HomeMy WebLinkAboutPermit Electrical 2014-5-22 .4t
GSPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
„c'•o ego:+-- : K Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01132
www.spdngfieldor.gov permitcenter@spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/22/2014 EXPIRES: 11/17/2014
STATUS DATE: 05/22/2014 APPLIED: 05/22/2014 -
SITE ADDRESS: 423 D ST,Springfield,OR 97477 . SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703352409600 TYPE OF STRUCTURE: Residential
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PROJECT DESCRIPTION: Service and 20 circuits '
OWNER: JENKINS HOUSE LLC Phone Number:
ADDRESS: 40063 LITTLE FALL CREEK RD
FALL CREEK OR 97438
CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor RS ELECTRIC LLC CCB 149509 11/02/2015 541-359-1192
INSPECTIONS REQUIRED
Inspections
4220 Electrical-Service
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
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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 nt oft,- •roperty, and the approved set of plans will remain on the site at all times during
construction.
-.2117,thee 2z /'f
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Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001- • THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 5/22/2014 12:34:18PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
z,p's ✓- 541-726-3753
:OREGON 811-SP R2014-01132
www.springfieldor.gov 423 D ST permilcenter @spnngfield-or.gov
RECEIPT NO: 2014001130 RECORD NO: 811-SPR2014-01132 DATE:05/22/2014
CODE/TRANS.CODEM-4-i FAMOUNT DUE
Branch circuits with service or feeder each circuit 224-00000-426102 1004 140.00
Services 200 amps or less 224-00000-426102 1004 91.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 27.72
Technology fee(5%of permit total) 100-00000425605 2099 11.55
• TOTAL DUE: 270.27
PAYMENtelifiE S,AYOR cnsifiR': aesox ..COMMENTS - .. .AMOUNT-RID _, .� •
Credit Card James Porter 270.27
160877
TOTAL PAID: 270.27
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Electrical Permit Application , . DEP.ARTmENT USE ONLY
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W A ¢ F2a:1 .+ --.4k<z-y.+-r�.. ,<-v e i:--5 , : ✓t i E
/ ITY,TOF SPRINGFIELD OREGLON
R Permit no.:� /KZ.-01 Lr -o
1132, I~ :it,� t , . . ,se . w ,- 9ryyr:8rs..µ ,( - ° � 4
225 Fifth Stree •Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 - -
Date: CA...ZI/
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.
° " LOCAL1„GOVERNMENTxAPPROVAGZ );:' , . P144Mss t a'FEE1kSCHEDULEl nv 4:111 ;:t7.7s
Zoning approval verified? ❑ Yes Number of ms ectwns erntem t ;Total
❑No . r, P P 4 O QtY -(Cost c`-:cost
Residential,J
~_CATEGORY`:OF;;CONSTRUCTION . ,. ` - ea
1,per unit,service included:
bill Residential ❑ Government ❑Commercial
1,000 sq. ft.or less(4) $147.50 $
-? JOB'SITE;INFORMATION AND=LOCATION <, , `�
Each additional 500 sq.ft.or portion
Job site address: 4l /I D thereof - $ 27.50 $ C3�
City: .5-y�( l State: O ZIP: Limited energy(2) $ 35.00 $ e"
Reference: ! 1 - Taxlot.: Each manufactured home or modular
.-;. dwelling service or feeder(2) ,
$ 69.00 $
.;:' t.;,415DESCRIPTION QF1 WORK;;], w F,SS, > :
. Services or feeders: installation,alteration, relocation _
v
l W r Fti 5 et..
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200 amps or less(2) $ 89.00 $
w
�G%s�^ >s;'t.-A'�3L� ?:P.ROP„ERT,Y�,OWNER .vrs ?_:;:u.4;�� 201 to 400 amps(2) $ 104.50 $
Name: l.I-c4n-. r/Lt GC �h c- - 401 to 600 amps(2) $174.00 $ t.Y
Yr Address: 7 - ( 601 to 1,000 amps(2) 1
( la/G P O $225.50 $ \?
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City: .J t.cv State:OgL ZIP:q 740/ Over 1,000 amps or volts(2) $516.00 $
ry
.us�7 --
Reconnect only(2) $ 69.00 $ (Y
Phone: 54 Fax:' -
0 C _y.. Il�� Temporary services or feeders: installation, alteration, relocation
E-mail:, -fir O caa'6
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
479.5400)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
."«a, ' MCONnTRACTORfJNSTALL'ATION g'^p "-txsw; Branch circuits:new alteration, extension per panel
Business name:t"-' � a Fee for branch circuits with purchase of a service or feeder fee:
Address: .2tc� �ce -5- . "' �/ Each branch circuit Zd $ 6.50 $
City: ,,6,6„.6- State: f e. 1 ZIP: p74/a y b.Fee for branch circuits without purchase of a service or feeder fee:
Phonerya -u7- Dace Fax: - - / First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.://fiscal BCD license no.:,,,,)or-L/SZ(� Miscellaneous fees:service or feeder not included
•Signing supervisor's license no.: A77Q S Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: ! i 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:(I) $80.00 $
`wM r..,.!s °1:4I-IT/APPLICANT>USE,, . ,' ," ,$.ls.. "`., -'x
(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): $ 2.?c t-!
440-2584-1(4/012013/C0M)
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