HomeMy WebLinkAboutPermit Electrical 2014-7-14 SPRINGFIELD 225 Fifth St
"` CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
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` OREGON Building I Residential Permit Inspection Phone: 541-726-3769
. Fax: 541-726-3676 r
PERMIT NO: 811-SPR2014-01514
AWN permitcenter @springfeld-or.gov
PROJECT STATUS: Issued ISSUED: 07/14/2014 EXPIRES: 01/09/2015
STATUS DATE: 07/14/2014 APPLIED:. 07/14/2014 .
SITE ADDRESS: 1070 S ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703261400900 TYPE OF STRUCTURE: Residential .
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PROJECT DESCRIPTION: Replace main panel,sub and conductors to sub at garage
OWNER: FEDERAL NATIONAL MORTGAGE ASSOCIATION _ Phone Number:
ADDRESS: 14221 DALLAS PKWY STE 1000
DALLAS TX 75254 •
OWNER: SANCHEZ ROBERTO OCHOA Phone Number: 541-
ADDRESS:
SPRINGFIELD OR .
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_ CONTRACTOR INFORMATION
Contractor Type Contractor Name • Lic Type Lic No Lic Exp Phone •
Electrical Contractor OWNER COB 000000 08/01/2025
' INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
4500 Rough Electrical Rough Electric: Prior to Cover
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. 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.
Rah Ochoq scrnrAez 7 //5' lo /4(
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'Owner or Contractor Signature Date
ATTENTION:Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Notification Center. Those ruh OAR 952 001- THIS PERMIT SHALL EXPIRE IF THE]WORK
0090.OAR 952-001-0010 obtain opie AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copses of the rules by
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR .
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
Center is 1-800-33 2.2344).
Springfield Building Permit • 7/14/2014 11:12:2BAM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield,OR97477
OREGON •
541-726-3753
811-SPR2014-01514
www.springfeldor.gov. 1070 S ST pennitcenter(ojspringtield-or.gov
RECEIPT NO: 2014001509 RECORD NO:811 SPR2014-01514 DATE:07/14/2014
kffaccutesm I+ , :L'1;._.s "ACCOUNTCODETRANSCODE ' _°'-`2E. '= C 1
_ ,a , DUE;z;l
Branch circuits with service or feeder each circuit 224-00000-426102 1004 7.00
Electrical Continuing Education fee 224-00000-425606 1032 2.50
Services 200 amps or less 224-00000-426102 1004 182.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22.68
Technology fee(5%of permit total) 100-00000-425605 2099 9.45
� TOTAL DUE: 223.63
.Mi AYMENMITYP - . PAY,OR ^swER oeoWLrser t.c5inEENTSETAMOIlfaMIDIteRtiFI
Cash ROBERTO OCHOA 223.63
TOTAL PAID: 223.63
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Electrical Permit Application DEPARTMENT USE ONLY
s Pt a� -�,. '.R ait " wffig:? r ermi no.:
225 Fifth Street*Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 . '- //
Date: 7 u
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 iris`pections per item () Qty. Cost' 'Total
!
;,CATEGORY OF CONSTRUCTION
Residet
n_ iat;per unit,service included:
residential I ❑ Government I ❑ Commercial
JOB;SITE. INFORMATION- AND;:LOCATION.: • 1,000 sq. ft. or less(4) $151.00 $
"' Each additional 500 sq.ft.or portion $ 28.00 $
Job site address: /c 70 S 571 thereof
City:9P(r 9 Fic/C> State:Q� ZIP:?PI �� Limited energy(2) $ 36.00 $
Reference: 76 3 (jry Taxlot CO 7C) Each` u ctured home or modular $ 71.00 $
�. _ 7 dwellinnser*ice or feeder(2)
II -_ - DESCRIPTION OF WORK�-:
r� - ,t/,� 2 /4- /mss Se ceders: instaRC 'on, alteration, relocation el
I(.., I L/r(iS(� A-�/N/us vv 200 amps o (2)—=''"�' , $ 91.00 $ )
C✓I✓LIK S PROPERTY ,OWNER —2000 amps(2) $106.00 $
Name: Ro to h ac{,p Z 401 to GOO.•amps(i) $178.00 $
60'1 to 1;(100 anips(2) $230.00 $
Address: �YTs DA%SY SYF CPC 42 - '
City47 5Pi;r05:cid I State: On ZIP: ?7Y 7s Over:1,900 a amps or volts(2) x_.._$527.00 $
Recd+nnect only(2) $ 71.00 I $
Phone: - - Fax - - I. t _ t..'
E-mail: !I' iipporary services or feeders: installation,1&7teration, relocation
200'amps or less(2) t."
This installation is being made on residential or farm property ¢— 7$ 71.00 $
owned by me or a member of my immediate family. This 201 to 400 amps(2) r_T$ 98.00 $
property is not intended for sale, exchange, lease, or rent. OAR
479.5400)and 479.560(1). 401 to 600 amps(2) ,$142.00 $
,Signature: PoLec k O c/100 Over 600 amps or 1,000 volts,Seg'services or.feeders section above
CONTRACTOR-;INSTALLATION ; Branch circuits:new alteration, extension per panel
Business name: rx,,,N,, 6%.11Y\_. a.Fee for c uits 'th purchase of a service or feeder fee:
Address: ach branch circuit .1-----H. 1 I $ 7.00 I $
City: State: ZIP: Eee-forbranch circuits without purchase of a service or feeder fee:
Phone: - - Fax: - - First branch circuit(2) $ 62.00 I $
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 $
Print name of signing supervisor: Each sign or outline lighting(2) $ 71.00 $
Signal circuit or a limited-energy panel, $ 82.00 $
Signature of signing supervisor: alteration, or extension(2)
I Each additional inspection:(I) I I $62.00 $
, APPLICANT°USE
(A) Enter subtotal of above fees $ I�Q /
(Minimum Permit Fee$82.00) ((// p
G
(B)Enter 12%surcharge(.12 x[A]) $ ZZ 68
(C)Technology Fee(5%of[A]) $ / if"
(D)Continuing Education Fee$2.50 $2.50 /
TOTAL fees and surcharges (A through D): $ �7 2.- b 3
G --
440-2584-i(5/2 12014/COM)