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HomeMy WebLinkAboutPermit Electrical 2014-3-28 j SPRINGFIELD 225 Fifth St ` CITY OF SPRINGFIELD Springfield,OR 97477 f yy. -.. • Phone: 541-726-3753 '-'''':A" "� k Inspection Phone: 541-726-3769 °a�°°" Permit & Inspection Summary Fax: 541-726-3676 www.springfeld-or.gov PERMIT NO: 811-SPR2014-00664 perm itcenter @spri ngfieldrocgov IVR Number: 811131192763 PROJECT STATUS: In Review ISSUED: EXPIRES: 09/24/2014 STATUS DATE: 04/11/2014 APPLIED: 03/28/2014 , VALUE: $0.00 SITE ADDRESS: 5717 Peridot WAY,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802041401206 WORK INVOLVED: New TYPE OF STRUCTURE:A Residential PROJECT DESCRIPTION: E-New single family residence Morning Vie"""w���1Suu'bd Lot 6 1 OWNER: HAGEMAN GORDON R 8 COURTNEY LYNNE 49 ft 1 1,,,/��,A /IvtA Phone Number: ADDRESS: 6019 GRAYSTONE LOOP ' , `I L I 1 SPRINGFIELD OR 97478 L mom'. , .:..i .kf .7mi1 : v -tf::..t"fr ,,T"j{.t',n 9 v 1'_ o :r o . i... „e :7:2 ' ._.,vo 3nst.:Qt a e izar -# Atwi Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor PHANTOM INC CCB 109864 01/14/2015 541-688-2549 General Contractor TOWN&COUNTRY HOMES LLC CCB 171258 07/21/2014 541-521-8412 i?a' . '= Caa?F; Si 114V; VALUAt ION?DE§GRIR hilt `k .,„tttaraf '` '"' ° a rif Description Type of Construction Unit Amount Unit Type Unit Cost Value pmr".; iM- "ra" i liMt lhii. ' t WITI SMEESIP,AIDrt ?TS`'rmr.y zip: W:3Pnu"'50:fiagtimaiwta lei " ..e4 Description Amount Paid Date Paid Receipt Nbr Temp services 200 amps or less $69.00 04/11/2014 2014000786 State of Oregon Surcharge(12%of applicable fees) 58.28 04/11/2014 2014000786 Technology fee(5%of permit total) $3.45 04/11/2014 2014000786 Total Paid $80.73 k' 2k p le:-a w Niit"` iIit. PY I AWREVIEVV WesrxRtl fA--riea % : 4c RWw 441 Department Received Due Date Completed Result Reviewer Application Acceptance 04/11/2014 03/28/2014 03/28/2014 Over the Counter James Larson Initial Review 04/11/2014 04/11/2014 04/11/2014 Over the Counter James Larson Comments: Over the counter permit Electrical Review 04/11/2014 04/11/2014 04/11/2014 Not Required James Larson Comments: Over the counter permit . gym _ at . r ,,, , : w+INSPECTIONS REQUIRED "y.*a _..�, r t tf p :7-';:-.7.17,;•.0¢n Inspection1TyN• .. . lnsp Date . Result I t follow pSQ��° rti by the Oregon Utility 4000 tl6PItil MITTrSM941i9! EXPIRE IF THE WOW{Scheduled Pending Notification Center. Those rules are set forth Comme{1ts:i,�'1ZED UNDER THIS PFRMIT IS NOT in OAR 952-001-0010 through OAR 952-001- 4225 ei(vide P �OR IS ABANDONED FOR Not Scheduled Pending 0090. You may obtain copies of the rules by comma ts. t, calling the center. (Note: the telephone 4500 Rough Ele t rE^IOD' Not Scheduled Pending number for the Oi t9U.l Ut;l;ty Notifcation Comments: na Center is 1-800-332-2344). 4999 Final Electrical Not Scheduled Pending Comments: na. Permit&Inspection Summary 4/11/2014 12:58:30PM Page 1 of 1 .1 SPRINGFIELD — CITY OF SPRINGFIELD 1 r'ry;x TRANSACTION RECEIPT 225 Fifth SI Spnng,ield.OR97477 OREGON 541-726-3753 811-SPR2014-00664 www.springfield-or.gov 5717 Peridot WAY permitcenter©springfield-cr.gov RECEIPT NO: 2014000786 RECORD NO:811-SPR2014-00664 DATE:04/11/2014 •.IF? o I fril i _•. "' I '0:it:': a`°--.