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Home My WebLink AboutPermit Electrical 2014-7-8 ''SPRINGFIELD • 225 Fifth St hit ulk CITY OF SPRINGFIELD Springfield,OR 97477 di La Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01467 www.springfield-or.gov permitcenter @spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 07/08/2014 EXPIRES: 01/03/2015 STATUS DATE: 07/08/2014 APPLIED: 07/08/2014 • . SITE ADDRESS: 490 24TH ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703361408200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Adding 4 circuits for garage • OWNER: RODRIGUEZ JOSE A 8 NORMA N Phone Number: ADDRESS: 490 24TH ST . SPRINGFIELD OR 97477 _ CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER GCB 000000 08/01/2025 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. /Sit. Owner or dr - ature Date ( ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth NOTICE: in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone . COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 7/8/2014 12:22:29PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD r TRANSACTION� IRECEIPT s<i Fifth St 225 F field,OR 97477 .; ‘-'4. 26-3753 OREGON www.springfield-or.gov 490 24TH ST pennitcenter @springfield-or.gav RECEIPT NO: 2014001472 RECORD NO:811-SPR2014-01467 DATE:07/08/2014 (DESCRIP_TION _ _ACCOUNT CODE/TRANS CODE • _s AMOUNT DUE Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 62.00 Branch circuits without service or feeder-each additional 224-00000-426102 1004 21.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.96 Technology fee (5%of permit total) 100-00000-425605 2099 4.15 TOTAL DUE: 99.61 PAYMENT TYPE' ' AMOUNT PAID -" PAYOR cnsRlERp�LnRSOR' , • COMMENTS - :.-. - - .. __. . .-.< ._ Check- - - - R A ODRIGUEZ JOSE B NORMAN -• - -- - - - - 99.61 - 539 TOTAL PAID: 99.61 • Property Owner Statement Regarding Construction •Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) • This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. • Please chec -the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. r • • will be performing work on property I own, a residence that I reside in, or a residence that I will I l reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction • Contractors Board. If I change my mind and hire a general contractor, I will select a contractor . who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • • 12. Ce- CQ---(4-Art5 Pn tiiCam of Permit Applicant al 77s (, q Sig ature ofljj•plicant Date . ir __ • Permit#: o F Address: Q -4 f`;• :r ah i, a Issued by: Date: - 859 • This Copy for Permit Offices • Electrical Permit Application spa H�FiE p DEPARTMENT USE ONLY = off ( $ ittal -E's',.- d matt,. " ,4 ; Permit no S (7v(LI— O l N 67 - 225 Fifth Street•Springfeld,OR 97477.PH(541)726-3753+FAX(541)726-3689 "" Date: 7/SA( 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.LOCAL:GOVERNMENT- APPROVAL - • •• ' FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No -.Number.of irispectmus per item () ; Qty. .Cost Total. CATEGORY OF CONSTRUCTION a, '. cost Residential,per unit,service included: ❑ Residential ❑Government ❑ Commercial 1,000 sq. ft. or Tess(4) 1 $151.00 $ JOB.SITE. INFORMATION'AND '.LOCATION q•v 'L r Each additional 500 sq.ft.or portion Job site address: Y`s thereof $ 28.00 $ City:S Yi A.) 0 H/1 State: 3 yr ZIP: G cl e-1 7t, Limited energy(2) $ 36.00 $ ' Refer Ace: Taxlot.: Each manufactured home or modular $ 71,00 $ - DESCRIPTION"OF'WORK`i -- dwelling service or feeder(2) Services or feeders: installation, alteration, relocation 200 amps or less(2) $ 91.00 $•.PROPERTYOWNER 201 to 400 amps(2) $106.00 $ Name: t l 9 SP ct ,v^� 401 to 600 amps(2) $178.00 $ Address: .444 - 2_6) g [,t 4 [i N/ lot 57 601 to 1,000 amps(2) $230.00 I $ City: q Got Qk State: err— ZIP:9 r)Ve, Over 1,000 amps or volts(2) $527.00 $ �/ O9 ,- ^ r Reconnect only(2) $ 71.00 $ Phone:5(1/V( 'fax: E-mail: 6 L.` ' ? "-\ O\ '+AG\\ :Ott-N.-Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 71.00 $ owned by me or a .s ember of my immediate family. This 201 to 400 amps(2) $ 98.00 $ property is no inter-141.d for sale, exchange, lease, or rent. OAR 479.540(1) ..d 479.5:0' 401 to 600 amps(2) $142.00 $ %r Signature: � Over 600 amps or 1,000 volts,see services or feeders section above .+ . : ::CO .. - a :INSTALLATIONS Branch circuits:new, alteration, extension per panel Business name: a.Fee for branch circuits with purchase of a service or feeder fee: Address: • Each branch circuit $ 7.00 $ City: - State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) LI $ 62.00 $ E-mail: Each additional branch circuit $ 7.00 $ CCB license no.: BCD license no: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle(2) $ 71.00 I $ Print name of signing supervisor: Each sign or outline lighting(2) $ 71.00 $ Signature signing supervisor:P alteration, or extension(2) Each additional inspection:(1) $82.00 $ APPLICANT USE . .. (A) Enter subtotal of above fees $ (Minimum Permit Fee$82.00) (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ (D)Continuing Education Fee$2.50 $2.50 TOTAL fees and surcharges(A through D): $ 77-LL 440-2584-1(5/212014/COM) •