HomeMy WebLinkAboutPermit Electrical 2014-5-30 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
MI5, Lao Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01174
www.springfield-or.gov - permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/30/2014 EXPIRES: 11/25/2014
STATUS DATE: 05/30/2014 APPLIED: 05/30/2014
SITE ADDRESS: 2571 G ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703361116100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace meter base and service mast
OWNER: PETERSON JODI Phone Number:
ADDRESS: 1195 JANUS ST •
SPRINGFIELD OR 97477
• CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor TRITON ELECTRIC INC CCB 164857 05/25/2015 541-484-9800
INSPECTIONS REQUIRED II
Inspections •
4220 Electrical-Service •
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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Springfield Building Permit 5/30/2014 9:57:19AM • Page 1 of 1
SPRINGFIELD'--- CITY OF SPRINGFIELD
~t - 225 Fifth St
`o OREGON TRANSACTION RECEIPT Spnngfield.OR 97477
541-726-3753
811-SPR2014-01174
www.spnngfieldor.gov 2571 G ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2014001179 RECORD NO: 811-SPR2014.01174 DATE:05/30/2014
)ol 'n 7ao tl CODEITRANS,CODE. .:9 iln:`'`AMOUNT'DUE L�Ht
Electrical Continuing Education fee 224-00000-425606 1032 2.50
Services 200 amps or less 224-00000-426102 1004 91.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.92
Technology fee(5%of permit total) 100-00000-425605 2099 4.55
TOTAL DUE: 108.97
IttlatIVIENT*TYPENWPAY0kMrsagage, 14VCrl.:,"..`£COMMENTS - - AMOUNTiFAIDI$ '�r +�
Credit Card berry lister 108.97
055628
TOTAL PAID: 108.97
Electrical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
'tell TATI: OF SPi2INC;Efk,Ll),`(312EGC►N Permit no.: S*fl "I7__�_l_._
225 Fifth Strret•Springl1tld.Oft 97477♦Pli(541)726.3753•FAX(54l)7263689 S oasaoW _S/719 i
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 ISO days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑Yes ❑No Number of inspections per Rem() Qty. Cost Total
_ ea, cost
CATEGORY OF CONSTRUCTION -'Residential,per unit,service(imitated:
LEt Residential ❑Government ❑Commercial
1,000 sq. O.or less(4) $447.60 $
JOB SITE INFORMATION AND LOCATION
-- '- - Sash additional 500 sq.11.or portion
Job site address:_ 35'1\ Gt_ g.ryp_� thereof $ 27.60 $
City: S?H+sl4frtrs3-s� __I State: oq._ ZIP; el fl Limited energy(2) $ 35.0D $
Reference: 6.311 1 TaxlaL: /6,0 0 Each manufactured home or modular- $ 69.00 $
7DESCRIPTION OF WORK dwelling service or feeder(2)
Services or feeders:installation,alteration,relocation 9�
2. .PL ca_ Vs'�R274.h- a ar- da./S 200 amps or less(2)------ L_$ 8 s
q
wtcs. Q E PR OWNER 2oIm4(R)amps(2) $
Name:. AL- RsTraa-0es.F _- - 401 to 600 amps(2) $174.00
Address: 11 95 sus c+ts SR2rGr" 6131 to 1,000 amps(2) $225.50 $
s>ey ��0 l Slate: ®p_ ZIP: Grail ` Over 1,00 amps or volts(2) $516.00 $
City:
Phone: - - I 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) $ 6900 $
owned by me or a member of my immediate family. This 201 to 400 amps(2) ; 66.00 $
property is not intended for sale,exchange, lease,or rent. OAR '
479.540(1)and 479.560(1). 401 to 600 amps(2) Y $138.50 S
Signature: Over 600 amps or 1,000 volts,see services or feeders section above 1.
CONTRACTOR INSTALLATION Branch circuits: new, alteration,extension per panel
Business name: TOGrA G ,rte .L Lr a.Pce for branch.circuits with purchase of a service or Feeder lee:
Address: 2-8,2'1 I _ . _• _ e4 #- ' It".OR-, Each branch'.circuit 7 I $ 6.60 $ __
City: ti Stale: o9.- ZIP: oZ b.Fee for branch circuits without purchase of a service or feeder fee:
. 1_ mod ---
Pbone:_4j--AS:- en oo Fax: s*-4b4--c' 541 First branch circuit(2) $ 60.60 $ -
E-mail:-4 :v}o n uses, c c P ow r .c a.%jr Yyck_ Each additional brunch circuit $ 6.50 $
CC$ license no.: lash S7 BCD license no.:2,.._ St-3t- Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: ,q-i-2 L s Each pump or irrigation circle(2) $ 69.00 5
Print name of signing supervisor: Sc. -r La,s TS.R- Each Sign or outline lighting(2) -S 69.00 $
Signal circuit or a limited-coca panel,
t
Signature of signing supervisor. , BY Pa $ 80.00 $
g g B P y=T' alteration,or extension(2)
t 1 Each additional inspection:(I) $80.00 $
III APPLICANT USE
MAY t3'LO II (A) Enter subtotal of abovefees $ //
(Minimum Permit Fee$80.00) . / q
t (B)Enter 12%surcharge(.12 x[A]) - $ I /Q/Z
By C'LC 7 S, (C)Technology Fee(5%of[A)) $ _ ((Sr
, '440.-3584-J(4/01/2013/COM) r'�-- TOTAL fees and surcharges(A through C); era i
%d. 97
T00/T00l XYB 0Z :OT 6T07./9T/90
05/23/14 FRI 09: 22 FAX 5417263689 CITY OF SPRINGFIELD Z001
**********.**.******.***
*** RX REPORT ***
*********************
RECEPTION OK
TX/RX NO 7290
CONNECTION TEL
CONNECTION ID
ST. TIME - 05/23 09: �
USAGE T / e'---
PGS. 1
RESULT OK