HomeMy WebLinkAboutPermit Electrical 2014-7-9 SPRINGFIELD 225 Fifth St
ht.7- CITY OF SPRINGFIELD Springfield,OR97477
�t ; Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
r Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01424
www springfield-orgov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07109/2014 EXPIRES: 01/04/2015
STATUS DATE: 07/09/2014 APPLIED: 07/01/2014
SITE ADDRESS: 463 S 38TH ST, Springfield,OR 97478 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702314401620 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Remove and replace panel
OWNER: DORMAN STEVE&MAUREEN Phone Number:
ADDRESS: 383 BANTON AVE .
EUGENE OR 97404
CONTRACTOR INFORMATION
II
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor JB ELECTRIC INC CCB 104929 03/14/2016 541-687-5770
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 ,J,,. Q�"y_"� Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE: x°:}
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
In OAR 952-001-0010 through OAR 952-001• UTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone `!M!MENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification 'Y 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 7/9/2014 9:15:52AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELI)
oo Fifth*
TRANSACTION RECEIPT op"�nmu.unor4rr
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811^SPR2014'01424
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RECEIPT NO: 2014001479 RECORD NO: 811'SpH201*'01424 DATE:
,DESCRIPTION :-' -----_-_ _-` -` -` "� ` �_ ACCOUNT C�}DE/TFANS CODE- _ _ ^, AMOUNT DUE
Electrical Continuing Education fee 224'00000'425600 1032 2.50
Services 200 amps or less 224'00000'426102 1004 91.00
State of Oregon Surcharge (12% of applicable fees) 021'00000'215004 1099 10.92
Technology fee (5%of permit total) 100'00000'425605 2099 4.55
.- . ---- -- - ----- - ------------- --.- ''- -------- --' '— ' - - ----
TOTAL DUE: 108.97
`
' PAID � �
PAYMENT/TYPE 1 ��'�P/Y�}RCA�Ig����R�>��. . , ~ : COMMENTS� . " �---' � - -/-�,/ ����� . � � , � ��
Cr�i�Ca"d'---- JD ELECTRIC~^--~-~------ ~-^--~-^^-^^ -- - '- --' '---- 108.97- - -
887752
TOTAL PAID: 108.97
.
07/01/2014 08:23 5413028296 JBELECTRIC PAGE 01/01
. .rieciricai Permit Application DEPARtiwA..
• NTusE ONLY.-
• ,. ..„,,, _,_ , ..„ .., ,,,,...■,, ,;,4p,,,,,,;t-icii '','":10:'''s ':: .R.I'llAi. A&
i',:CITIN(7,01?,SPRING.FIFLIYIOREC-ON±n,:i: '. ari. it , 0004
.!fiws ,, ••:•,..2 tho.%,;;•i *-::.•,;;),"- ,-..r,;,i,k'. ., ,M7.4:4,;---..,,:,,,A.14,,,,ix:0,*;Z:‘,4, ,z4i ;:'" 45,44,,„,,,,J 4,,,,._ .9,,,,c; . Permit no.:, fitzen"-t — a 419
tra‘0:4- FAIW —
225 Fifth Street*Springfield,OR 97477 ging541)726-3763.FAX(541)726-368.
Dam:
This permit is issued under OAR 918-309-0000.Permits are no transferable.Permits expire If work is not started within 180
days of Issuance or if work is suspended for 1S0 days.
vi:c.e,tiiggc. -A: 'vo'ay. VINO"Tit--1/411,P.00.4:21).,InKi il',E,. 1,‘P. 3.17rialaingEfink4
Zoning approval verified? n Yes 0 No 74e$rgii WSW n2cW071/5“6":99 ... ,111VI TrT -'7 • 'i
tii° 41;1 4751:;;:. faat §-419.47.\ 1
ii ‘,..; , cc , , . stf, r .4g.e.. ifita •a:Kb
ORMITIMAL '..C)7 '1'6'2'at: 1"P:g.TR"0.0 '' NaiLibld - — - ' 6 `
Residential,per unit,service included:
PIMN11.1 D Government El Commercial
1,000 sq.ft.or less(4) $147.50 $
19.4F: 0.:lialfarlaWAMEMP t:K4 Cii tr oNtigral -
Job site address: ler 3 3 ?
Each additional 500 sq.ft.or portion
i -
e S r thereof - $ 27.50 $
City: 9p . State: criC--- ZIP: Limited energy(2) $ 35.00 $
1222ealliallill Taxlot: Each manufactured home or modular
.MarelIge 1$• Eirelt itiMMINEDISM dwelling SCTV[Ce. or feeder(2) $ 69.00 $
Services or feeders: installation,alteration,relocation
; —
1 200 amps or less(2) . • / $ 68.00 $
.„‘
FaTititrgEtWEEMTWASM iliMiMPEEN 201 to 400 amps(2) . $ 104.50 $
Name: • Tre/r./9„--' rniriPtcm^ 401 to 600 amps(2) $174.00 $
• . Address: Te; 73„,--/-&„ ,4-c 601 to 1,000 amps(2) $225.50 $
City: 7-„,go.f r j State: ofC I ZIP: Over 1,000 amps or volts(2) $516.00 $
Phone: - v- I Fax: - - Reconnect only(2) $ 69.00 $
E-mail: Temporary services or feeders:installation, alteration relocation
$ 69.00 $2
amps or less(2)This installation is being made on residential or Latin property 200 amp
owned by me or a member of my immediate family. This ' 201 to 400 amps(2) $ 95.00 $
property is not intended for sale, exchange, lease, or rent. OAR _
479.540(1)and 479.560(1). 401 to 600 amps(2) $138.50 $
Signature: Over 600 amps or 1,000 volts,see services or feeders section above
411 klarritio.e '4,1. ç010„le •:ainittP:12 0 !i.v..„1"::.o.l4iLdkJ Branch circuits: IIP.W, alteration extension per panel
13usiness name: , Mr-NIM 4,-Z.,; _ a.Fee for branch circuits with purchase of a service or feeder fee:
Address: , es___ ■ ..... .."----- Each branch circuit ' 1 1 $ 5.501 S
City: %e„5„,„4,,e State: ,: ; ZIP:T2gf b.Fee for branch circuits without purchase of a service or feeder fec:
PhoneS,71/47' c-71,0 Fax:52/7---,w. 40'4 First branch circuit(2) $ 60,50 I $
E-mail: _ . ..- 1714;(11 0 f ■ /
Each additional branch circuit $ 6.50 $
„ „ .9, op ' 4, .
CCB license no.: ,454/92/ BCD license no,:_ .,..rsi Miscellanea OS fees:service or feeder not included
Signing supervisor's license no.: 3g72..5 Each pump or irrigation circle(2) $ 69.00 $
Each sign or outline lighting(2) $ 69.00 $•Print name of signing supervisor: ,....-r 0... 4
Signal circuit or a limited-energy panel, $ so so $
Signature of signing sup. '-i. ,
, alteration,or extension(2)
I .
Each additional inspection:(1) $60,00 $
,tii:AM ViEtallaiMMIAMETAEREP
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80-00)
(13)Enter 12%surcharge(.12 x[A]) • $
(C)Technology Fee(5%of[A]) $
_TOTAL fees and surcharges (A through C):
440-25844(4/0 1/20I3/COM)