HomeMy WebLinkAboutPermit Electrical 2014-4-10 SPRINGFIELD -- 225 Fifth St
CITY OF SPRINGFIELD • Springfield,OR97477
kerk ety Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676 .
PERMIT NO: 811-SPR2014-00771
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued • ISSUED: 04/10/2014 EXPIRES: 10/07/2014
•
STATUS DATE: 04/10/2014 APPLIED: 04/10/2014 .
SITE ADDRESS: 5916 G ST,Springfield,OR 97478 SCOPE:. Electrical Only
ASSESOR'S PARCEL NO: 1702342200408 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Service change
•
OWNER: BAYS RICHARD D TE Phone Number: •
ADDRESS: 5916 G ST
• SPRINGFIELD OR 97478
•
•
OWNER: RICHARD BAYS REVO TRUST Phone Number:
ADDRESS: 5916 G ST -
SPRINGFIELD OR 97478 1,
•
CONTRACTOR INFORMATION p
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor ' BOB FISHER ELECTRIC INC CCB 96275 01/25/2016 541-689-7973
[
•
INSPECTIONS REQUIRED
Inspections
•
4220 Electrical-Service
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. (�
4 i a c
• 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
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
•
• calling the center. (Note: the telephone -
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit _ 4/10/2014 1:17:12PM Page 1 of 1
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SPRINGFIELD CITY OF
225 Fifth St
;,,,r t�,,:r.., TRANSACTION RECEIPT Springfield,OR97477
+ ' ' OREGON 541-726-3753
811-SPR2014-00771
www.springtield-or.goy 5916 G ST permitcenter @spdngfield-or.gav
RECEIPT NO: ,2014000780 RECORD NO: 811 SPR2014.00771 DATE:04/10/2014
DESCRIPTION _ 3 t- "ACCOUNT GODEJTRANSCODE '„ ' 1t.'AMOUNT'DUE:1k
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.68
Technology fee(5%of permit total) 100-00000-425605 2099 4.45
TOTAL DUE: 104.13
:!PAYMENT.TYPE it:.' "-PAYOR,. ;cnsHleRSmi�RSON .Rr "?�,�_�,�COMMENf n+• [ELI; ,'`:AMOUNT PAID 7
Cash BOB FISHER ELECTRIC INC 104.13
TOTAL PAID: 104.13
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Electrical Permit Application - DEPARTmENT,usE ONLY' :.•:.SPRINGFIELD
5kITVOFSPRINGFIELDSOREGON la;s:aVr. Permit no cie2C1' 9 - °cll.? I
215 Fifth Street•Springfield,OR 97477•PH(541)726-3753*FAX(541)726-3689
Date: (-7/C) A V
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.
,,0:;:eig:;,tg;C)CALF:,'GOV,ERNMENT:TAPPROVAL;.NafVS''..t ii';t::"''4C.5.0:4102iFEE'diStHEDLILE'±-:*_Q-AgitZfil
Zoning approval verified? 0 Yes D No .to .slattqYVi.11474111:3:12,1129:"1 :111fay1111;1:11;f1%1t.ditT4-11:;ii.„1.ilrotillc'1
lillsliniitiir of iniPections-peritem;(0l. Zci Qty:.f=V-%—,-,V; '..-
(,.,-,: :,.A3', ,."4.: .172.,,d,11;? costgi?,,
1%CATEGORYAIOFACONSTRUCTION:-:WAV,„N'.;:,';-:
Residential,per unit,service included:
ihesidential 0 Government 0 Commercial
• . „ 1,000 sq.ft.or less(4) $147.50 $
:1 i';YrJ OFI'SITE:AN FO RMATIO N'I.AN InOCATIONWW
Each additional 500 sq.ft or portion
Job site address: 9-cy /le, a. 9f 4_,-_-T thereof $ 27.50 $
City: 60 te..._,,,t/ ' tr.
I C C( State: ZIP: Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular
,,,3r-,,,,z..;n1DESC RIPTION'llPF:;;;WO RFC 11l11,. 1::::'':?:;;Vitri" dwelling service or feeder(2) $ 69.00 $
Services or feeders: installation, alteration, relocation
C- 4 0 1A- ,--- frici.L.J 70--)4 C>
200 amps or less(2) / $ 89.00 $
WillaiMMARROFIERT:(40YVNERKaota-Xl:nam 201 to 400 amps(2) $ 104.50 $
Name: Le4teril / 7' 401 to 600 amps(2) $174.00 $
Address: 5-7/6 . . 2'4-, , 601 to 1,000 amps(2) $225.50 $
City: I State: . I ZIP: Over 1,000 amps or volts(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) $ 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 479.560(1). 401 to 600 amps(2) $138.50 , $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
e:zittigi*ReorsnacypRDNsTALCATioNki::yi%iftgai0 Branch circuits:new alteration extension per panel
Business name: b 4, Fi 4,4.—,_- g:5‘,.-e.e2 a.Fee for branch circuits with purchase of a service or feeder fee:
Address: /0., X( 12,91 kir(' ecir Each branch circuit $ 6.50 $
City: 0ti r else— State: I ZIP:
b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - I Fax: - - First branch circuit(2) $ 60.50 $
E-mail: S Each additional branch circuit $ 6.50 $
CCB license no.: 9 b, 775- 1 BCD license no.: Zo.... --7.e. Miscellaneous fees:service or feeder not included
Signing supervis63 l'errpp.b 4,44....10--S> F-_,,,,..c, Each pump or irrigation circle(2) $ 69.00 $
Each sign or outline lighting(2) $ 69.00 $
Print name of signing supervisor: ro 14 c. .-41 I) k15.[4.---
Signal circuit or a limited-energy panel,
$ 80.00 $
Signature of signing supervisor: /AAA e--s. alteration,or extension(2)
Each additional inspection:(I) $80.00 $
'1.1.14V-4,1V*ViZO,NsfAl5PE1d'ANt.,TOSEWANFAVii-67,
3 (A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
rt
TOTAL fees and surcharges(A through C): $/0t------
440-25844(4/01/2013/C0M)