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HomeMy WebLinkAboutPermit Electrical 2014-4-11 • SPRINGFIELD- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 t Y% .`et; Phone: 541-726-3753 ri`�OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00777 www.springfeld-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/11/2014 EXPIRES: 10/08/2014 STATUS DATE: 04/11/2014 APPLIED: 04/11/2014 SITE ADDRESS: 912 D ST, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703351307100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install Sub-Panel OWNER: THOMAS GLENN SOFGE REVOCABLE TRUST Phone Number: ADDRESS: 1641 BELLEVUE AVE#201 SEATTLE WA 98122 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor TRITON ELECTRIC INC COB 164857 05/25/2015 541-484-9800 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. Owner or Contractor Signature Date 9 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT 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). K. • Springfield Building Permit • 4/11/2014 10:07:43AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD kcREGON TRANSACTION RECEIPT Sp97477 541-726-3753 r 811-SPR2014-00777 www.springfield-or.gov 912 D ST permitcenter @springfield-or.gov RECEIPT NO: 2014000783 RECORD NO: 811-SPR2014-00777 DATE: 04/11/2014 ;DESCRIPTION _ _ -_ -ACCOUNT CODE/TRANS CODE `-. : 'AMOUNT DUE Branch circuits with service or feeder each circuit 224-00000-426102 1004 39.00 Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 15.36 Technology fee (5% of permit total) 100-00000-425605 2099 6.40 TOTAL DUE: 149.76 PAYMENT TYPE PAYOR CASHIER:JLARSON '. - . y COMMENTS ' ' - '" .:AMOUNT PA ID 1,11 3 Credit Card TRITON ELECTRIC INC 149.76 Tye 015177 TOTAL PAID: 149.76 • • • • • Electrical Permit Application 1 DEPARTMENT USE ONLY SFRINGFIEW -0-1.••Ct Y OF SPRING FIELD ()[t (,ON ry�{r�t� ,�y., Permit /l7l+4/— L '77 -225 Fifth Sireet43pdngileld,OR 97477•Pi1(541)726-37334FAX(S41)726-3689 �-Sl µ'. OREGON • • Date: y/// //L This permit is Issued under OAR 918-309-0000. Permits are nontransferable.Permits expire if work is not started within 1.80 , days of issuance or'if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL I __ FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No 1 Number of inspections per item() Qty.. Cast Total CATEGORY OF CONSTRUCTION I -------- ea. cost --- Residential,per unit,service included: .Residential 0 Government ❑Connnercial - JOB SITE INFORMATION AND LOCATION 000 sq.O.or less(4) $147.50 $ Each additional 500 sq.at.or portion $ 27.60 $ Job site address:_.._nib---_[' STy„yt-ef-� . thereof City: S4Q\t1G`G1/4 riX-i) State: op_ ZIP: C]"'[.t\^(-( I.imited energy(2) $ 35.00 $ Reference: '['axial.: Each manufactured home or modular $ 69.00 DESCRIPTION OF WORK dwelling service or feeder(2) Services or feeders:installation. alteration,relocation fM TYiiL_ `�3t ?RnLrts 200 amps or less(2) 1 $ 89.00 $ PROPERTY OWNER 201 to 400 amps(2) S 104.50 $ 401 to 600 amps(2) $174.00 $ Name: Tosdv4 Sopts_ _--------..... Address: If04.\ S s„ �u q _ RrJ f4, d'7-OI -6nt to 1,000 nmps(2) $225.50 $ City: State: ZIP:y$(Z'L Over 1,000 amps or volts(2) $516.00 $ Y S4orr- S.C. _ I.s A- Phone: 206-4&t--949t Fax: - Reconnect only(2) $ 69.00 $ E math Temporary services or feeders:installation,aleration. relocation This installation is being made on residential or farm property 200 amps or Icss(2) $ 69.00 $ owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 5 property is not intended for sale,exchange, lease,or rent. OAR. -- 479.540(1)and:479360(1). 401 to 600 amps(2) 5138:60 $ Signature: Over 600 amps or 1,000 volts,sec services or feeders section above CONTRACTOR INSTALLATION Branch circuits:new,alteration,extension per motel Business name: ,� ic 6i Z a.Fee for branch circuits with purchase,of a service orfeeder fen: TYO.. N r n r r r 'ree+e. --' Address: Z„bris__ aj:L4a.,,,0.1.64_ OR. Each branch circuit (, $ 6.50 I $ ate City:' 5-0Gd£11K State: p Ct- ZIP: p..2.... h.Fee for branch circuits without purchase as service or feeder fee: Phone: 5.4 -4 5 4--`1 4-0 l I Fax: -404- (e.6 First branch circuit(2) $ 80.60 S E-mail:-[.,r sJn,,,x c4 c{r,`QW,...r_u4-,/1crf Each additional brunch circuit $ 6.50 $ CCB license no.: IQ,4ta S7 , BCD license no.: -SszL Miscellaneous Ices:service orfeeder not included Signing supervisor's license no.: 4-[-f� S Each pump or irrigation circle(2) $ 69.00 $ • Print name of,signing supervisor: r la qT c—tZ Each sign or outline lighting(2) $ 69:00 $ Signature of signing supervisor: Signal circuit or nlimited-energy panel, $ 80.00 $ . i8 _iSm g p alteration,or extension(2) Each additional inspection: (I) Sao.00 $ • APPLICANT USE _ • (A) Enter subtotal of above fees (Minimum Permit Fee$80:00) $ I ZS (B)-Enter 12%surcharge(.12 x[A]) $ 1S,Sfp (C)Technology Fee(5%of[A]) $ fe Abp 440-25641(4/01d013ICOM) TOTAL fees and surcharges(A through C); $Mat 110 ■ Too/TO011/1 XVd SO:TT 6ToZ/6o/40