HomeMy WebLinkAboutPermit Electrical 2014-4-22 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
• (\Lar 4 Phone: 541-726-3753
• "`OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00872
www,springfield-ar.gov permitcenter @springfield-ar.gov
PROJECT STATUS: Issued ISSUED: 04/22/2014 EXPIRES: 10/19/2014
STATUS DATE: 04/22/2014 APPLIED: 04/22/2014
SITE ADDRESS: 1747 MAIN ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703363106600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New services and circuits for tire damage repairs etc Units 21-24
OWNER: YU EDWARD&SU Phone Number:
ADDRESS: 3121 KEVINGTON AVE
EUGENE OR 97405
CONTRACTOR INFORMATION
• Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical.Contractor WILLIAM A GRAY JR CCB 21351 04/28/2016 541-485-3954
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
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
ATTENTION: Oregon law requires you to NOTICE:
rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
NOTICE:
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
Springfield Building Permit 4/22/2014 9:51:34AM Page 1 of 1
SPRINGFIELD "- CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT 225 FifthSt 897477
541-726-3753
OREGON 811-SPR2014-00872
www.spnngfeldor_gov 1747 MAIN ST permitcentedgspdngfield-or.gov
RECEIPT NO: 2014000884 RECORD NO:811• PR2014-00872 DATE:04/22/2014
: : *z"`,.245t_ ._? .` WACCOUNTCODE/TRANSCODE_ :; , tea'. .-,
jo7�'Ie�Dl;�l�Ce1�� ry AMOUNTDUE�i,I:
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less 224-00000-426102 1004 267.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 34.38
Technology fee(5%of permit total) 100-00000-425605 2099 14.33
TOTAL DUE: 335.21
P AYMENTTrYPE P.AYOR CASiI�ER:ccaRPENTER -CSNIENTS r, ,L iNTAPAIO•
Check J8G INV 335.21
1469
TOTAL PAID: 335.21
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Electrical Permit Application DEPARTMENT USE ONLY
+f..';I " 'sLi- Ja., Seine( iiELU
` «z, koat�t. i,,ogosi J - Permit no.:
225 Fifth Street*Springfield,OR 97 477*P11(54f)7263753$f\x(541)7263689 s:---•''---' J
Oa ao Oi1
Date: 2-7, / c
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 wort: is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No I I Cost Total
CATEGORY OF CONSTRUCTION Number of inspections per item O Qty,
ea. cost
❑ Residential. Residential,per unit,service included:
❑ Government ❑Commercial
JOB SITE INFORMATION AND LOCATION 1.000 sq. h. or less(4) $147.50 $
Job site address:/7 91 //7rT;,'Z) c�j•"T Each additional 500 sq. 0. or portion
thereof $ 27.50. $_City5 e —1cl Fie f State: pV ( ZIPV g:;)y
I_i roiled energy(2) $ 35.00 $
ReferencebJ/r F Tax lot.: • Each manufactured home or modular
C e C I ,/°�l_JL,/C�,, — dwelling service or feeder(2) $ 69.00 5
•
v� al9 r r//nC. 1 I, 42 4 YS Services or feeders: installation. alteration. relocation
3 3y�L Cpr 200 amps or less(2)
$ 89.00 8'6
_ PROPERTY OWNER 201 to 400 amps(2) _
4 S 104.50 5
Name: 4 t f- L r L.1C , 401 to 600 amps(2) .5174.00 S
Address: /7417
,� 601 to 1,000 amps(7
) $225.50 8
City: a . f It Slate: , ZIP: Over 1,000 amps or volls(2) 5516.00 $
97yo/
Phone:$i./(-7<-4bNl/ Fax: - - Reconnect only(2) S 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) I g 69.00 g
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR 201 to 400 amps(2) $ 96.00 $
479540(1)and 479.560(1). 401 to 600 amps(2) $138.50 g
Signature: Over 600 amps or 1.000 volts,see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: mac alteration.extension per panel
Business name: -B'7 (I/ S to c.:7 (-. e a. Fee for branch circuits tvith purchase of a service or feeder lee:
Address: '-J75-0 LP/ r•� 3 S 6.50 5 9 j
` �( •- �/ �'r �9 Each branch circuit / ,
City: L✓ a. i l State: &p ZIP: 1 / 101. b. Pee for branch circuits without purchase of service or feeder 1-et::
PhoneSsf f 1 - 0 I 4•. > Fax,$'( ,;/ 2
� y� ( � S-� First hrandh circuit (_) $ 60.50 5
E-mail: _ Each additional branch circuit 5 6.50 __S
CCB license no.: 13 3 •1 i BCD license no.: 61iscell:mcous fees:service or feeder not included
Signing supervisor's license no.: CL n S Each pump or irrigation circle(2) $ 69.00 5
Print name of signing supervisor: Hi Cr-s�. S: Each sign or outline lighting(2) — $ 69.00 5
� Signal circuit or a limited-energy panel,
Signature of signing superviSAr
'r V r' alteration.or extension(Zp - S 80.00 —�----
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A) Enter uisuPero ul:ee$8Ices S�LL7�
(Piininunn Permit Fee$80.00) p
(B)Enter 1294)surcharge(.12 x IAO $ lju7
(C)Technology Fee(5%ofiA)) $ 7��
440-2584-i(4/012(113/CO\i) TOTAL fees and surcharges(A through C): $ 73 --.41._