HomeMy WebLinkAboutPermit Electrical 2014-5-27 --r
SPRINGFIELD .
225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01109
www.springfield-or.gov permitcenter @spnngfield-or.gov
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PROJECT STATUS: Issued ISSUED: 05/27/2014 EXPIRES: 11/22/2014
STATUS DATE: 05/27/2014 . APPLIED: 05/20/2014
SITE ADDRESS: 1003 S 69TH ST,Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1802022307800 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: E-Finish basement,add bathroom
OWNER: DEMERS LOUIS R&JANET A Phone Number:
ADDRESS: 1003 S 69TH ST - .
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SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
. Plumbing Contractor MICHAEL ALAN BROWN CCB 164093 04/07/2015 541-536-7960
General Contractor LOWES WEATHERIZATION INC CCB 176741 06/19/2015 541-485-2282 •
Mechanical Contractor LOWES WEATHERIZATION INC CCB 176741 06/19/2015 541-485-2282
BC ELECTRIC CO CCB 66799 06/04/2016 541-998-3736
. _ 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.
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Owne-or Contractor Signature Dat
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ATTENTION: Oregon law requlce!VRI4; NOTICE:
follow rules adopted by the Oregon gip, THIS PERMIT SHALL EXPIRE IF THE WO'
Notification Center. Those rules are set tp
In OAR 952-001-0010 through OAR 95200 _ AUTHORIZED UNDER THIS PERMIT IE
0090. You may obtain copies of the rulespy COMMENCED OR IS ABANDONED r
calling the center. (Note: the tetepl cflg ANY 180 DAY PERIOD.
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Springfield Building er for the Oregon Utility Notif'icats yr�•
127/2014 9:37:12AM - Page 1 of 1
Center is 1-800-332-2344).
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SPRINGFIELD CITY OF SPRINGFIELD
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i TRANSACTION RECEIPT Spnngfield,OR97477
., 541-726-3753
oascor+ • 226 Fifth St
811-SPR2014-01109
www.springfieldor.goy 1003 S 69TH ST permitcenter @spnngfield-or_gov
RECEIPT NO: 2014001101 RECORD NO:811-SPR2014-01109 DATE:05/20/2014
DESCRIPTION 41 -: ,dIl 4 :::::S H.L `. ;.t,..._ACCOUNT CODEITRANS`CODE ' P:a{ H'AMOUNT DUE' d
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'EWE • P.AYOR_ casNtea ccaaaeNrea. COMMGU?cam •-°_ _`-" AMOUNTjP/CID
Check Bent.Nail Enterprises 93.60
2043
TOTAL PAID: 93.60
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Electrical Permit Application DEPARTMENT USE ONLY. H
SPNINGFlELD }. '.
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,^-.'.rfii`,".�+3�. ,4, ,..:>x� .,. ., ..rr '. •*`,4..�..w_2'-:2.e ,, ,-air s...3 x t�',, ell Permit no.:
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 `-
Date: 5/7d/ /
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.
„': :R ' LOCALaGOVERNMENT'APPROYAL - _"; :I? i'{, iFEE:`SCHEDULE :;3
Zoning approval verified? ❑Yes ❑No
N�,.umb-e. o f,,.i:.,._petio.ns z p..;e r item O, ., Qty Cos ,Total;
,.' CATEGORY;OE. CONSTRUCTION .. „
Residential,per unit,service included:
IWResidential ❑ Government ❑Commercial
!' JOB ;SITE..INFORMATIONHAND LOCATION' . 1,000 sq.fr.or less(4) $147.50 $
"O/b3 S- Each additional 500 sq.ft.or portion
Job site address: 6 7'�^ thereof $ 27.50 $
City:S�j /e(J State: 6) ZIP: 97/78 Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
'` DES/CRIPTION .OF WORK dwelling service or feeder(2)
1 //4�t'/71C� Services or feeders:installation, alteration,relocation
F,NUJ f� 200 amps or less(2) $ 89.00 $
.: ,f `;PROPERTY OWNER , 201 to 400 amps(2) $ 104.50 $
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Name: L6Uis# TN e/ AA,ens' 401 to 600 amps(2) - $174.00 $
Address: ,'O25 S ,041 Se 601 to 1,000 amps(2) $225.50 $
City:. '— / 1e/I State:Q� ZIP:f7!/ e Over 1,000 amps or volts(2) _ $516.00 $
Phone:: pc) 73g"/$77 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
,I° s' ;tJCONT,RACTORR1lNSTALLATION. Branch circuits:new alteration, extension per panel
Business name: BC , /`o//'�G a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 10,6165( .2/4 /� Each branch circuit 4 $ 6.50 $ '
City: Cies-( 7c State: *eV ZIP:929/9 b.Fee for branch circuits without purchase of a service or feeder fee:
Phone:,5V, 15:3--2111, Fax: - - First branch circuit(2) I $ 60.50 $
_ E-mail Each additional branch circuit $ 6.50 $
CCB license no.: a7,9 BCD license no.: Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: tie, 2. 5 Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: f1toi2.✓Z Each sign or outline lighting(2) $ 69.00 $
Signature of signing superviso • Signal circuit or alimited-energy panel,
o �- p alteration,or extension(2) $ 80.00 $
Each additional inspection:(1) $80.00 $
.M Q.1,APPLICANT>USE - „
(A) Enter subtotal of above fees '� et>
(Minimum Permit Fee$80.00) - $ -Oa`�
(B)Enter 12%surcharge(.12 x[A)) $ /C'U
(C)Technology Fee(5%of[A)) $branch■ ci fees and surcharges(A through C): $ 9-7 GO
440-2584 4(4/01/2013/COM)