HomeMy WebLinkAboutPermit Electrical 2014-6-30 17
SPRINGFIELD 225 Fifth St
- `+ - CITY OF SPRINGFIELD Springfield,OR 97477
�d=...-.a ( Phone: 541-726-3753
• OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01082
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/30/2014 EXPIRES: 12/26/2014
STATUS DATE: 06/30/2014 ' APPLIED: 05/16/2014
SITE ADDRESS: 1390 M ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703253302100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: ELE-Bathroom addition-under existing roofed area,no root expansion
OWNER: TRUST AGREEMENT DATED JUNE 28, 2007 Phone Number:
ADDRESS: PO BOX 622
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp - Phone
OWNER CCB 000000 08/01/2025
' General Contractor NYE BUILDING CO LLC CCB 152683 10/18/2014 541-520-5257
LINSPECTIONS REQUIRED
Inspections
4500 Rough Electrical Rough Electric: Prior to Cover
4999 Final Electrical Final Electric: Wien all electrical work is complete.
4500 Rough Electrical Rough Electric: Prior to Cover
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
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requires you to
ATTENTION: Oregon law req on Utility
NOTICE: follow rules adopted by the Oregon
Notification Center. Those rules are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK h OAR 952.001-
0090. You may obtain copies o1 the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952.00 1 0010 throu
COMMENCED OR IS ABANDONED FOR calling the center. (Note:the telep
ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800 332 2344).
Springfield Building Permit 6/30/2014 9.55:54AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
.s• OREGON TRANSACTION RECEIPT Springfield,OR97477
541-725-3753
811-S P R2014-01082
www.springfield-or.gov 1390 M ST permitcenter @springfield-or.goy
RECEIPT NO: 2014001408 RECORD NO:811-SPR2014-01082 DATE:06/30/2014
DESCRIPTION_;- ..._._._,: - � _ _ , . . _ ACC.OUNTCODE/TRANS;CODE .AMOUNT DUE ..
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 TYPE _PAYOR CASHIER:ccARPERTER - _._COMMENTS " AMOUNT PAD •
--Select-- NYE BUILDING CO LLC 93.60
080537
TOTAL PAID: 93.60
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Electrical Permit Application 5PR1NOFIELD DEPARTMENT.USE ONLY ,
tits. t4z• s-? ;.awl, v ..,ir r J„4g?F' tfi'.n,titft Et+=i tr .1
:CFF, WOFySPRINGFIELD;(UREGON Permit no.: S/y— �D �L
eifix d""A.,-„-t.: zp ..,�.X;:tesroe,LW rZ,-srr.(r',4s?:x t,nr,i, "c *, .., e,
225 Fifth Street•Springfield,OR 97477.P11(541)726-3753•FAX(541)726-3689 �/
, Date: // ,/7 y
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.
.,;il iSL`'QCALLO0VERNMENT2'APPRO,VAL ='+;; tt '"slt+S x311 "FEE SCHEDULE::} _ 9 y <! r
°"' Mu 3 a Cast y Total
Zoning approval verified? ❑ Yesti s.--
❑No ��Number of ibspecGOns per+t m�Oy�-, Qty �<,ea = 4.r�c_ost,: �.
s„ 15:e CATEGORY;-OEtC.ONSTRUCTION ?”P, " i , " '' "' ' 4 '" ""'
'! Residential,per unit,service included: •
Residential , ❑Government ❑Commercial
1,000 sq.ft. or less(4) $147.50 $
:JOB;SITEANF.ORMATION; ANp°'LOCATION .; t, ;.'s
r �j v 1 Each additional 500 sq. ft.or portion
Job site address: (j13 rr (fU n� A 7 thereof - $ 27.50 $
City:5P ! 14.--i--11 4 J State: ZIP:77977 Limited energy(2) $ 35.00 $
Reference: t/ Taxlot.: Each manufactured home or modular
in„,"a't?SDESCRIPTION;OF{WORK.: A' -%?i " dwelling service or feeder(2) $ 69.00 $
1L) K1 I 0 ga Ft I F4 G1 t1-j-,/ Ev l(_'t' ailea Services or feeders: installation,alteration,relocation
N- .�a�-f(�fbw ( 7/ f T7 L IDU 200 amps or less(2) $ 89.00 $
7 1=t t'' .:',.,[IA44o1 =.I-PROPER�TiY OWNERf`";; _+ ", „ u V 201 to 400 amps(2) $ 104.50 $
Name: ,5 t' ' 1 CO /C 401 to 600 amps(2) _ $174.00 $ _
Address: / 601 to 1,000 amps(2) $225.50 $
City: S ;' Stat•0 • ZIP:•7V Over 1,000 amps or volts(2) $516.00 $
Phone: 50-7)..q.-1/1 Far - - Reconnect only(2) $ 69.00 $
E-mail: 5 C G(-Zl0 (9M a/( , C'C�01 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• y immediate family. This 201 to 400 amps(2) 5 96.00 $
property is not intended for s. e, • hange, lease, or rent. OAR
479.540(1)an. 4 9.560(1 / 401 to 600 amps(2) $138.50 $
Signature:, i'C JI / Over 600 amps or 1,000 volts,see services or feeders section above
' rk?.y"'? ,CON `..' r, :OR';INSTALLATION t,r, ;' }'O Branch circuits:new alteration,extension per panel
Business name , -(hc 1_n,-( a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Each-branchcircuit - $ 6.50 $
City: - State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - - First branch circuit(2) l $ 60.50 $
E-mail: • Each additional-branch circuit $ 6.50. $
CCB license no.: BCD license no.: Miscellaneous fees:service pr feeder not included
Signing supervisor's license no.: Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: 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:(1) $80.00 $
,t r,, < `c1,APPLICANT;UEra`.'�"'- - matity?t
(A) Enter subtotal of above fees 6p
(Minimum Permit Fee$80.00) $
(B)Enter 12%surcharge(.12 x[A]) $ 5 7-
• (C)Technology Fee(5%of[AD $ Ij
TOTAL fees and surcharges(A through C): $ q36....!%
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440-2584-J(4/012013/COM) •
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