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HomeMy WebLinkAboutPermit Electrical 2013-12-3 SPRINGFIELD-" 225 Fifth St $ t CITY OF SPRINGFIELD Springfield,OR974 �9d ,c` our oN Phone: 541-726-3753 •' �F,g.��' Building / Residential Permit Inspection Phone: 541-726-3/ 7 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02601 www.springfield-ocgov permitcenter©springfield-ar.gov PROJECT STATUS: Issued ISSUED: 12/03/2013 • EXPIRES: 06/01/2014 STATUS DATE: 12/03/2013 APPLIED: 12/03/2013 SITE ADDRESS: 2001 7TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703261301400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Permits for bathroom and garage conversion by proir owner OWNER: SELCO COMMUNITY CREDIT UNION Phone Number: ADDRESS: PO BOX 7487 SPRINGFIELD OR 97475 CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone 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. Owner or Contractor Signature Date • • NOTICE: ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR - in OAR 952-001-0010 through OAR 952-001- ANY 180 DAY PERIOD. 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 12/3/2013 3:39:49PM Page 1 of 1 • SPRINGFIELD -- CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springreld,OR97477 6\02* OREGON 541-726-3753 811-SPR2013-02601 www.springfieldor.goy 2001 7TH ST pennitcenter©springfield-or.goy RECEIPT NO: 2013002593 RECORD NO:811-SPR2013-02601 DATE: 12/03/2013 '.- s i,.i = . '4AC000NT. 0 o e o E sL _. =AMOUNT DUES u 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 P.AMEN7#TyYE P,AYOR,_ casNieR ccaR ENTER COMMENTS AMOUN:10)1D Credit Card Doren Roberts 93.60 029546 TOTAL PAID: 93.60 Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD 'CITY'OF.SPRINGFIELD, OREGON 1 iite ( � Permit no.: C/7 - 260 / 225 Fifth Street*Springfield,OR 974770 P14541)726-3753*FAX(S41)726-3689 \(OREGON Date! Z( 7 // 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. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑ No Number of inspections per item() Qty. Cost Total ea. cost CATEGORY OF CONSTRUCTION Residential,per unit,service included: ''4 Residential ❑Government ❑Commercial JOB SITE INFORMATION AND LOCATION 1,000 sq.ft.or less(4) $147.50 $ Each additional 500 sq. fl.or portion Job site address: Zeb) -4. S-ree4 thereof $ 27.50 $ City: ;n5.c,e( d State: 012_ ZIP:94//1 71 Limited energy(2) $ 35.00 $ Reference:Mit 0.2,502-g Taxlot.: p I L/0 o Each manufactured home or modular $ 69.00 $ dwelling service or feeder(2) / DESCRIPTION OF WORK L ��N� /� f.Q / _ Services or feeders: installation, alteration,relocation 1.` (61/4 200 amps or less(2) $ 89.00 $47 i C/''JW IC w/n Fi'r(Tf OPERTY OWNER 201 to 400 amps(2) $ 104.50 $ PRR Name:lj axe 401 to 600 amps(2) $174.00 $ Address: p. -7\-($-7 601 to 1,000 amps(2) $225.50 $ City: C. State:0,(2— ZIP: 9)-7t-I— c Over 1,000 amps or volts(2) $516.00 $ Reconnect only(2) $ 69.00 $ Phone: - - Fax: - 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: new,, alteration,extension per panel Business name: a.Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit I $ 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 $ g signing P alteration,or extension(2) Each additional inspection:(I) $80.00 $ CTGA C---.,c } , J VP APPLICANT USE .J 0"c`, , 12 'l4-S l (A) Enter subtotal of above fees \v,h,L_ P.ptf! £S t'.CD (Minimum Permit Fee$80.00) $ 11bS Peso✓( S-/ , F rn-a 17 IFe) / (B)Enter l2%surcharge(.12x[A]) $ 0— (9-t I) 2oto - YO el (C)Technology Fee(5%of[A]) $ Ol) d4ren 13 t <s it—co ,C o irtri 440-2 584-1(4/01/2013/COh) TOTAL fees and surcharges(A through C): $ Gf 7 i