HomeMy WebLinkAboutPermit Electrical 2014-7-8 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
: t + Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769 •
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01465 •
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/08/2014 EXPIRES: 01/03/2015
STATUS DATE: 07/08/2014 APPLIED: 07/08/2014
SITE ADDRESS: 620 LEVEL LN,Springfield;OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703341406700 TYPE OF STRUCTURE: Residential •
•
PROJECT DESCRIPTION: Service change
OWNER: MARTINEZ ELVA Phone Number:
ADDRESS: 620 LEVEL LN
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor WALTER J CANNON - GCB 76304 09/09/2015 541-747-0959
INSPECTIONS REQUIRED
Inspections
4210 Service Change
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 Date
•
ATTENTION: Oregon law requires you to NOTICE;
follow rules adopted by the Oregon Utility • THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT •
in OAR You may obtain through copis OAR 952es by COMMENCED OR IS ABANDONED FOR
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone ANY 180 DAY PERIOD. .
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•
Springfield Building Permit 7/8/2014 10:38:41AM Page 1 of 1
• SPRINGFIELD CITY OF SPRINGFIELD
.f La 225 Fifth St
ti TRANSACTION RECEIPT Sp ngfield,OR 97477
``' }.OREGON 541-726-3753
811-SPR2014-01465
www.springfieidor.gov 620 LEVEL LN permitcenter @springfieId-or gov
RECEIPT NO: 2014001468 RECORD NO:811-SPR2014-01465 DATE:07/08/2014
5L‘iN aaticl: _? :,:ic ;: ` .-ttaittIaTr7farAcco UNT CODEFFRANS_CODE 'ter ..f i,.AMOUNT DUE `t
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 21.84
Technology fee(5%of permit total) 100-00000-425605 2099 9.10
TOTAL DUE: 215.44
. pAyME1JTaTYPE PAYOR cti'sNiea 9uh=sm rrjMIIAENTsi°"' 1 '" R` AMOUNTiPAIO
Check Walter Cannon 215.44
26433
TOTAL PAID: 215.44
•
DEPARTMENT USE ONLY .
Electrical Permit Application =Pa,��F,E�o _..� � I
$" ?rte'7 ems- =1::5,,:$y '-- w%k7.::7 4e,? ' - ivics19::: .f>,: 3 fiVI r . 1 G TY OF SPRINGFIEE OREGOW ir
.a?e -::: ,,, ,TAP{2FfireAsn iviri4:::::8-fi?' }3_ x z pa 0 ;•
Permit no.: 5
2eri/ - 0 1 N 6
225 Fifth Street+Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689
. Date: 7/e// g
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.
�t ,.tLQCAL„GgVERNMEtsFr AFPf20vA[�_aM: Mic$0€ ,FEE SCHEDULE ,# 3
i 3i :Yh.Ct^s l 1 .Cloy{K�,, .Y t
Zoning approval verified? ❑ Yes No `-Number of(hspecbons.perttem( " c 1 Qty#xt east ', cost,.'"
f ;' rCATEGORYlOEACONSTRUCTIQN '1 fir �- n. : - '
Residential,per unit,service included:
Q Residential I ❑Government ❑Commercial
1,000 sq.ft.or less(4) $147.50 $
z? JOB S ITE_:IN F RMATION. AN D9.LOCATION';% t=k`
Lao 4 1 I 1 Each additional 500 sq. ft.or portion $ 27.50 $
Job site address: G (�N hereof
City: 25r/(k, State:OR. ZIP:97'i'n Limited energy(2) $ 35.00 $
Reference: Taxlot.: Each manufactured home or modular $ 69.00 $
.; dwelling service or feeder(2)
":v „ t ;DESCRIPTION OE4 WORK. am
" ,, (� _ ,�a'Q Services or feeders: installation,alteration, relocation
yv 1.M R e; C:_S�-( � �`� 200 amps or less(2) 2 $ 89.00 $
_' 't TROPE 2T�Y1 eYVNJJJ ERFA Ytt}.. ., i 201 to 400 amps(2) $ 104.50 $
Name: n Ups! 401 to 600 amps(2) $174.00 $
Address: DAla— 601 to 1,000 amps(2) 5225.50 $
City: I State: I ZIP: Over 1,000 amps or volts(2) $516.00 $
Phone(-52 s'7)J/ I Fax: - -
Reconnect only(2) $ 69.00 $
.1j
E-mail: 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 my immediate family.This 201 to 400 amps(2) $ 96.00 $
' property is not intended for sale, exchange, lease, or rent. OAR
479.540(1)and 479.560(1). 401 to 600 amps(2) 5138.50 $ .
Signature: - Over 600 amps or 1,000 volts,see services or feeders section above
? `3 , yu. _ ;'CONTRACTOR,,UNSTALLATION 4,.4.'< Branch circuits:new alteration, extension per panel
`--� a.Fee for branch circuits with purchase of a service or feeder fee:
Business name: ��� IC�AAd`� _ P
Address: 6, ' q(� Each branch circuit 1 I $ 6.50 $
City: (�q StateOR - ZIII)711 / Fee for branch circuits without purchase of a service or feeder fee:
Phone: -7' .j bl q Fax: - - o623 First branch circuit(2) $ 60.50 $
E-mail: Each additional branch circuit $ 6.50 $
CCB license no.2O -%o).4 BCD license no.: /111,3 09 Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: 3-2-2 9 -5..- Each pump or irrigation circle(2) $ 69.00 $
Print name of signing supervisor: l tU ,t 1 V d Each sign or outline lighting(2) $ 69.00 $
Signal circuit or a limited-energy panel,
Signature of signing supervisor: r7r V , ArNA lwtx alteration,or extension(2) $ 80.00 $
JV� Each additional inspection:(1) $80.00 $
a 'nt gi APPLICANTm USCalkl Ng
(A) Enter subtotal of above fees
' (Minimum Permit Fee$80.00) $17cq
(B)Enter 12%surcharge(.12 x[A]) - $ 2J.3j
(C)Technology Fee(5%of[A]) $ yr.9n
TOTAL fees and surcharges(A through C): .$ a�t.4
Z IC 83
440-2584-1(4/012013/C0M) .