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HomeMy WebLinkAboutPermit Electrical 2014-08-13SPRINGFIELD -" 225 Fifth St v CITY OF SPRINGFIELD Springfield,OR97477 r vO OREGON Building / Residential Permit Phone: 541-726-3763 Inspection Phone: 641-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01760 vv i springfield-or.gov permitwnter@spdngfield-orgov PROJECT STATUS: Issued ISSUED: 08/13/2014 EXPIRES: 02/08/2016 STATUS DATE: 08/13/2014 APPLIED: 08/13/2014 SITE ADDRESS: 3250 HAYDEN BRIDGE RD, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702190000699 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Reconnect existing service OWNER: MILLER VALLEY LTD PTRSHP Phone Number: ADDRESS: 3330 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone INSPECTIONS REQUIRED Inspections 4200 Reconnect Service By signature, I slate 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 ATTENTION: Oregon lmv rerl,;h es you to follow rules adopted by tile, Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAH 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 [\I OT ICC: I I11S PERMIT SHALL EXPIRE IF THE WORK rAUTIIOR17_ED UNDER PHIS PERMIT IS NOT I 111.6gENCEp OR IS ABANDONED FOR SO F)AY PERIOD. Springfield Building Permit 8/13/2014 3:02:13PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGPItiLD 225 Fifth S TRANSACTION RECEIPT Spnngfield`OR 97477 OREGON 541-726-3753 811-SPR2014-01760 v i.spdngfield-or.gov 3260 HAYDEN BRIDGE RD permito nter@spnngfield- r.gov RECEIPT NO: 2014001761 RECORD NO: 811•SPR2014-01760 DATE: 08/13/2014 DESCRIPTION ' ACCOUNT CODE/TRANStCODE AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 Service reconnect only 224-00000-426102 1004 71.00 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 Credit Card Janet Lovelace / Robbins Electric 030732 TOTAL DUE: 98.44 98.44 TOTAL PAID: 98.44 Aug 13 2014 3:43PM HP Fax Electrical Permit A i � I 221 Fifth 8treet6springneld, OR 97477+F 'Chis permit Is issued under OAR days or Issuance or if work Is susp page 1 CaUQll Vornrc nnonr roc SPRING MUD Permit ll0,: Vim✓ 2G37Ci�1+A'X(Sil)72fi-3689 �cao I Date: 9.0000. Permits are nontransferable. Permits expire If work is not started within 180 for 180 Clays. LOCAL GOVERNME T APPROVAL Zoning approval verifier(? E Yes © No CATEGORY OF CO 4STRUCTION tcsidential I p Oovernm of 10 Commercial JOB SITE INFORMATIOt I AND OCA ION ob-site address �( City: s j Stat : ZIP: _7 Reference: I TWO.: DESCRIPTION OF WORK �Cd t eXi 5 l Vd Lfi ,.201 to 400 maps (2) $ 104,60 $ PROPERTY OWNER - Name: Address: City: Sta ZTP: Phone: E•mall: This installation is being made on relsidet>tinl_or faint properly owned by tine m' u member of my in medlate family, This property is not.intended for sale, ex hange, lease, or rent. OAR 479.540(l) and 479,560(1). Signature: CONTRACTOR INSTALLATION Business name: L-� Address: Igo City p Ste 9: Z1P:,q-?14 Phone: 7 rax: jf l �j$$ 7c10 Over 600 amps or 1,000 volts, see services or feeders section nbove CCB licente n A ;D license no.: Signing supervisor's license no.: `J S. Print natile of signing supervisor: lc S S Signature of signing supet•vlsm••' 44U 3584-1(4/01/2013/COM) LdOur (/(W 1 PEE SCHEDULE Number of inspections per Item O Qty. Cost en. Total cost Retidewinl, per unit, service Included: _ 1,000 sq. 0. or less (4) 5147.6o $ Each additional 500 sq, 0. or portion $ —thereof Limited energy (2) $ 36,110 $ Each manufactured hone or modular $ 68.00 $ dwelling service or feeder (2) Servicos or feeders: Installation, ademiion, relocation 200 amps or less (2) $ 89.00 $ ,.201 to 400 maps (2) $ 104,60 $ 401 to 600 amps (2) $174.00 601 to 1,000 amps (2) Over I OW n or volls (2) $61.6.00 S �'Rcconnectouly(2) $ 69,00 rvices or reeders: installation, alteration, rehcatiun 200 amps or less (2) S 69100 $ 201 to 40n naps (2) g 96,00 $ 401 to 690 anps (2) $100,60 $ Over 600 amps or 1,000 volts, see services or feeders section nbove Branch ciretdts: new, alteration, extensio)tperpnnel a. Fee Cor branch circuits kvith purchase of a service or lewder fee: Bach branch circuit S 11.60 $ h, Fee rot, branch circuits tvlthout purchase of a service or feeder fee: First branch circuit (2) $ 60.60 $ Each additional branch circuit S 6.60 $ M'Iscellaneous tees; aawlce a+ fieder not inchded Each pump or irrigntion circle (2) $ 69.00 $ Each sign or outline lighting (2) $ 69.00 $ Signal circuit or a lirhited•energy pdnel, alteration, or extension (2) $ 80.00 $ Each additional Inspection: (1) $80.00 $ APPLICANT .USE Z'/ (A) Enter subtotal of above fees (ilfinlnmm Permit Fee 580.00) $ (13) Enter 12%surcharge (.12 x [A]) S 9' (C)'I'echnology Fee (6%of(A]) $ .� TOTAL fees and surcharges (A through C): '$