HomeMy WebLinkAboutPermit Electrical 2014-5-2 SPRINGFIELD " 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
t -'-- Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00973
www.springfield-or.gov permitcenter@spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/02/2014 EXPIRES: 10/29/2014
STATUS DATE: 05/02/2014 APPLIED: 05/02/2014
SITE ADDRESS: 1195 10TH ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703264413300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Service Change and circuit •
OWNER: LONG BEACH MORTGAGE TRUST 2006-2 Phone Number:
ADDRESS: 3815 SOUTH WEST TEMPLE
SALT LAKE CITY UT 84115
CONTRACTOR INFORMATION 1
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
4210 Service Change
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.
Cod •
Owner or Caontrt��nature Date
NOTICE:
• ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT In OAR 952-001-0010through OAR 952.001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 5/2/2014 8:13:13AM • Page 1 of 1
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I. SPRINGFIELD - CITY OF SPRINGFIELD
lil - 225 Fifth St
„ TRANSACTION RECEIPT Spdngfield,OR97477
OREGON 541-726-3753
811-SPR2014-00973
www.springfieldor.gov 1195 10TH ST permitcenter @sphngfield-or.gov
RECEIPT NO: 2014000972 RECORD NO:811-SPR2014-00973 DATE:05/02/2014
■O` *' ' ` ” ' yD.,: LL. W ",_2 x aACCOUNT-:CODE/TRANS COD rri]
Branch circuits with service or feeder each circuit 224-00000-426102 1004 6.50
Services 200 amps or less 224-00000-426102 1004 89.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 11.46
• Technology fee(5%of permit total) 100-00000-425605 2099 4.78
TOTAL DUE: 111.74
i ,PAYMENT.TYPE�e PAYOR '=l castueR: RSR ,.,YZ=7COMMENTS ` .rf L•.:* J„'.- 'AMP UNTiPAID:4{V 5M111},,.L
Credit Card Dale Adney 111.74
01141C
TOTAL PAID: 111.74
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Electrical Permit Application DEPARTMENT USE ONLY
SPNINGFIELO -..--y
CITYx 0 SPRINGFIELD` OREGON L, g $f Zv `I— 667 73
v:,:::.,,*,,,,,,-, n"`,.xs i'C x%�,rr..:M.,,:e,,t r;t'?t Sg;1. r:7S::nom c rAii4- — r'?/:77: rxg, : `w w. Permit no.: l
225 Fifth Street•Springfield,OR 97477*PH(541)726-3753*FAX(541)726-3689
Date: 7 F-
/Z //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 work is suspended for 180 days.
. 6 _ 'ttLOCAL,GOVERNMENT:APPROVAL,YM „ , °,* ' x'?r1a;t ' i,.FEE SCHEPULEr ;ct kl , An^e-
Zoning approval verified? ❑ Yes ❑No '.Numberlof inspections peratetti O' Qty: �"'',C604; 'Total-i
"+b-,.4- ` , CATEGORY;�OE-ciCONSTRUCT;ION w?'U, `',2 ; `° - " - -` -_. .�•:ea
x}a— .-
Residential,per unit,service included:
❑Residential ❑ Government ❑Commercial 1,000 sq.ft. or less(4) $147.50 $
,'.0 JOBySITE.JNEORMATION AND---`.LOCATION;;,,, z, __
Job site address: Q !! e-�- Each additional 500 sq.ft.or portion
n\ c3 tC) R S' 1 thereof $ 27.50 $
Cit :' {s X\Cc; e a State:O . ZIP: 97 it 477 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
r „ r a atDESCRIPTION OFZWORK r dwelling service or feeder(2)
Services or feeders: installation, alteration, relocation
CY 200 amps or less(2) / $ 89.00 $
r' %`.i'rha .`q M`'PROP,ERTYY OWNER its;`*, ` ;' t. 201 to 400 amps(2) $ 104.50 $
Name: 'J O i- n a-., 1A pko - 401 to 600 amps(2) $174.00 $
Address: 1 l c'c 10 Inn S f 601 to 1,000 amps(2) $225.50 $
City: C 6k I .c\GS\A Stater K. ZIP: '\ 7Oil? Over 1,000 amps or volts(2) $516.00 $
Phoned O$-%9 I 6,1-t(3 Fax: - - Reconnect only(2) $ 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) , $ 59.00 $
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). 401 to 600 amps(2) $138.50 $
Signature:' Q� ^ Over 600 amps or 1,000 volts,see services or feeders section above
?';`?`K�; r,r ONT CTOR„;INSTALf LATIQN + p";`?- "c,:cii: Branch circuits:new alteration,extension per panel
Business name: a Fee for branch circuits with purchase of a service or feeder fee:
Address: Each branch circuit / $ 6.50 $
City: State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 60.50 $
E-mail: _ Each additional branch circuit $ 6.50 $
CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervisor: Signal circuit or alimited-energy panel, $ 80.00 $
alteration,or extension(2)
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Each additional inspection:(I) $80.00 $
AP
'.�.� APPLICANTIUSEn-Me ".aa.n
(A) Enter subtotal of above fees $
• (Minimum Permit Fee$80.00)
(B)Enter 12%surcharge(.12 x[A]) $
(C)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through C): $ /1/ .7L1
440-2584-J(4/01/2013/COM) s