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Home My WebLink AboutPermit Electrical 2014-07-164999 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 Safely. 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. I ) '� _ � I Owne ontraclor Signature Date ATTENTION: Oregon law requires YOU to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952.001.0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1.800.332-2344). aE: PERMIT SHALL EXPIRE IF THE WORK H 10RIZED UNDER THIS PERMIT IS NOT I;i,4�NAENCED OR IS ABANDONED FOR v1,!Y 180 DAY PERIOD. Springfield Building Permit 7/16/2014 11:24:53AM Page 1 of 1 225 Fifth St LSPRIGFIELO CITY OF SPRINGFIELD Springfield,OR97477 Phone:541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01530 w Y.springfield-orgov permilcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 07116/2014 EXPIRES: 0111112015 STATUS DATE: 07/16/2014 APPLIED: 07116/2014 SITE ADDRESS: 4073 VIRGINIA AVE, Springfield, OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702314406500 TYPE OF STRUCTURE: Residential —PROJECT DESCRIPTION`Circuits-f or -shop OWNER: REED DONALD J & CHRISTAL V Phone Number: ADDRESS: 4073 VIRGINIA AVE SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4140 Underground Electric Underground Electric: Prior to cover 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 Safely. 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. I ) '� _ � I Owne ontraclor Signature Date ATTENTION: Oregon law requires YOU to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952.001.0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1.800.332-2344). aE: PERMIT SHALL EXPIRE IF THE WORK H 10RIZED UNDER THIS PERMIT IS NOT I;i,4�NAENCED OR IS ABANDONED FOR v1,!Y 180 DAY PERIOD. Springfield Building Permit 7/16/2014 11:24:53AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD - 225 Fifth Sl �J TRANSACTION RECEIPT Spnngfield,OR97477 --" OREGON 541-726-3753 811-SPR2014-01530 mvw.spdngheld-or.gov 4073 VIRGINIA AVE permits nter@spnngfield-or.gov RECEIPT NO: 2014001530 RECORD NO: 811-SPR2014.01530 DATE: 07/16/2014 DESCRIPTION ACCOUNT CODE(TRANS CODE AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00 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 7.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 9.84 Technoloqv fee (5% of permit total) 100-00000-425605 2099 4.10 Credit Card REED DONALD J & CHRISTAL V 316142 TOTAL PAID: DUE: 98.44 INT PAID 98.44 98.44 Property 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 flied with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor Name CCB# Expiration Date 1 will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will 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. T, P ttNameo�fPermitApplicant�}—� Sis�[u ofPermitA plicant Permit #: Address: Issued by: 0� Date: - Date ��YF.'T1f"a This Copy for Permit Offices Electrical Permit Application 225 Fifth Sheet eSpringrield, OR 97477oPH(541)726-3753eFAX(541)726-3689 DEPARTMENT USE ONLY Perm itno.: D 12 276 Date: 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 Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION [XResidential I ❑ Government I ❑ Commercial JOB SITE INFORMATION AND 'LOCATION Job site address: 03 S d - City:Pr State: i�-- � L1 r� _. _.ZIP:c"! 7 f79 Reference: Taxlot.: DESCRIPTION OF WORK<_ U QIC2C IZ-c.� v.1 �- 5 'PROPERTY OWNER Name: hmald ej Address: '10-73 Ul ]'t,6 city: 11/ state: ZIP: 77Y79 Phone: Fax: E-mail: This installation is being made on residential or fans property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479 540= 560(1). Signatur``e: NFRACTOR INSTALLATION., Business name: Address: City: State: ZIP: Phone: Fax: E-mail: CCB license no.: BCD license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: 440-2584-J (5n1 OWCOK FEE SCHEDULE Number of inspections per item O Qty, Cost ea. Total cost Residential, per unit, service included: 1,000 sq, ft or less (4) $151.00 $ Each additional 500 sq. ft. or portion thereof 28 00 $ $ Limited energy (2) $ 36.00 $ Each manufactured home or modular dwelling service or feeder (2) $ 71.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 $ 601 to 1,000 amps (2) $230.00 $ Over 1,000 amps or volts (2) $527.00 $ Reconnect only (2) $ 71.00 $ Temporary services or feed6rs: installation, alteration, relocation 200 amps or less (2) $ 71.00 $ 201 to 400 amps (2) $ 98.00 $ 401 to 600 amps (2) $142.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: nein, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit 1 1 $ 7.00 $ , b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 62.00 $ Each additional branch circuit $ 7.00 $ Miscellaneous, fees: service orjeeder not included Each pump or irrigation circle (2) $ 71.00 $ Each sign or outline lighting (2) $ 71.00 $ Signal circuit or a limited -energy panel, alteration, or extension (2) $ 82.00 $ Each additional inspection: (1) $82.00 $ APPLICANT, U.S E. (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (6% of [A]) $ (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): $ 9