HomeMy WebLinkAboutPermit Electrical 2014-5-16 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
x:, I-var Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01081
www.springfield-ar.gov permitcenter @spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/16/2014 EXPIRES: 11/11/2014 .
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STATUS DATE: 05/16/2014 APPLIED: 05/16/2014
SITE ADDRESS: 973 S ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703261308600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Two circuits for Addition-office room
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OWNER: CURRAN LIVING TRUST Phone Number
ADDRESS: 973 S ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2015 541-741-1499
General Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396
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 oft 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
follow rules adopted by the Oregon Utility •
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001- �O t(OE. RIK
0090. You may obtain copies of the rules by ;
calling the center. (Note: the telephone SHA��EXPIRE if THE W NO
number for the Oregon Utility Notification AUTHORIZED UNDER THIS PERMIT iS NOT
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR
THIS PERMIT
ANY 180 DAY PERIOD.
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Springfield Building Permit 5/16/2014 6:50:37AM Page 1 of 1
SPRINGFIELD-- CITY OF SPRINGFIELD
225 Fifth St
( ,� TRANSACTION RECEIPT Spnngfeld,OR97477
^'�f 541-726-3753
.".4.O
.OREGON
www.springfield-ocgov 973 S ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2014001076 RECORD NO: 811-SPR2014-01081 DATE:05/16/2014
DESCRIPTION --a"' __ :a ;3ACCOUNTCODE/TRANSCODEM12 ._ `'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
pmPAYMENS;TWEE P.AY.ORrrcaSH�`�'i�rtrc-AIFT ER 4 COMMENTS 4MOUNTIPAIq.'"
Credit Card EASTSIDE ELECTRIC INC 93.60
08383g
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY `
SPNINGFIELD Pik,
rAa s 3 .ScC'_"-z:.tx ----- ti :zr s- :.tJ'W u4,t a y b '' / /
IT�Y*OF SPRIsiGE1!�;LD, GREG'6N ` Pc Jury ! a
z Mt5ir# sS:-°:ar ,xrl.Aze,-s*+4'.: ,j�.-,,.. �1.N,fv b¶4 Permit no.:
225 Fifth Street•Spnngtield,OR 97477•PH(541)726-37535 FAX(541)726-3689 ��`
Date: s-- /(/
./Jy
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.
x ;1:LOCAL,GOVERNMENT-APPROVAL ^.`,- ?' „ . ? r, ,, ':FEE;•SCHEDULE , . '- W`
Zoning approval verified? ❑ Yes ❑No
:Nmb of in setions pe item() Qty i Cea os t "Tcootsa
»,CATEGORYrOF ,,CONSTRUCTION . , .. l.
Residential,per unit,service included:
aResidential ❑Government ❑ Commercial
JOB;SITE INFORMATION:=AND 'L'OCATION '' 1,000 sq.fr.or less(4) $147.50 $
Each ad
Job site address: o73 S ST, thereof ditional 500 sq.ft.or portion -n $ 27.50 $
City: SP CCC D State:o R ZIP:9.)477 Limited energy(2) $ 35.00 $
Reference: /70 ' 2-o)(-J Taxlot.: gep 0-6 Each manufactured home or modular $ 69.00 $
'iDESCRIPTION":OF WORK; _ dwelling service or feeder(2)
'u i 2 F t 001 T ION Services or feeders: installation, alteration,relocation
200 amps or less(2) $ 89.00 $
A:: ,PROP.ERTY;OWNER `. 201 to 400 amps(2) $ 104.50 $
Name: (44it.'L�../ 401 to 600 amps(2) $174.00 $
Address4f73 s 1-)/1"— 601 to 1,000 amps(2) $225.50 $
City: State: ZIP: Over 1,000 amps or volts(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 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
, ',g, .
' C CONTRACTOR'1NSTALLATION. „? "j Branch circuits:new, alteration, extension per panel
Business name: G t.STS ho E C L F(T(?IC a Fee for branch circuits with purchase of a service or feeder fee:
Address: 3 V..S'.3 g OSC/1 G 6 C/o.,E Each branch circuit $ 6.50 $
City: S Q F CO State: O 2 ZIP::/9 7 Y 7Y b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: -9 IS 9 o a$ Fax: T - } dl 60 First branch circuit(2) 3 $ 60.50 $60.SC
E-mail: Re I( 1961 t , Y I\H 4 0 .C O M - Each additional branch circuit I $ 6.50 $ 6,SO
CCB license no.: 1 17 7-)0 BCD license no 0 ^V 0 r C Miscellaneous fees:service or feeder not included
. Signing supervisor's license no.: 4 7 27 s Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: Re G E R K) /.,6 Each sign or outline lighting(2) $ 69.00 $
1241 /11
"IJ � lteration,or extension(2)Signal circuit or a limited-energy panel,
Signature of signing supervisor: $ 80.00 $
" "ri
l Each additional inspection:(1) $80.00 $
i s ,tARPLICANT„USE 1-
(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): $
440-2584-)(4/012013/C0M)