•+.4 ACCOUNT CODERRANSfCODE Ni -iiiRD AMOUNT.DUE°tt' State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 8.28 Technology fee(5%of permit total) 100-00000-425605 2099 3.45 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 80.73 PAl!MENWPE , PAYOR- ;<cnswek:151M in:. , r Atli I9ENT5 AMOUNT PAID 3' ati Check PHANTOM INC 80.73 2575 TOTAL PAID: 80.73 Electrical Permit Application 5PR1 GFIELD DEPARTMENT USE ONLY • ^�'-, .c'y'�.ru itr.Y -x k. a..kY+ �7- a "*.ara SEd�&> :;ads - . I:,ITY OF,,. PRINGFIE_LD„3OREGON � ' permit no.: S�t�_ TAU'#3`:,..xL.tk .,. ,,[..-r-:-.'J.-T iitt.._.: '. 'irr ,S.�,K4,1 .�irj$... •a..S;.. -tr -,, a 225 Fifth Strect♦Springfield,OR 974774 PH(541)726-3753♦FAX(541)726-3689 '"a / Date: y7/ / /7 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. l' LOCAL:GOVERNMENi APPROVAL L. i, r; `" t, i. . r. ,: ',FEE< SCHEDULE a .,< sa s'kfl,3 Zoning approval verified? ❑ Yes ❑No Number of inspections per item O . Qty. Cost Total ear. cosh 7 CATEGORY,:OF 'CONSTRUCTION ' Residential, per unit,service included: 5� JResidential ❑Government ❑ Commercial t`('7 s s. s 1,000 sq ft. or less(4) t $.9.4100 $ ,,,,=JOB.7,SITE INFORMATIONYAND 4L'OGATION,.,:x +' Each additional 500 sq. ft. or portion $ $ Job site address:6 171 7 On � bh4— Oa, thereof �f City: lj i c State: a/Z ZIP: INT Limited energy(2) $ 32.00 $ Reference: Taxlot.: Each manufactured home or modular $ 63.00 $ ' DESCRIPTION OF WORK r�'-•�"r. dwelling service or feeder(2) ^ 1-09: Services or feeders: installation, alteration, relocation . c 1 Z I Or 17 fe'� 200 amps or less(2) $ 81.00 $ lam 'PROPERTY RI1C� - 201 to 400 amps(2) $ 95.00 $ PROPERTY OWNER/ Name 1.h a @ o, [ u 't-p vl F4o <<S 401 to 600 amps(2) $158.00 $ Address: &Lb 19 a U s' o - e Z„-OOP 601 to 1,000 amps(2) $205.00 $ City: S i (9 State: CA) ZIP: 9t7cnc/ Over 1,000 amps or volts(2) $469.00 $ Phone: F cjl.t7Gt 3 3 7 Fax: - - Reconnect only(2) $ 63.00 $ E-mail: Temporary services or feeders: installation, alteration relocation 200 amps or less(2) /Cy This installation is being made on residential or farm property $ $(� owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(1)and 479.5600). 401 to 600 amps(2) $126.00 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION , Branch circuits: new, alteration, extension per panel. Business namef. -(-Ot,tt-t[,},, , A/7. be] 4e0-12;c_ a. Fee for branch circuits with purchase of a service or feeder fee: Address: PO ,_ S✓7pr1 Each branch circuit $ 6.00 $ City: ��Lt5 e-//t e State: O w ZIP: 9,co z-, b. Fee for branch circuits without purchase of a service or feeder fee: Phone4 U 1 ct./ Fax: �j`yc7 9,35- w.s 2 First branch circuit(2) $ 55.00 $ 1-93s E-mail: t ;I S `(et'TtC. {//it,10'(0-h^ Each additional branch circuit $ 6.00 $ CCB license no.:,DC/ry,N II BCD license no.: , C) ,q'•-C. Miscellaneous fees: service or feeder not included Signing supervisor's license no.: It e7�-,-5 Each pump or irrigation circle(2) $ 63.00 $ Print name of signing supervisor: as tinter 465-tit);cl,_ Each sign or outline lighting(2) $ 63.00 $ Signature of signing supervisor: ��.�,,....-4��� Signal circuit or alimited-energy panel, $ 63.00 $ alteration,or extension(2) _ , Each additional inspection: (1) $58.00 $ n ,'tfich.'' -' 1`,AP.PL'ICANT4USEt ..__ 1 . ._4r.''..r. (A) Enter subtotal of above fees $ _ (Minimum Permit Fee$58.00) • (B)Enter 12%surcharge(.12 x [A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $ 7 7 .x- 440-2584-J(9/08/C0M)