HomeMy WebLinkAboutPermit Electrical 2014-4-22 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
:,i r . • Phone: 541-726-3753
• OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00664
www.springfieltlar.gov permitcentergspringfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/22/2014 EXPIRES: 10/19/2014
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STATUS DATE: 04/22/2014 APPLIED: 03/28/2014
SITE ADDRESS: 5717 Peridot WAY,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1802041401206 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: E-New single family residence Morning View Subd Lot 6
OWNER: HAGEMAN GORDON R&COURTNEY LYNNE Phone Number:
ADDRESS: 6019 GRAYSTONE LOOP
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
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
INSPECTIONS REQUIRED
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Inspections • -•
4000 Temporary Power Service
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.
qe EContractor Signature Da/
ATTENTION: Oregon law r" equires you to •
follow rules adopted by the Oregon Utility •
Notification Center. Those rules are set forth
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in OAR 952-001-0010 through OAR 952-001- NOTICE:
0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD-
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Springfield Building Permit • - 4/22/2014 8:26:17AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
--' OREGON 541-726-3753
811-SPR2014-00664
www.springfeld-or.goy 5717 Peridot WAY permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000880 RECORD NO:811-SPR2014-00664 DATE:04/22/2014
o C- P. ION Ysr-F_n:' d'._M_..':r" , f _ `--A000UNTCODEhTRANS CODE a. cAMOuNTOMTJ
Each added 500 sq. ft. or portion 224-00000-426102 1004 82.50 '
Residence wiring 1,000 sq.ft. or less 224-00000-426102- 1004 147.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 27.60
Technology fee(5%of permit total) 100-00000-425605 2099 -11.50
TOTAL DUE: 269.10
�P.AYMENT+TYE P'AYaiea::duRSOR COMMENTS � �1
Check HAGEMAN GORDON R&COURTNE 269.10
2062 LYNNE
• TOTAL PAID: 269.10
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