HomeMy WebLinkAboutPermit Electrical 2014-4-28 SPRINGFIELD- 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR 97477 *
Phone: 541-726-3753
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Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00931
www.springfeld-or.gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/28/2014 EXPIRES: 10/25/2014
STATUS DATE: 04/28/2014 APPLIED: 04/28/2014
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 fire damage repairs etc Units 11812
OWNER: YU EDWARD'S,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
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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 Ia•/ rer.ires you to
foilo,v r;-i adopted by the O!egcn Utility
c IS PERMIT Notifjcation Center. Those rules are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT 0 OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
COMMENCED OR IS ABANDONED FOR • calling the center. (Note: the telephone •
ANY 180 DAY PERIOD. number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 4/28/2014 2:14:30PM Page 1 of 1
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Electrical Permit Application DEPARTMENT USE ONLY
e. «; akt"t kn ‘44,4444.54,K..:' ,.44 ; 4' .4. 5PR I NGF I tLO
.CI Y OF SP N r ;40RE O — ti 5/1 — �3/
S S��S migt'ager;� ,> =: 4 : .( �% _{� Permit no.:
225 Fifth Slreet•Sprmg[eld.OR 97477•P11(511)726-3753,1AX(541)726-3689 =..v OUCGON
Date: 0.9A-
This permit is issued tender OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within ISO
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes -❑ No Number ofinspections per item O Qt-v Cost Total
ea. cost
CATEGORY OF CONSTRUCTION
Residential, per unit,service included:
❑ Residential I ❑Government I ❑ Commercial
JOB SITE INFORMATION AND LOCATION
1.000 sq. li. or less P1) $147.50•
�,7 r� �� —. Each additional 500 sq. li. or portion $ 27.50 $
Job site address: V� F.i Ihcreol'
City: or�P;,ti e-t/A State: r>r ZIP: 97V77 Limited energy(2) _- S 35.00 $
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Retell/At t 1 /1 `-/y I Taxlot.: Each manufactured home or modular
DESCRIPTION OF WORK dwelling service or feeder(2) $ ss.00 $
Services or feeders: installation. alteration. vetoer:1 mr
-„ 200 amps or less(2) I� S 89.00 $ 77
—� /PPROPERTY OWNER 201 to 400 amps(2) • $ 104.50 S
Name: 401 to 600 amps(2) $174.00 S
Address: 1797 601 to 1.000 cups(2) $225.50 $
City: " State: ZIP: Over .000:imps or volts(2) $516.00 S
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47y77
_ Phone: r, 1- -(- p-( Tax: - Reconnect only(2) 5 69.00 $_
E-mail: Temporary services or feeders: installation. a/freonon. relacanon •
._...........-.-- 200 mops or less(2)
This installation is being made on residential or farm properly S 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
479.540(1)and 479.5600). 40110 600 amps(2) $138.50 $
Signature: Over 600 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch circuits: nee. alteration, ex/ens/on per panel
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Business name r r ft S C ie e t ei G a. Fee for branch circuits with purchase of a service or!center Ice:
Address: gl 7Y etc:-- i4 r t-.).- , Each branch circuit 3 $ 6.50 5 / l
City:2 U t� State: B r ZIP: 9'7 yv z h. Fee for branch circuits without purchase of a service or feeder tee:
Phone: -/ - Fax: - - First branch circuit(2). $ 60.50 $
E-mail: Each additional branch circuit S 6.50 S
CCB license no.: 3 /3 .5 ( BCD license no.: Miscellaneous fees: service or feeder not included
Signing supervisor's license no.: 9(O 5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: st : I( e5 ,_ k -3--✓ Each sign or nod inc lighting(2) $ 69.00 $
Signature of signing su ervis l� % Signal circuit or a limited-energy panel. $ 80.00 $
P �/,� - �ahcrauon.or extension(2) _--------
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[Their additional inspection: (I) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees $
. (Minimum Permit Fee 580.00) Ady�
(B)Enter 12%surcharge(.12 x Al)i $ t3d,�.
(C)Technology Fee(5%of IA I) $47j__
440-2584-1(4/01/2013/COM) TOTAL fees and surcharges(A through C): 1 7�
SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
EGON TRANSACTION RECEIPT 54nnZfiae13pR97477
811-SPR2014-00931
www.springfield-ar.gov 1747 MAIN ST perrnitcenter(gspringfield-or.gov
RECEIPT NO: 2014000942 RECORD NO: 811SPR2014-00931 DATE:04/28/2014
Ie9i.Qwl T IF z_ ifa$` �' F >sp.'_"'g _'ACCOUNT CODEffRANS.CODE- _:.*t AMOUNT,DUEi?';I
Branch circuits with service or feeder each circuit 224-00000-426102 1004 19.50
Services 200 amps or less 224-00000-426102 ' 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.02
Technology fee(5%of permit total) 100-00000-425605 2099 5.43
TOTAL DUE: 126.95 •
PAYMENT.TYPE _ PAYOR:0:a` '. ':`COMMENTS ! 7. .,=,T,lr<tr "-AMOUN.. ;A e'r
Credit Card YU EDWARD&SU 126.95
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028113
Credit Card YU EDWARD&SU 126.95
028113
Credit Card YU EDWARD&SU 231.08
028113
Credit Card YU EDWARD&SU. 231.08
028113
TOTAL PAID: 716.06
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