HomeMy WebLinkAboutPermit Electrical 2014-09-08SPRINGFIELD
225 Fifth St
CITY OF SPRINGFIELD
Springfield,OR97477
;9-1v
Phone: 541-726-3753
oaecON Building / Residential Permit
Inspection Phone: 641-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01579
v .epdngfieldor.gov
permitcenter@spdngfield-acgov
PROJECT STATUS: Issued ISSUED: 09/08/2014
EXPIRES: 03/06/2015
STATUS DATE: 09/08/2014 APPLIED: 07123/2014
SITE ADDRESS: 4865 A ST, Springfield, OR 97477
SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1702324101500 TYPE OF STRUCTURE:
Residential
–PR03EC-T-D ESCRI PT10N—FN ew$F
OWNER: SPRINGFIELD/EUGENE HABITAT FOR HUMANITY
Phone Number:
ADDRESS: 1210 OAK PATCH RD
EUGENE OR 97402
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type
Lie No Lie Exp Phone
Plumbing Contractor SPECIALTY PLUMBING CO CCB
102974 11/21/2015 541-6864191
Electrical Contractor BEAM ELECTRIC LLC CCB
192844 01/20/2015 541-968-1962
Mechanical Contractor ALPINE HEATING LLC CCB
193586 04/01/2015 541-954-9959
General Contractor HABITAT FOR HUMANITY SPRINGFIELn EUGENE CC8
196367 03/22/2016 541-741-1707
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 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.
Owner or Contractor Signature
PI:I ALM SHALL EXPIRE If THE WORK
hOIil1(7) UNDER THIS PERMIT IS NOT
NCLD OR IS ABANDONED FOR
0 DAY PERIOD.
Springfield Building Permit
Date
to
fr n✓ :`1I Irl {rCh ,ontiiility
Pluuut 'tion (-,(.I I I c� I. l l o!:., et forth
in OAR 952-001-0010 uta ouc ih ,i
if °�2-001-
0090. You may obtain Copies of the rulos by
Calling the Center. (Note: the telephone
number for the Oto47)n Utili'l.y Potification
9/8/2014 12:05:11PM Center IS 1-800-332-23,14).
Page 1 of 1
CITY QF SFRl GFIELDt ORF'G�'N'
DEPARTMENT USE ONLY f,
Permit no.: S/'-(- / V / /
Date:
This permit is issued tinder OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance m- if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION,
❑ Residential
❑ Government
❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address:
i
tate-
ZI
Reference:
Taxlot.:
DESCRIPTION :OF WORK'-
201 to 400 amps (2)
PROPERTY OWNER
Name:
Address:
City:
State:
ZIP:
Phone:
Fax:
E-mail:
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) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION-,
Business name: ,
Address: ILI AZT'
City: I
State: &,Z
I ZIP: 5'7 74�
Phone: S f 16f,- 1 c?aj
Fax:,;V- 51/1 o G2
E-mail: OD ]n/l-aO - 5 6 i%fivt4it, Ce")
CCB license no.:192Y64 1
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
201 to 400 amps (2)
Signature of signing supervisor: S`Ee -' Q t, -j I 14
440-2584-J (5/21/2014/COM)
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) $161.00 $
Each additional 500 sq. ft. or portion
thereof l $ Y8,00 $
'mited-e-ne-rg 36-0
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 feeders: installation, alteration, relocation
200 amps or less (2)
$ 71.00
1 $
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, exiensionperpanel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$ 7.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
$ 62.00 1
$
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
$
APPLICANTUSE',;
,7
(A) Enter subtotal of above fees
(Minimum Permit Fee $82.00)
$
/
(B) Enter 12% surcharge (.12 x [A])
$
(C) Technology Fee (5% of [A])
$
(D) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (A through D):
$