HomeMy WebLinkAboutPermit Electrical 2014-5-2 •
SPRINGFIELD' 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
la Phone: 541-726-3753
. OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00980
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/0212014 EXPIRES: 10/29/2014
STATUS DATE: 05/02/2014 APPLIED: 05/02/2014
SITE ADDRESS: 2198 8TH ST,Springfield,OR 97477
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SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703261201411 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Two circuits
OWNER: J&G STOTT TRUST Phone Number:
ADDRESS: 2198 8TH ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor LEABURG ELECTRIC LLC CCB 198057 10/02/2014 541-510-9443
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_ INSPECTIONS REQUIRED
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
Notification Center. Those rules are set forth PERMIT THIS PERMIT EIS NOT
in OAR 952-001-0010 through OAR 952-001-
AUTHORED UNDER
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 5/2/2014 12:42:04PM Page 1 of 1
t
SPRINGFIELD CITY OF SPRINGFIELD.11 =.tea 225 Fifth St
«; TRANSACTION RECEIPT Springfiel&OR 97477
OREGON 541-726-3753
811-SPR2014-00980
www.springtield-or.gov 2198 8TH ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000981 RECORD NO: 811-SPR2014-00980 DATE:05/02/2014
;DESCRIPTION" a _. a. : _.._.. ,` ACCOUNT CODE/TRANS;CODEL_ 1...... ,,,AMOUNTDUE _2
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 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
__PAYMENT TYEE__PAYOR__cASRIER_JpARSON ' . COMMENTS....___._ .__ ._ .,,, _;AMOUNT PAID _ _ v. .. . _1
•Check LEABURG ELECTRIC LLC 93.60
1171
TOTAL PAID: 93.60
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I
Electrical Permit Application DEPARTMENT';USE ONLY ;:
SPNINGFIELD���
&CITY OF,=,SPRINGFIELD;rORE'GON Lt �*w- ' ^ k4 / 20( 0,pd0
ag::.,=:- ,j+x- :r.la ..-n ;tri;myrstl:ZI a. . _ sus -s :i4- 1, ,c * ,y , Permit no.: �/ �(— /cJ
225 Fifth StreeNSpringfield,OR 97477 KPH(541)726-3753•FAX(541)726-3689
'-y
Date: 2 //
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.
, WiLOCAL GQV ERNMENT.vAFPROVAL4eW( .°„ ,x 1A KaPFEE;`SCHEDULE;,_, ,* V"A," ',, ,
Zoning approval verified? ❑Yes ❑No ' : _ tlNumber df inspectionsper demQ Qty x Cst Toa ,y:
"` a , n cost :;
,'CATEGORYtOFCONSTRUCTION 4?i „
Residential,per unit,service included:
Residential ❑ Government ❑Commercial 1,000 sq. ft.or less(4) I $147.50 $
; JOB;SITEANFORMATION ,AND'LOCATION 11:174 L, Each additional 500 sq. ft.or portion
Job site address: 2J' 4E711 thereof - $ 27.50 $
City,j-j 4�:c I static/\ ZIP:q-75'1 7 Limited energy(2) $ 35.00 $
Reference: Taxlot Each manufactured home or modular
s 't`5= ,,agjD.ESCRIPTION! OF,EWORI( ` ,''fx, rja dwelling service or feeder(2) $ 69.00 $
,{. Services or feeders: installation, alteration,relocation
'_jcrill Cf�Gt.c-1` - / 0 kiwi' 51/2 cet.o✓
- 200 amps or less(2)
$ 89.00 $
s , , , t, "£PROP ERTYalliNER V , '_ ',' 201 to 400 amps(2) $ 104.50 $
Name: c.$s Sf—dt
401 to 600 amps(2) $174.00 $
Address: 2) q'146 q 601 to 1,000 amps(2) $225.50 $
City:salll% 71+t. l State:O2 ZIP: /7`'9 Over 1,000 amps orvolts(2) $516.00 $
Phone: - - 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) $ 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). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
v1151 i 941 1CONTRACTOR,INSTALLATION W R - Branch circuits:new alteration, extension per panel
Business name:£_c&.;//bt+r Q.-cc-fin-0- ( _t a Fee for branch circuits with purchase of a service or feeder fee:
Address:n0 f3ox tf'$ „$ Each branch circuit $ 6.50 $
City:(J, J.f'yyj f IC State ZIP: 5-7 lt 4' b.Fee for branch circuits without purchase of a service or feeder fee:
Phone9/f(- I5/f' ! tfg3 Fax: - - - First branch circuit(2) / $ 60.50 $4e7.5-0 E-maiL479011€ th ,--,/4 jL r Ji ei- o.A0. 6C0"7 Each additional branch circuit / $ 6.50 $ 1,jam
CCB license no.:/9gi.C7 BCD license no.: Miscellaneous fees:service or feeder not included
—
_Signing supervisor's license no.: *'782 S Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor:Dif,V r1 `� '/°8%A/ Each sign or outline lighting(2) $ 69.00 $
Signature of signing supervise/ , �����y. /. Signal circuit or alimited-energy panel, $ 80.00 $
alteration,or extension(2)
Each additional inspection:(I) $80.00 $
:,: k:sear:PLICANT USE ";' "° xa# :'m
(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): $ S3 C c.
440-2584-1(4/Oi/20I3/COM)