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HomeMy WebLinkAboutPermit Electrical 2014-5-1 f: SPRINGFIELD 225 Fifth St ` CITY OF SPRINGFIELD Springfield,OR 97477 hr t,C� Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00957 www.springfield-or.goy pe rmitce nter @s pringtield-or.gov PROJECT STATUS: Issued ISSUED: 05/01/2014 EXPIRES: 10/28/2014 STATUS DATE: 05/01/2014 APPLIED: 05/01/2014 SITE ADDRESS: .225 E ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703352304200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install gas water heater OWNER: LABRECQUE CHRISTER R Phone Number: ADDRESS: 225 E ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp - Phone Electrical Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor SHAD CHASAN SURRETT CCB 158295 01/15/2016 541-741-3553 INSPECTIONS REQUIRED II 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 ATTENTION: Oregon law requires you to NOTICE: • follow rules adopted by the Oregon Utility Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK inoOAR 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 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 5/1/2014 8;2824AM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD . 11 ..at*,. 225 Fifth St ,:4(``ONEGON TRANSACTION RECEIPT Springfield OR 97477 541-726-3753 811-S PR2014-00957 www.springfield-or.gov 225 E ST permitcenter @springfield-or.gov RECEIPT NO: 2014000965 RECORD NO:811-SPR2014-00957 DATE:05/01/2014 !DESCRIPTION_;_______ ACCOUNT_CODEITRANS.CODE_ _ _ -_---AMOUNT.DUE.__! State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 0.10 TOTAL DUE: 0.10 1_PAYMENTTYPE _ ._ AMOUNT PAID .�' ' ___ -sPAYOR. CASHIER:CCARPENTER� COMMENTS I ., _,_.!'_„__ __ „- .. _ _.- __- .._. _._J Cash LABRECQUE CHRISTER R 0.10 TOTAL PAID: 0.10 • SPRINGFIELD-- - CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT SpringfielQOR97477 OREGON 541-726-3753 811-S PR2014-00957 www.springlield-or.gov 225 E ST permitcenter©springfield-or.gov RECEIPT NO: 2014000964 RECORD NO:811-SPR2014-00957 DATE:05/01/2014 :DESCRIPTION-r _w � ACCOUNT_CODE/TRANSCODE AMOUNT,DUE :7 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 9.50 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.50 - P • • LPAYMENT TYPE • �� .PAYOR dnsRIER:ccnaaENrER " •-� COMMENTS ... 'AMOUNT PAID?. ,- ... _ • nm;_J Check LABRECQUE CHRISTER R 93.50 1560 TOTAL PAID: 93.50 • Electrical Permit Application DEPARTMENT USE ONLY _ :ay ,y y:; -. SERINGFIELI� CIS O , PRI'NC i a ,IWIOREGONa l 1 , ..,_. S/y_ ,s2 • a. Permit no.: r �.d4- a • 225 Fifth Sbu•t•Springlield,OR 97477•m1(541)726-3753.1 \\(541)726-3689 -4-4-). ''• OHEGON / Date: 57//76( 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 ISO days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑ No Number of inspections per item ( ) Qty. Cea ost Tolnl cost CATEGORY OF CONSTRUCTION Residential, per unit,service included: ❑ Residential ❑ Government ❑ Commercial $ JOB SITE INFORMATION AND LOCATION 1,000 sq. II or less(4) $147.50 �� Each additional 500 sq. ft. or portion $ 27,50 5 Job site address(: / thereof City: SQci'r'9�►a� State: Q, ZIP: Limited energy(2) $ 35.00 $ Reference: .4 -I a.xlot.:3I 0365 Each manufoctured home or modular $ 69.00 $ _ DE�',CRIPTION OF WORK dwelling service or feeder(2) Dr_ (� _ J( Q-��_ ,Q _ - Services or (ceders: instnlla(ian. of/era/ion. rclucaliort p,Q�AM�e,�.y�ti/� T ((��( `� 200 amps or less(2) S 89.00 $ PROPERTY OWNER 201 to 400 amps.(2) $ 104.50 1$ Name: ( r\s L�,)(�fAtl,Qi 401 to 600 amps(2) $174.00 $ Address: c -- JT 601 to .000 amps(2) $225.50 $ �q bR Over 1.000 amps or volts(2) 5516.00 S City: Irr State:011k Phone: 13. L19� ( I43 Fax: - - Reconnect only(2) $ 69.00 E-mail: Temporary services or feeders: iiista/latinn, alteration. relacariarr • This installation is being made on residential or farm property 200 amps or less(2) S 69.00 $ owned by me or a nlem r of my immediate family. This 201 to 400 amps(2) $ 96.00 5 property is not inte let for sale, exchange, lease, or rent. OAR 479540(l)and 47 .56 (I). 401 to 600 amps(2) $138.50 $ Signatre: —� Over 600 amps or 1.000 volts,see services or (ceders section above CO �R7f/A �CTOR INSTALLATION Branch circuits: nen', alteration, extension per panel Business name: or --- a. Pee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit 7 S 6.50 S City: State: t ZIP: b. Pee Rrr branch circuits without purchase ofa service or Iceder fee: • Phone: - - - Fax: - - First branch circuit(2) $ 60.50 5 E-mail: Each additional brunch circuit $ 6.50 S CCB license no.: BCD license no.: Miscellaneous fees: service or feeder nor included Signing supervisor's license no.: Each pump or irrigation circle(2) S 69.00 $ Print name of signing supervisor: Bach sign or outline lighting(2) 5 69.00 $ Signal circuit or a limited-energy panel. $ 80.00 $ Signature of signing supervisor: alteration.or extension(2) Earl] additional inspection: (I) $80.00 $ APPLICANT USE (A) Enter subtotal ofabove lees $ p7) (Minimum Permit Fee$80.00) .ry (B)Enter I?%surcharge(.12 x lAl) $ i (C)Technology pee(5%oflAl) $ fs00 440-2584-1(4/01/2013/COM) TOTAL Ices and surcharges(A through C): $ 6„3 6,40 •