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HomeMy WebLinkAboutPermit Electrical 2014-5-27 1 - \ SPRINGFIELD • 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 " OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01144 www.springfieldor.gay permitcenter @springfield-or.gav PROJECT STATUS: Issued ISSUED: 05/27/2014 EXPIRES: 11/22/2014 STATUS DATE: 05/27/2014 APPLIED: 05/27/2014 SITE ADDRESS: 6171 FERNHILL LOOP,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702343407600 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Circuit for hot tub OWNER: JOHNSON KELLY LEE Phone Number: ADDRESS: 1265 REGENCY DR EUGENE OR 97401 OWNER: JOHNSON LISA SUZANNE Phone Number: ADDRESS: 1265 REGENCY DR EUGENE OR 97401 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor WESTERN STATES ELECTRICAL CONSTRUCTION INC CCB 155472 05/15/2015 541-265-8067 L INSPECTIONS REQUIRED Inspections • 4500 Rough Electrical Rough Electric: Prior to Cover 4710 Pool Bonding 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 Lli per—71 Date ,)o ybr// (/ cfringexiti STS &r NOTICE: ATTENTION: Oregon law requires you to 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 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Springfield Building Permit 5/27/2014 10:46:56AM Center is 1-800-332-2344). Page e 1 of 1 ^ ° SPRINGFIELD CITY OF SPRING /6LD o5 Fifth m TRANSACTION RECEIPT o,uo@*m»nor4rr +&���sn� 541-726-37 811-GPR2014'01144 wwn.p,n"wm«-n«w' G171FERNH|LLLOOP v"nnmzmo*y,,noonom-owov RECEIPT NO: 2014001143 RECORD NO: 811'SpR2o14,01144 DATE:05/27/2014 ,� �� `' ` �.�p��1-,� `��. �� ~ ~- _^_ � � '� ^~"�-�� . ~ -` � , ' . Electrical Continuing Education fee 224-00000-15606 1032 2.50 • Electrical Inspection For Which No Fee is Specifically Indicated 224'00000426102 1075 82.00 State of Oregon Surcharge(12%of applicable fees) 821'00000'21500* 1009 9.84 Technology fee(5%of permit total) 100-00000-425605 2099 4.10 TOTAL DUE: 98.44 Credit Card WESTERN STATES ELECTRICAL 98.44 023120 CONSTRUCTION INC TOTAL PAID: 98.44 05/23/2014 09: 49 5412657652 WESTERN STATES ELECT PAGE 01 w #. Electrical•permit Application C['fY OF S['R[NC.FI1 [ 1l /'R SPRINGFIr� Ids riot S rivet*Springfield,OR 477*P1i(54])726-3753e FAX(Sd1)726 3689 oaaaoM This permit is issuer! under OAR 918-3(19- 'Date: : , (1000.Permits are nontransferable. permits expire if work is not started dugs of permit is u d unde is OAR 918-3 for ISO days, within 180 LOCAL GOVERNMENT APPROVAL' Zoning approval verified? �Nn PEE SCHEDULE CATEGORY O ❑Yes F CONSTRUCTION 111221511111 Number of fpEr unioh per item O Qty® Total Cost O Government Q Commercial JOB SITE INFORMATION AND LOCAT ON Job site address• ern Each additional R or ��t kl- portion ■®© City: ,�4 >fE!I/a thereof State; r ZIP:�h Reference: • 3 . S 35.00 all DESCRIPTION OF '�^'E Each manufactured home or modular � I+ WORK dwelling service or feeder(2) .$ 88.00 g r m . Services or feeders:installation,alteration,rclocnlion 200 amps or less(2) PROPERTY OWNER/1I! $ ee.o. s IMEIIIIII A. S 104.50 $ 401 to 600 amps 12) III Address: $17a.o. $ ��s� 601 to 1,000 amps(2) — . $225.60 $ ZIP: Over 1,000 amps or volts(2) . 5516.00 S . • Phone: - - Fax: F..-mail: - S 69.00 5 Temporary services or feeders:installation,allerarion, relocation This installation is being made on residential or fa property 200 amps or less(2t owned by me or a member of my immediate family.This mg $ 69.0. $ farm property is not intended for sale,exchange,lease,or rent.OAR 201 t°'100 amps(2) NI S 98.ao 479.540(1)and 479.560(1). 401 to 600 amps(2) - .$1J8.60 $' • Signature: Over 600 amps or 1,000 volts;sec services or feeders section above CONTRACTOR INSTALLATION I— /` I_ Branch circuits: neut aireranon.eslensiou per panel Business name: - /e c—elrno 5-f ,4-es EifCM GG( (,ST a.Fcc for branch circuits with purchase of a service or feeder lee: Address: I F iJ� 0 7 Poch branch circuit $ 6.60 $ City: N e ,jay-'- . State: 0 'Z ZIP:?73 6•s h.Fee for branch circuits without purchase of a service or feeder(be; PhoneSl : rs'ub'j Fax:5tfJ_J(if -•)(Q5 . First branch circuit(2) $ 0oso /r� E-mail: Each additional branch circuit w sic ac•� n..nft, --, 5 6.50 CCB license no.:ES S/-7 rf BCD license no.: Miscellaneous fees:senirc or feeder not included ..__-.._._ ,--.--. - Signing supervisors license no.: cif"15E5 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor:Tim 4/714—chen„ Each sign or outline/!gating(2) $ 88.00 allil Signature of signing supervisor: l'`��- �,r,,�� Signal circuil or n limited-energy panel, ® $ !; bn S P ei�, JrLf alteration,or cvtension(2) 1 1 �� Each additional inspection:(I) $9080 $ rf1�f`�rr APPLICANT USE ',fAl,'�• )) r-5_^„/ '1 (A) Enter subtntnl nl'nbovcfet �I► Sr'Z� ��'/i /LO I (Minimum Pcrmil Fee$80.00) �� Q Sri* Le �-CO (B)Enter 12%sureharge(.12 x(A.11 tf 7(q Tcchnnlugy Fee(5'%a of(Al) --- /� TOTAL fees and surcharges(A through C): f - /L��r jr aIn25s4-r(4101;2n1}/r.r7M) - G '� 05/23/14 FRI 10: 24 FAX 5417263689 CITY OF SPRINGFIELD U21001 rt* RX REPORT *** RECEPTION OK TX/RX NO 7291 CONNECTION TEL 5412657652 CONNECTION ID ST. TIME 05/23 10: 23 • USAGE T 00'44 PGS. 1 RESULT OK •