It t/ Aff L' ,/ G/SS 200 less l
or amps o
I (2) 5 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: Lot C N A �Ep //yiA 1 401 to 600 amps(2) $174.00 $
Address: -I`7fic 1011.1 Si # '1 Gt . `' pp 60110 1,000 amps(2) $225.50 $
City: S�n I N b(L tab State: Oft- ZIP: cn -1 9 D Over 1,000 amps or volts(2) 5516.00 $
,Io� Reconnect only(2) $ 69.00 $
Phone$yl-232 Fax: - -
E-mail: Temporary services or feeders: installa tion, al(erolto". 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 4170 amps(2) • $ 96.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 401 to 6(10 amps(2) $130.50 $
Signature: Over 600 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits:new alteration,extension per panel
Business name: A'1 item a. Fee for hnylcb circuits with purchase of a service or feeder fee:
Address:9V ,S Dp.‘s..L,St. * 1-0i Each bran.n circuit I I $ 6.50 $
City: 5-911.1N(p f LElD State: OA • ZIP: co-Lin b.Fee liw bra itch circuits without purchase of a service or feeder fee:
Phone:5yl-132- 9208 Fax: - - First hrane 1 circuit(2) / 5 60.50 $
Lt
E-mail: Each additi anal branch circuit ? $ 6.50 5
CCB license no.: BCD license no.: Miscellaneous fees:service m /eeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 S
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel. $ 80.00 5
Signature of signing supervisor: allelalloll.or extension(2)
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees $
(Minims m Permit Fee$80.00) 25
(li) linter 12%surcharge(.12 x[A]) $
(CI I cchnology Fee(5 70 of[A]) $
TOTAL fees and surcharges(A through C): $ 6Od
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