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Home My WebLink AboutPermit Electrical 2014-09-10GFLD -. EEIL't�0 CITY OF SPRINGFIELD 225 Fifth Sl Springfield,OR97477 Phone:541-726-3753 REGON Building / Residential Permit Inspection Phone: 641-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01951 mmairringfield-ocgov, permileenter@spdngfield-or.gov PROJECTSTATUS: Issued ISSUED: 09/10/2014 EXPIRES: 03109/2015 STATUS DATE: 09/10/2014 APPLIED: 09/10/2014 SITE ADDRESS: 64510TH ST, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703351402300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace branch circuits in house. OWNER: SAMPSON DAPHENE L Phone Number: 541.852-8606 ADDRESS: 645 10TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections I, 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work is complete. By signature, 1 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 7st7(n. �f O r or ontraclor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rides are set forth in OAR 952-001-0010 through 01"R 952-0011 - 0090, 52 001- 0090. You may obtain onhie or III,,, w, h" Calling the center (No, number for the Oleoan Ut on Center is t 00 3v IIS PERMIT SHALL EXPIRE IF THE WORK I' HORIZED UNDER THIS PERMIT IS NOT i�d FNCED OR IS ABANDONED FOR Y 180 DAY PERIOD. Springfield Building Permit 0/10/2014 8:21:22AM Page 1 of 1 SPRINGFIELD- CITY OF SPRINGFIELD 225 Fifth Sl �,� TRANSACTION RECEIPT Sprngfield,OR97477 ---- OREGON 541-726-3753 811-SPR2014-01951 w .springfield-ocgov 645 10Th ST permitcenter@spdngfield-acgov RECEIPT NO: 2014001983 RECORD NO: 811-SPR2014.01961 DATE: 09/10/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE 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 70.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 15.84 Technology fee (5% of permit total) 100-00000-425605 2099 6.60 TOTAL DUE: 156.94 Credit Card Daphene L Sampson 098107 156.94 TOTAL PAID: 156.94 BMW O O !PNGF�DOi(GO DEPARTMENT USE ONLY Permit no.: Date: C) 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 ,&yResidential ❑ Government ❑Cour nercial JOB SITE INFORMATION AND'LOCATION > Job site address: p ' /0 6� Cityn —� State: 0/t, Reference: Taxlot.: DESCRIPTION OF"WORK /.it ho k -X36:00- PROPERTY OWNER Name: ��&26 Address: (p U City: i n G State: Services or feeders: installation, alteration, relocation Phone: S5a J&o Fax: E-mail: 02oht-lel V &2 6m .4Aoq This installation is being made on-residt5htial 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(1 479.560(1). Signature: CO TRACTOR -INSTALLATION . Business name: Address: City: State: ZIP: Phone: Fax: E=mail: CCB license no.: BCD license no.: Signing supervisor's license no.: Print frame of signing supervisor: Signature of signing supervisor: 440-2584-J (5/21/2014/COK FEE SCHEDULE `Number of inspections per item (Qty. Cost ea. Total 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)--- __-- — __--- -X36:00- _-$-- --__ 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) $527.00 $ Reconnect only (2) $ 71.00 1 $ 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, extension perpanel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit 1 1 $ 7.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) 1 $ 62.00 $ (, Z Each additional branch circuit C) $ 7.00 $ %6 Miscellaneous fees: service orfeedernot 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 582.00) $ (B) Enter 12% surcharge (.12 x [A]) $ ,Sr Sy (C) Technology Fee (5%of [A]) $ Wp (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): $ i 5� 1 qi