HomeMy WebLinkAboutPermit Electrical 2014-6-20 •
o.
. t SPRINGFIELD • 225 Fifth St
' ' — CITY OF SPRINGFIELD Springfield,OR 97477
_,.<( L Phone: 541-726-3753
°"E�°" Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01341
www.springfield-or.gov permitcenter@springfield-or.gov 9
PROJECT STATUS: Issued ISSUED: 06/20/2014 EXPIRES: 12/16/2014
STATUS DATE: 06/20/2014 APPLIED: 06/20/2014 .
SITE ADDRESS: 716 F ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703351211100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 200A service and 2 Branch Ckts
OWNER: WATTS MERL JR Phone Number:
ADDRESS: 716 F ST
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION
• Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor BOB FISHER ELECTRIC INC COB 96275 01/25/2016 541-689-7973
INSPECTIONS REQUIRED
•
Inspections
4225 Service or Feeder
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.
Owner or Contractor Signature Date
ATTENTION: Ore gd bow a Orlegon Utility WURIC
follow rules ado NOTICE: IT SNA&I-EXPIRE IF THE
Notification Center. Those wh OAR 952f001h THIS PERM UNDER THIS PER, IS NOT
in OAR 952-001-0010 throug AUTHORIZED
obtain copies of the rules by ENCED DR IS ABANDONED FO
0090. You may Note: the telephone COMM .
calling the center. ion Utility Notification ANl/ j 80 DAy pERIDD
number for the Oregon
Center is 1-800-332-23441.
Springfield Building Permit 6/20/2014 2:59:50PM Page 1 of 1
SPRINGFIELD --- CITY OF SPRINGFIELD
.1 .aa_ -- 225 Fifth St
c TRANSACTION RECEIPT S pringfie1QOR 97477
OREGON 541-726-3753
811-SPR2014-01341
www.springfield-or.gov 716 F ST permitcenter @springfield-ar.gov
RECEIPT NO: 2014001353 RECORD NO:811-SPR2014-01341 DATE:06/20/2014
(DESCRIPTION ACCOUNT.CODE/TRANS CODE : AMOUNT DUE
Branch circuits with service or feeder each circuit 224-00000-426102 1004 14.00
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 12.60
Technology fee(5%of permit total) 100-00000-425605 2099 5.25
TOTAL DUE: 125.35
PAYMENT TYPE,, _: PAYOR _CASHIER:CCARPENTER _ . _COMMENTS _ . AMOUNT PAID .
Cash BOB FISHER ELECTRIC INC 125.35
TOTAL PAID: 125.35
•
Electrical Permit Application SPfliNOFiELO :DEPARTMENT USE ONLY
,4-3,fr)=4tRau:mtlifasurristfutaq.P.Att:aterariatornoopab:wititostylett::iortio
IsEITYTORSPRINGEIELMOREGOIS112,vi , a-t,---',,t'41'Fi
awf.i 'laSki:if.Y.:aalfSttli44Thii'SatfailitrrthalS4..,S7,1v<S1 54-. 7'.47fS 411 Permit no.: 5 i q -/ 9 V/
225 Fifth Street•Springfield,OR 97477oPt1(541)726-3753.FAX(541)726-3689 .1/4'
Date: 472.4//I/
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.
Zoning approval verified? El Yes E No ir
'5.4-'1•P . : cb , k‘ 66 ,'-`
,ENUmber.of inspections per itett r a 6I:, :p ,, 6, T1
,.., - -
:: :CATEGORY OF CONSTRUCTION:.t;l'iti.K.:':;v:;.,-
6(
El
Residential Government El Commercial Residential,per unit,service included:
1,000 sq. ft. or less(4) • $151.00 $
Each additional 500 sq. ft.or portion
Job site address: --77 f f 54- thereof $ 28.00 $
City:s p A, „i e_--,_, ,cc. State: Ow_ ZIP: , Limited energy(2) , $ 36.00 $
Reference: / 20 5 -3 5-/ 2_ Taxlot.: /7/dc) Each manufactured home or modular
$ 71.00 $
; ... -7
;;1;.. i::‘.J1:*. -.41‘i :1:i'iDESCRIPTION Or-WORK",.01r--:: t.." dwelling service or feeder(2)
Services or feeders: installation, alteration, relocation
nit 51-A tk .7--60 A - .2- 13c-- r-P-L 200 amps or less(2) it $ 91.00 $, 1
201 to 400 amps(2) $106.00 $
PROPERTY,OWNER .,"3'ffra'7.:71':::?..:.Mk:
Name: LO
401 to 600 amps(2) $178.00 $
Address: -4err _7/6 r 5 _
601 to 1,000 amps(2) $230.00 $
City: 5 p p T.-_-„zu State: 0. ZIP: Over 1,000 amps or volts(2) $527.00 $
Phone: - -
In 7 Fax: - - Reconnect only(2) . $ 71.00 $
E-mail: Temporary services or feeders: installation, alteration, relocation
This installation is being made on residential or farm property 200 amps or less(2) 1 $ 71.00 $
owned by me or a member of my immediate family. This 201 to 400 amps(2)
I $ 98.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 401 to 600 amps(2) $142.00 $
1
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
'' 't f';:CONTRAtTOR:INSTALLATIONI:)?;,;,LW•:.:A.;.:Vii Branch circuits:new, alteration, extension per panel
Business name: to h ricc,„.., ...-2,0„..f-A..,e• a.Fee for branch circuits with purchase of a service or feeder fee:
Address: /9c) fslc n,'5 It'v„--,1 fi Ict...." Each branch circuit 2__ $ 7.00 $ / C/
City: 47; ori(stet__ . State: as-p.- I ZIP: b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 62.00 $
E-mail: Each additional branch circuit $ 7.00 $
CCB license no.: 9 , 2_75 BCD license no.:pc--55-z-0- Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 37755 Each pump or irrigation circle(2) $ 71.00 $
Each sign or outline lighting(2) $ 71.00 $
Print name of signing supervisor: 4 b,,,,_t- (Z c,___
Signal circuit or a limited-energy panel, $ 82.00 $
Signature of signing supervisor: ,girday- 4, ...e...,..t alteration, or extension(2)
Each additional inspection:(I) $82.00 $
ciVirt.Ii.. ./A0I5LICAfsit ji§titilkfMnR.:ngg
(A) Enter subtotal of above fees
(Minimum Permit Fee$82.00) $
(B)Enter 12%surcharge(.12 x[A]) $ /
(C)Technology Technology Fee(5%of[A]) $ 5 2-5-
(D)Continuing Education Fee$2.50 $2.50
--"C
TOTAL fees and surcharges(A through D): $ (2U
440-2584-J(5/2112014/COM) -,