HomeMy WebLinkAboutPermit Electrical 2014-4-3 SPRINGFIELD- 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR 97477
..,. ft.;. • Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769 .
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00721
www.springfield-or.gov - permitcenter @spnngfeld-or.gov
PROJECT STATUS: Issued ISSUED: 04/03/2014 EXPIRES: 09/30/2014
STATUS DATE: 04/03/2014 APPLIED: 04/03/2014 •
SITE ADDRESS: 7169 B ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702353103300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: E-Heat purnp and air handler,one for each duplex unit
OWNER: DUTSON CORY J Phone Number:
ADDRESS: 7169 B ST
SPRINGFIELD OR 97478
• CONTRACTOR INFORMATION .
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor OWNER CCB 000000 08/01/2025
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-pr lY
Owner or Contractor Signature Date
NOTICE: ATTENTION: Oregon law requires you to
• 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
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344). •
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Springfield Building Permit 4/3/2014 1:50:15PM Page 1 of 1
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SPRINGFIELD — CITY OF SPRINGFIELD
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225 Fifth St
TRANSACTION RECEIPT Spnngneld,OR97477
OREGON 541-726-3753
811-SPR2014-00721
www.spnngfleld-or.gov 7169 B ST permitcenter @spnngfield-or.goy
RECEIPT NO: 2014000727 RECORD NO: 811-SPR2014-00721 DATE:04/03/2014
D IIO' 7;" ` '„ iti-_Fa;t ili'i.`_ 'R
�+- 'j E ACCOUNTCODE/TRANSICODE.Eat 4_AMOUNVDUE
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
uPAVMENTuTYPE i PAY,OR cnsHlE"�R.,ccgRgENiER
Cash DUTSON CORY J 93.60
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD hit CITY OF SPRINGFIELD, OREGON Permitno.: SIli - 721
225 Fifth Street•Springfield,OR 974 77•PH(540726-3753•FAX(541)726-3689 OREGON
Date: G/ Z 73 , /
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 Qty. Ceoast Total
cost
CATEGORY OF CONSTRUCTION
- - - Residential,per unit,service included:
a Residential ❑Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1,000 sq. ft. or less(4) $147.50 $
Each additional 500 sq.ft.or portion $ 27.50 $
Job site address: 7 I (o 9 B S- thereof
City: SgrinTli eld State: OR ZIP: 9747$ Limited energy(2) $ 35.00 $
Reference: `7o2 3 57 / 11 Taxlot.:170Z35;103300 Each manufactured home or modular $ 69.00 $
DESCRIPTION OF WORK L dwelling service or feeder(2)
Services or feeders:installation, alteration, relocation
In$'1all Zx Z.ZUv linef [ i on rack paMI)
200 amps or less(2) $ 89.00 $
PROPERTY OWNER 201 to 400 amps(2) $ 104.50 $
Name: (Ji{ D Jt ioA 401 to 600 amps(2) $174.00 $
{
Address: 7 l Gq 5 '
601 to 1,000 amps(2) $225.50 $City: Serif-n(1-4 State: OR. ZIP: '11471
Over 1,000 amps or volts(2) $516.00 $
Phone:503-91 O-S 563 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 $
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
CONTRACTOR INSTALLATION Branch circuits: neat alteration,extension per panel
Business name: ee' a. Fee for branch circuits with purchase of a service or feeder fee:
Address: 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) $ 60.50 $
E-mail: Each additional branch circuit $ 6,50 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 80.00 $
o g g P alteration,or extension(2)
Each additional inspection:(I) $80.00 $
hi APPLICANT USE.
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $ i
(B)Enter 12%surcharge(.12 x[A)) $ C}G C2
(C)Technology Fee(5%of[A)) $ (foc)
440-2584-i(4/01/2013/COM) TOTAL fees and surcharges(A through C): $ G?IPA.