HomeMy WebLinkAboutPermit Electrical 2014-7-9 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR 97477
t t: Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01430
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/09/2014 EXPIRES: 01/04/2015
STATUS DATE: 07/09/2014 APPLIED: 07/02/2014
SITE ADDRESS: 886 V ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703261201002 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Permit for failed(lost)minor label installation
OWNER: JONES AUDREY M Phone Number:
ADDRESS: 886 V ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor VIVINT INC GCB 173349 01/03/2015 877-479-1670
INSPECTIONS REQUIRED
Inspections
4550 Limited Energy
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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Springfield Building Permit 7/9/2014 11:43:00AM Page 1 of 1
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Electrical Permit Application orminemate DEPARTMENT USE ONLY
qE :SYGOkSP,R/N 4"WI J;ORE QNf i s - . Permit no,: L�7 �/t/50
_25 Fifth Street•Spr,ngfield,OR 9'472.PH(@411726-T53•FAX(S4l)716-]r.A9 ""
LDate: 7/Z//Y_
This permit is issued wider OAR 918-309-0000.Permits are nontransferable.Permits expire if work is not started within 180
1 days of issuance or if work is suspended for 160 days.
[1 ) _ ._ _ fns Total GOVERNMENT APPROVAL FEE SCHEDULE — F
Znnin apprnv I s rif eel. ❑ Yes ❑No_ f i Number of inspections per item O IQ'is-1 ea_t i_ costl
_ CATEGORY OF CONSTRUCTION__ 1 I__-"—"-- —`
1
Residential,per unit,service included: _ ___ A
�+ Residential 1 0 Government 10 Contmelcia) t i
I JOB SITE INFORMATION AND LOCATION "- _ 1,000 s`1_f5 or less(4) 5151.00 I S
■ --" --' Each additional 500 sq.ft.or portion
�.� f J{, 5 28.00 i f i
lob site address: � \ 1/ I the ref _ 1
C_ry_Sprtr 'S I.._ I State OR, ( ZIP:qq 4a. i Limile$energy(2) _ — I 5 36.00 i f
!! J
Reference j Taelor.: ( Each nnntfactued home or modular $ ry.o0 I S
--'- ION dwelling s.rvice or feeder(2)
l DESCRIPTION OF WORK I — ._. I -,
I (1.y«� f�[�8_T Services or feeders:inrta(lNinn,alteration. relocation j, •
(i�l { `—y -�'T�__"�_�—___
200 amps or less(2) I I 5 91.00 $
__
4,41C)4_71 PROPERTY OWNER % 201 to 40ft amps(2) 1 5106.00 S •
Name:
__:.��. - 401 to bo0 amps(2) ' sne__ I $
I —�-- - 601 to IOW amps(2) $230.00 S
Address: __—__..__ —. �E--.--.--
-ciryOyer 1,000 amps or volts(2) t $627.00 E
City: Slate: ZIP: ______._..__..._.___ I
Phone: - - I Fax: - - I [ Reconnect only(2) I I 5 71.00 I S 1 -
Temporary services or feeders:invaflanor alteration,re!acation I
E-mail:
200 amps or Icss(2) 1 I $ 71.00 s I
This installation is being made on residential or farm property
owned by me or a member of my immediate family.This 201 re 400 amps(2) I 5 99.00 I $
property is nut intended for sale, exchange, lease,or rent.OAR
j'479.540(I)and 479.560(1). 401 to 600 snips(2) 5142,00 I S
S igpaftrre' ' Over 00 amps or 1,000 volts,see services or feeders section above
CONTRACTOR INSTALLATION " - Branch circuits:new,alteration,e.renrron per pane!
Business name: V�( uq t r i- s�c.. I a.Fee for branch circuits with purchase of a service or feeder fee:
Address: Lir\3\ lit 116r 4a f I Each branch circuit f $ 7,0171 S
x.21 .X� _..,_
1 I (-611(01 City: Qroh.Fee for branch circuits without purchase of a service or feeds,fee:
yJO f State: (>, ZIP: _
IPhone: - I Fax'. - First branch circuit(2) I Y 62.00 I $
Each additional branch cirimit S 7.00 I $
—f I BCD license 00.' Miscellaneous fees:rervlce or feeder not included
CCB license nu.: �` —
4719 LEA Each pump or irrigation S 71.00 circle(2) t f
Signing supervisor's license no.:
Each
Prior rate of signing supervisor: J2S Siigttgn sign or outline lighting(2) I s 71.00 I $
I nl circuit or a limited-energy panel, $ 82,00 I $yet-
Sigtature of Signing supervisor: • 1 I alteration,or extension(2) _
I Each additional inspection:(!) 1, 582,00
. •:1.:a APPLICANT-USE , .. .
I(A) Enter subtotal of above fees $ (�
(Minimum Permit Fee$82.00) .2.„
(B)Enter 12%surcharge(12 x[Aj) S 9 34 —
(C)Technology Fee(5%of[A]) S fi✓
•(D)Continuing EAucation Fee S2.50 $2.50
TOTAL fees and sot-dui-gee ges(A through Lt f D): $'I
rch
440-25844(571/2014!C0M)