HomeMy WebLinkAboutPermit Electrical 2014-4-28 (3) SPRINGFIELD' 225 Fifth St
" _ a CITY OF SPRINGFIELD Springfield,OR 97477
: ( 't Phone: 541-726-3753
K7. \OREGON
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00933
www.springfield-or.gov permacenter@springfield-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 Unit 10
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
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth QTII.E:
in OAR 952-001-0010 obta n cop es OAR 52-001-
0090. You may IS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone THORI7_ED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification Ti,/ENCED OR IS ABANDONED FOR
Center is 1-800-332 2344)• y 130 DAY PERIOD.
Springfield Building Permit 4/28/2014 217:23PM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
1 i +wa...... 225 Fifth St
TRANSACTION RECEIPT Springfield:OR 97477
:&ice ` 541-726-3753
OREGON 811-SPR2014-00931
www.springfield-or.gov 1747 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000942 RECORD NO:811-SPR2014-00931 DATE:04/28/2014
EDESCRIP.TION_. - • ' - ACCOUNT_CODE/TRANS CODE _..__ ;- ._AMOUNT DUE
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
LPAYMENT'TYPE.,, PAYOR_CASHiER:CCRRPENTER_ �_.COMMENTS _„AMOUNT PAID
Credit Card YU EDWARD&SU 126.95
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
•
Electrical Permit Application DEPARTMENT USE ONLY
r R SY( r
Gf1EL0
CI •Y OF SP N FIE I OL � N � - im_ . • SA -
3
..= ., r . ; Permit no.
225 Fifth Si ect•Spimgtelt.OR 97477•P11(541)726-3753•FAX(541)72673689 _ O,EGON `
. Date: ",Le/220%
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 ea. Totcost al
CATEGORY OF CONSTRUCTION
Residential, per unit,service included:
❑ Residential ❑Government ❑ Commercial
JOB SITE INFORMATION AND LOCATION
1.000 `q e>� less I
It. I) $147.50 S
�79/ ST
Each additional 500 sq. IL or portion
Job site address: �, thereof $ 27.50 $
CitySps,; 44,-;.,m State: Or Z_IP:775/77 Limited energy(2) $ 35.00 $
Refere4i ilii /0 Taxlot.: Each manufactured home or modular $ 69.00 S
DESCRIPTION O,FF WOR dwelling service or feeder(2) —
SQ /'U f I'�,� L •---
Services or feeders: installation, alteration. relocation
( r 200 amps or less(2) / $ 89.00 s t7 /
11t PROPERTY OWNER 201 to 400 amps(2) ` S 104.50 5
Name: q.,_� 401 to 600 amps(2) $174.00 S
Address: 7q7 601 to 100(1 amps(2) $225.60 $
1741
— Over 1.000;amps or volts(2) $616.00 5
City: 44 41) stale: � ZIP: �j7�j7�
Phone: �/"" Fax: Reconnect only(2) S 69.00 $
Sol - -4bN4 .
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 ate or a member of my immediate la dly. This 201 to 400 amps(2) $ 96.00 $ .
property is not intended for sale, exchange, lease,or rent. OAR
479540(1)and 479.560(1). 401 to 600 amps(2) • $138.50 S
Signature: Over 600 amps or 1.000 volts.see services or feeders section above
CONTRACTOR INSTALLATION Branch.circuits: new, alteration:a tension per panel
Business name: •i-/PS c/� (.e L7 h t C. a. Fee for branch circuits evith purchase of a service or Feder fee:
Address: 1775t0 6,& 4--1 --ziL / I xh branch circuit 3 S 6.50 $h ir
City: 'Cal State: or I ZIP: ?IVO Z h Fee for branch circuits evithout purchase of a service or('ceder tee:
Phone:.59/ S 0I S65 P Fax: - - First branch circuit(2) 5 60.50 $
E-mail: Each additional branch circuit ' $ 6.50 $
CCB license no.: 3(35 1 BCD license no.: Miscellaneous Ices:service or feeder not included
Signing supervisor's license no.: 9 QS! 5 Each pump or irrigation circle(2) $ 69.00
Print name of signing supervisor: ; �� a r v Each sign or outline lighting(2) _ $ 69.00 $
Signal circuit urn smiled-energy panel.
Signature of signing super `Q /, Signal circuit
extension(') 5 80.00 $
�-( Each additional inspection: (I) $80.00 $
APPLICANT USE
(A) Enter subunal of above fees
(Minimum Permit Fee 580.00) $ 7 0. -.-
(B)Enter 12%u surcharge(.12 x [Al) $ / %?Z
(C)Technology Fee(5%of Al)i $ y3 .
TOTAL fees and surcharges A through C): $ 9i
6-zs�l-i(4touzol-trcoroq g ( e ) ��o