HomeMy WebLinkAboutPermit Electrical 2014-07-28SPRINGFINv�
225 Fifth St
CITY OF SPRINGFIELD Spring0eld,OR 97477
Phone: 541-726-3753
-- OREGON Building if Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01608
wmvsprin9fietd-or.gov permitcenter@spdngrield-oc9ov
PROJECT STATUS: Issued ISSUED: 07/28/2014 EXPIRES: 01/23/2015
STATUS DATE: 07/28/2014 APPLIED: 07/28/2014
SITE ADDRESS: 2490 SHADYLANE DR, Springfield, OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703224407900
PROJECT DESCRIPTION: Two branch cin
OWNER: BECKER BRANCH CHRISTIAN
ADDRESS: 2490 SHADYLANE DR
SPRINGFIELD OR 97477
OWNER: RUARK SHAUNA D
ADDRESS: 2490 SHADYLANE DR
TYPE OF STRUCTURE: Residential
Phone Number:
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lie No Lic Exp Phone
Electrical Contractor JK GUCKENBERGER ELECTRIC INC CCB 45129 04/24/2016 541-74BA656
INSPECTIONS REQUIRED
Inspections
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 per . sion of the Community Services Division, Building Safety. I further
certify that only contractors and employees who����fte'tn Lrompliance with ORS 701.005 will be used on this project. i further agree
to ensure that all required inspections ar r d teclat the proper time, that each address is readable from the street, that the
permit card is located at the front of t�pr perry, and the approved set of plans will remain on the site at all times during
construction.
SOwner tractor Signature Date
Springfield Building Permit 7/28/2014 9:48:13AM Page 1 of 1
SPRINGFIELD --
CITY OF SPRINGFIELD
i
TRANSACTION RECEIPT
225 Fifth Sl
t� x,
224-00000-425606
Sp6ngfield,OR97477
2.50
Minimum Electrical Fee for 4 or fewer circuits
541-726-3753
.-..y OREGON
811-SPR2014.01608
State of Oregon Surcharge (12% of applicable fees)
w"v.spdngfield- r.gov
2490 SHADYLANE DR
permitcenter@spdngfield-or.gov
RECEIPT NO: 2014001604 RECORD NO: 811-SPR2014-01608
DATE: 07/28/2014
DESCRIPTION
ACCOUNT CODEITRANS CODE
AMOUNT DUE
Electrical Continuing Education fee
224-00000-425606
1032
2.50
Minimum Electrical Fee for 4 or fewer circuits
224-00000-426102
1075
82.00
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
9.84
Technology fee (5% of permit total)
100-00000-425605
2099
4.10
TOTAL DUE: 98.44
045606
TOTAL PAID: 98.44
FROM JKO El acSrlc I— <MOM)JUl- 28 2014 8:52/ST. 8:62/M— 7600000461 P 1
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Electrical Permit Application DEPARTMENT USE ONLY
SFNIMGF16L
_ Petmil no.: O
225R{(III SireellSprin;0eld, OR')74171YH(S 11)726-37531 F,\R(S41)726-689 -. ro�arwD
M ---'- _
1 ( Date:
ate.
'Phis permit is issued 0nd4n- OAR 918-309-0000. Permits tare nontransferable, Permits expire if work is not started within 180
days o1' issuance or If work is suspended for 180 days,
Zoning approval verified? ❑_Yes ❑ No
/ rCATEGORY OF CONSTRUCTION _
'E&esidcoti;d I l7 Government 1 ❑ Commercial
Jnb rile adeh'ess: 2y9O s- hQ t
.^__---___n .... ... ...... ........
TaNlot.:
N pP
Name:
_
Nuwhar of inspections per itemO
Address:
S/m/n/ 6/11
City:
Residential, per unit, service included:
State: Q)\_
DIY: 1 Y
I'hnne: -
- $--
Fax: .
E-mail:
,$ 27.50
-$_35.00-Each
This installation is heing made on residential or farm property
owned by me or a mcnnber of my Iinmedia(e family. This
progeny is not intcnc(ed for sale, exchange, lease, or rent. OAR
479.540(1) and 179.560(1).
f)Iltiilless mill
Address: 2
GIP:
Phone: 51J( -1E-:16 -4(05(, I Fax:541
L -mail: V
� � � �coo__--__•—
C'CTl license no.` 44A$ (2,571 BCD- license no.; Z -0-L4-1
Si_ning supervisur's license no.:
Priv( name of signiu� supervise: --
Signnlure of signing supervisor:
_
440- 584-3 (4101120INCOM)
of 1
- p4-+�m i1
FEE SCHEDULE
_
Nuwhar of inspections per itemO
Qly.
Cost
en,.,
To
�ldt
cast —
Residential, per unit, service included:
1.000 sq. R. or less (4) - �- —
$147.60
- $--
Ellett udditional 500 sq. Il, or por0ou
thereot'
,$ 27.50
-$_35.00-Each
--Lim4cd energy (2) --.
manufuclured home or modulor
thvelling service or Ncda (2)
S 69.00
Services or feeders; ht.dallotiou, allerulioue reloration —
- -
200 maps or less (2)
$ 89.00
$
201 to 400 amps (2)
$ 104.60
$
401 l0 600 amps (2)
5174.00
$
601 to 1,000 umps (2)T-- •—_ -^
$225.50
5
Over 1,000 amps or volts (2)
$616.00
$
f(m meet only (2)
69.00
—$--..---_
---------.._$
Temporary services or feeders: iastrdlolian, niteradon, reloewholl
200 amps o� les (z) ----
S 69.00
S
201 to 400 cups (2)
$ 96.00
S
1
401 Io 600amps (2) ----------5138.60
$
Over 010 6110 amps or 1,000 volts, Yee services or feeders section above
Branch clrculls; neo; o6erallon, en7encfon perpmlel
- -
n, fee for brmmh circuits whir purcbuse 01' It service or feeder fee:
—
Each branch circuit ~_ —
6.50 $
b, Fee for brmich circllitS \vilhow Porelluse Of a service or leer 1Ce:
First branch circuit (2)
S 6
5
Hach additional branch eircoil...._—^
61(scelimmons fees: service orleoder mol IneBnled
-- -- -S
Rich pump or ilrigiuiun circle (2)
69.00
S
---
F'neh sign or outlblc IighOng (2)
-
$ 69.00
...
- --$
51gaal circuit or a limited•cncrg>' prulet,
Oheraliml, orWellsion (2)
S 80.00
$
Each additional Inspection: (1)
$80.00
$
T APPLICANT USE G<6�,-_7�*?
(() Pnsu ; ve 1be
Minimium Permit Fe�
(H) Enter 12 %surcharge (.12 s IA)) $
(C)'rechuology Fee (6% of fAl)
'1.OTAI, fees and surcharges (A Through C):_ _--$_ �,�...
4/8/2013 11:38 AM