HomeMy WebLinkAboutPermit Electrical 2014-08-29SPRINGFIELD -- 225 Fifth Sl
CITY OF SPRINGFIELD Springfield,OR97477
s Phone: 541-726-3753
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Building Residential ermlt Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01869
Y�.spdnggeld-acgov permitcenler@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/29/2014 EXPIRES: 02/24/2015
STATUS DATE: 08/29/2014 APPLIED: 08/29/2014
SITE ADDRESS: 3792 OREGON AVE, Springfield, OR 97478 SCOPE:
ASSESOR'S PARCEL NO: 1702314208202 TYPE OF STRUCTURE:
-PROJECT- DESCRIPTION. -Installation-of-patio-lighting— --- --— - -- — ---
OWNER: GARCIA RALPH & JEAN T Phone Number:
ADDRESS: 3792 OREGON AVE
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
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 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.
ner or Contractor Signa ure 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• NOTICE:
0090. You may obtain copies of the rules by T1 {IS PERN41T SHALL EXPIRE IF THE WORK
calling the conter. (Note: the telophone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Orerrnl Utility Notification
Canter is 1-800-332'-2344). CO(difv1ENCED OR IS ABANDONED FOR
nI�Y 180 DAY PERIOD.
ipringfeld Building Permit 8/29/2014 9:20:01AM Page 1 of 1
SPRINGFIELD---
CITY OF SPRINGFIELD
TRANSACTION RECEIPT
225 FiSt
SpnngBld,OR97477
OREGON
641-726-3753
811-SP R2014-01869
w .spdngfield-0r.gov 3792 OREGON AVE
permitcenter@spdngfield-or.gov
RECEIPT NO: 2014001899 RECORD NO: 811-SPR2014-01869
DATE: 08/29/2014
C.OUN COD m=
N m .D_
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
Technology fee (5% of permit total) 100-00000-425605
2099
4.10
TOTAL DUE:
98.44
.A O
Credit Card Jean T. Garcia
98.44
042012
TOTAL PAID: 98.44
Electrical Permit Application SPRINGFIELD DEPARTMENT USE ONLY
Permit no.:
225 Fifth Street* Springfield, OR 97477+PH(541)726-37534FAX(541)726-3689-`---
Date: Z�l � ZU I 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.
Zoning approval verified? ❑ Yes ❑ No
(ZI Residential I ❑ Government 10 Commercial
Job site address:
Reference: / 1 Taxlot.:
PROPERTY OWNER
Name: 4-1O1, (:;'a !^fir: ck. JF'T 9,AO
I
Address: '2 '7 9 —1 14 ...n
ZIP:
I Phone3-'- VW:_ (� I Fax: - - I
E-mail:CavcG c 1e c�
This insta lation is being made on resided ial 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/)
Business name:
City: State: / ZIP:
Phone: ax:
E-mail: ATTENTION: OrP. n la` quires You o
CCB lAWWJ,' les '. ec 1,Val:forth
Signin 0. '8Wjsdittf3®iioklvough pAR 952--
Print ndw/ fsY�)1hiemayffil j0r[n.Us,P tail r>hone
call ltl y, a ICI Uc rno„ i...,......
Sinamr�,ofstetun¢superQlsonon Utility Notification
Ii C is
S 1'1 R[dIT SHALL [XPIR
101'IZED UNDER PHIS
LACED OR IS ARAN[
0 DAY PERIOD.
440-2584-1(5!21/2014/COW
FEE SCHEDULE
Number of inspections per itemO Qty.
Cost
ea,
Total
I 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)
$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
1 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extensiotperpanel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I
I
$ 7.00 1
$
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
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
( Iotal of above fees
_ . it Fee $82.00)
t r %surcharge (.12 x [A))
$
$ I
(C) Technology Fee (5% of [A))
$
(D) Continuing Education Fee $2.50
$2.60
TOTAL fees and surcharges (A through D):
$ qX -