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Home My WebLink AboutPermit Electrical 2014-5-9 SPRINGFIELD " 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Ir Phone: 541-726-3753 I'' °t^OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01035 www.springfield-or goy permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/09/2014 EXPIRES: 11/04/2014 STATUS DATE: 05/09/2014 APPLIED: 05/09/2014 SITE ADDRESS: 1631 VERA DR,Springfield,OR 97477. SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703243103800 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Circuit alterations(3) OWNER: EMMETT JEFF&LEAH Phone Number: ADDRESS: 1631 VERA DR SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 L 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 NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK ATTENTION: Oregon law requires you to AUTHORIZED UNDER THIS PERMIT IS NOT follow rules enter. T oye rules Oregon Utilirt Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001- ANY 180 DAY PERIOD. 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). • -Springfield Building Permit 5/9/2014 1:46:28PM Page 1 of 1 t SPRINGFIELD CITY OF SPRINGFIELD kia _..R6..___rn 225 Fifth St ''CLL TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2014-01035 www.springfield-or.gov i 1631 VERA DR permitcenter@springfield-or.gov RECEIPT NO: 2014001020 RECORD NO: 811-SPR2014-01035 DATE:05/09/2014 [DESCRIPTION _ACCOUNT CODE/TRANS CODE.? -'. ' r ; AMOUNT DUE-__! 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 ,AMOUNT PAID)t..PAYMENT TYPE a'': PAYOR'-CASHIER:ccnavENTER COMMENTS ; � - __.�._.�,;; . _:I Credit Card EMMETT JEFF&LEAH _w... 93.60 220778 TOTAL PAID: 93.60 • • • • • • Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. • Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or • `1 I will be performing work on property I own, a residence that I reside in, or a residence that I will / reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • Fl= l2— N VI C- I • Print Name of Permit Applicant • (a, Signature of'ermitApplicant Date Permit it SIC(— /O 7C o Address: Q •` u%s'=• 1!1 Issued by: Date: S `C// y Is • This Copy for Permit Offices Electrical Permit Application DEPARTMENT USE ONLY SPRINGFIELD _ CITY OF SPRINGFIELD, OREGON Permit no.: SJ LI ' (Q�S 225 Fifth Street4S rin field,OR 97477•PR 541 726-37534FA%571 726-3689 ( �y ! P S 1 ) ( ) \oaedoM �� . . Date: 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 l Tota CATEGORY OF CONSTRUCTION Residential,per unit,service included: Residential ❑Government ❑Commercial • JOB SITE INFORMATION AND LOCATION 1,000 sq.ft.or less(4) $147.50 $ Each additional 500 sq.ft.or portion 1 Job site address: /63i ✓E2q czzit: thereof $ 27.50 $ City:Spen.YacaOLp State: Oct ZIP: g'7477 Limited energy(2) $ 35.00 $ Reference: Taxlot.: Each manufactured home or modular $ 69.00 $ DESCRIPTION OF WORK dwelling service or feeder(2) �UNbct Loom •Qb,a' xOA� Services or feeders:installation,alteration.relocation 7 r 200 amps or less(2) $ 89.00 $ PROPERTY OWNER 201 to 400 amps(2) S 104.50 $ Name: zsEFF cretme 4olto600 amps(2) $174.00 $ Address: LGSt Vert JbeLTvff 601 to 1,000 amps(2) $225.50 $ City:.jQFt_D State:02 ZIP:9741) Over 1,000 amps or volts(2) $516.00 $ Phone: Setto(+.gqo.'8505 Fax: - - Reconnect only(2) $ 69.00 $ E-mail:: ��l1T.e N'U44e e net' k .il .C OtM Temporary services or feeders:installation, alteration, relocation This insf�llation 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 479.56 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits:new alteration,extension per panel Business name: t/ 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 a limited-energy panel, $ 80.00 $ g g g p alteration,or extension(2) I — Each additional inspection:(I) $80.00 $ — DE MO EXSST3/J6 1-[Egle ft_ APPLICANT USE — Abb .4... PUT LET To e,xSSTSJJ(i (A) Enter subtotal of above fees $( `0Q (Minimum Permit Fee$80.00) D CS 2GVST (B)Enter 12%surcharge(.12 x[A]) $(Y6°i A aD is Cat HT TO ex 3.s117Jc. (C)Technology Fee(5%of[A]) $ ,y-J 440-2584-1(4/012013/COM) 3.. -. 'Ay TOTAL fees and surcharges(A through C): $g3‘„0