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Permit Electrical 2014-5-6
SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 hr OREGON Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 • PERMIT NO: 811-SPR2014-01003 - www.springfield-or.gov permitcenteraspnngfield-or.gov • PROJECT STATUS: Issued ISSUED: 05/06/2014 EXPIRES: 11/02/2014 STATUS DATE: 05/06/2014 APPLIED: 05/06/2014 SITE ADDRESS: 933 A ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703354203900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Adding Circuit for attic conversion OWNER: FRITZ FREDERICK JOE 8 BARBARA Phone Number: ADDRESS: 933 A 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 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 Contractor Signature Date • ATTENTION: Oregon law requires you to NOTICE: 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 952-001-0010 through OAR 952-o0t- COMMENCED OR IS ABANDONED FOR - 0090. You may obtain copies of the rules by 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 5/6/2014 10:16:12AM Page 1 of 1 a SPRINGFIELD `-` CITY OF SPRINGFIELD 225 Fifth St o Ego' TRANSACTION RECEIPT 359999940R 97477 541-726-3753 811-SPR2014-01003 www.springfeld-or gov 933 A ST permitcenter @springtield-or gov RECEIPT NO: 2014000998 RECORD NO:811-SPR2014-01003 DATE:05/06/2014 'f' tleh .v TE^.h.: sy; .' lva ACCo I 1T{C0 0 4; :• • NS CODE -.;=^!i*.-itw.:.-AMOUNTDUE 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 I AYMENTeirle J . P,AY,OR cnsHIER:' L We . COMMENTS .AMOUN NAND -a. Check - FRITZ FREDERICK JOE&BARBARA 93.60 2778 TOTAL PAID: 93.60 Electrical Permit Application SPRINGFIELD DEPARTMENT USE ONLY ?;; }CtT Y O S PRN IE' L_ D. *ORztG3O N . �� -= „ r.3 '..;...:.:;7g _,.s.-d?>-_ i rn . sa. ,r ,, ma Permit SPtZv l y- (�Ieo3 225 Fifth Street•Springfeld,OR 974774PH(541)726-37534 FAX(541)726-3689 Date: Siff, b y . 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. .* * ALOCALLOOVERNMENTiAFFROVAL :. ..;%; , , ,,ig:,r.F,EE;SCHEpULE_-M-4`J�3 4-gtx:t; Zoning approval verified? Yes : "t ' ' `a�`' " :` k r `-",� f i kt Cost Total'-r, g PP ❑ ❑No Number of ms eccton} er item ea L-''' 4.;sjc‘3,,+,°' 7Ff:(CATEGORYrOF,„CONSTRUCTION 42.;, ;?. -,. -s z,. r.�.: cost., " ,P,. ` Residential,per unit,service included: ❑Residential ❑Government ❑Commercial .,�„ 1,000 sq. ft.or less(4) $147.50 $ t , ,,JOB:ISITE„INFORMATION' AND :LOCATION s- W Job site address: q.'3 3 4- S-71- ereof additional 500 sq. ft.or portion $ 27.50 $ City: 5117/A_ State: ©/< ZIP: Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ ?°, .. 'rliDESCRIPTION` F. WORK t 'C;t^x k dwelling service or feeder(2) j / Services or feeders: installation, alteration,relocation 4-01a11 C ✓e-Cn T �/ i 200 amps or less(2) $ 89.00 $ :`�ifii girari r rrPROPERTa I.OV11NERr,l . +`<w iW.1j1: '' 201 to 400 amps(2) $ 104.50 $ 5or �=✓, i I 401 to 600 amps(2) $174.00 $ Name: Z Address: 73 -s A , f , 601 to 1,000 amps(2) $225.50 $ City: /2 State: O/� ZIP: Over 1,000 amps or volts(2) $516.00 $ Phone:(y/Zc 7 y 9'Z 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 I 201 to 400 amps(2) $ 96.00 - $ property is not intended for sale,exchange, lease,or rent. OAR 479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: r Over 600 amps or 1,000 volts,see services or feeders section above yt�i, *'hlti Cl RACTON R ,I L'IL"AT;ION t Os'I; ?1Y, Branch circuits:new alteration, extension'per panel Business name: a. Fee for branch circuits with purchase of a service or feeder fee: I 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) 1 $ 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) Each additional inspection:(1) $80.00 $ . APPL CA tkUSE ' lei (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) - $ (C)Technology Fee(5%of[Al) $ TOTAL fees and surcharges(A through C): $ .73-C 440-2584-J(4/01/2013/C0M)