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Home My WebLink AboutPermit Electrical 2014-08-04NG�otRle 225 Fifth St CITY OF SPRINGFIELD V Springfield,OR97477 x Phone: 541-726-3753 ' �^ GON Building /Residential Permit Inspection Phone: 541-726-3769 Fax: 641-726-3676 PERMIT NO: 811-SPR2014-01659 v m.sprin9feld-ocgov permitcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 08/04/2014 EXPIRES: 01/30/2015 STATUS DATE: 08/04/2014 APPLIED: 08/04/2014 SITE ADDRESS: 2560 35TH ST, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702194200300 TYPE OF STRUCTURE: Residential -PROJECT- DESCRIPTION: Replace -service -panel -and -one -non -compliant -HVAC -circuit OWNER: JARVIS SHANNON D Phone Number: ADDRESS: 2560 35TH ST SPRINGFIELD OR 97477 OWNER: WILSON MICHAEL D Phone Number: ADDRESS: 2560 35TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 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 properly, and the approved set of plans will remain on the site at all times during construction. Owner or Contractor Signature ATTENTION: Oregon taw 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), Date �'O T ICE: IJITHORt EID UNDER THIS PERM TEWORK IS NOT ,;o!kr,MENOED OR IS ABANDONED FOR \1�iy 180 DAY PERIOD. Springfield Building Permit 8/4/2014 1:13:06PM Page 1 of 1 -' RECORD NO: 811•SPR2014.01659 CITY OF SPRINGFIELD LPRNGFIELD TRANSACTION RECEIPT 225 Fifth St Springfleld,OR97477 Branch circuits with service or feeder each circuit 224-00000-426102 541726-3753 OREGON 811-SPR2014-01659 224-00000-425606 wvnv.spdngneld-ocgov 2560 35TH ST permitoenter@spdngfield-orgov RECEIPT NO: 2014001661 RECORD NO: 811•SPR2014.01659 DATE: 08/04/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE 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 91.00 Stale of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 11.76 Technology fee (5% of permit total) 100-00000-425605 2099 4.90 TOTAL DUE: 117.16 PAYMENT'TYPE "PAYOR ':CASHIER: CCARPENTER :'COMMENTS HMVUNt rrau Credit Card Matthews 117.16 502422 TOTAL PAID: 117.16 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 filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my Name CCB# Expiration Date I 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. cor� Print Name of Permit Applicant Signature o` -Fe it Applicant Date Permit M N/ S� Address: 26-� Issued by: Date: G This Copy for Permit Offices ��TY OFtSP1ZiNGFIELD; QI�.�G(JN�. DEPARTMENT USEONLY Permit no.: Date: L% T 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 esidential ❑ Government ❑Commercial JOB SITE INFORMATION AND LOCATION Job site address: 29 Q N �f. - _City:— UIA Each additional 500 sq. fl. or portion thereof State_ - -ZIP- C 7 — Referen e: t Taxlot.; p' `jd-6 DESC IPTION'OF WO K —$ Each manufactured (tome or modular dwelling service or feeder (2) PROPERTY`OWNER Name: $ Address: 2 D Ve City: e $q�/ State: Phone: S - -(Q%(p Fax:---- x:.--E-mail: E-mail:C<3oK3_wjf} co,rjs , n This installation is being made on residential or farm 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(1) an (179.) 0(1). Signature: NTRACTOR 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: FEE SCHEDULE . Number of inspections per item () Qty. Cost ea. Tptal -.cost Residential, per unit, service included: 1,000 sq. fl. or less (4) Each additional 500 sq. fl. or portion thereof $ 48,00 $ - Limited -energy -(-2) -$-36:00— —$ Each manufactured (tome or modular dwelling service or feeder (2) $ 71,00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 $q�/ 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) $627.00 $ Reconnect only (2) $ 71.00 $ Temporary services or feeders: 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: new, alteration, extensionperpanel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit 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 or feeder 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 _USE (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $% (B) Enter 12% surcharge (.12 x [A]) $ i (C) Technology Fee (5% of [A]) $� (D) Continuing Education Fee $2.50 TOTAL fees and surcharges (A through D): $ 440-2584-J (5/21/2014/COM) /'��i