HomeMy WebLinkAboutPermit Electrical 2014-09-09SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
{ Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
'..
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01946
wapringfield-0cgov permitcenter@spdngfield-ocgov
PROJECT STATUS: Issued ISSUED: 09/09/2014 EXPIRES: 03/07/2015
STATUS DATE: 09/09/2014 APPLIED: 09/09/2014
SITE ADDRESS: 1612 CONCORD AVE, Eugene, OR 97403 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703344305900 TYPE OF STRUCTURE: Residential
-PROJECT DESCRIP-TION: Installation -and -relocation -of -feeder.----— — —---------
OWNER: MILLS ROGER Phone Number:
ADDRESS: 1612 CONCORD AVE -
EUGENE OR 97403
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lie No Lic Exp Phone
Electrical Contractor GARYS ELECTRIC SERVICE LLC CCB 195416 11/15/2015 541-729-0403
INSPECTIONS REQUIRED
Inspections
4225 Service or Feeder
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 Slate 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
Vconstruction. q CJS
!:�Ua l { l
Owner or Contractor Signature Date
ATTR N I TON: Ole yon laav reLluireS you to
follow, Init;s adopted by the Oregon Utility fE:
Notiiicatlon Centel. -those rules are set forth 1103 PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001- NORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by;i,;i(_(ICED OR IS ABANDONED FOR
i
calling the center, (Note: the telephone : � 1 n D/�Y PERIOD,
.-,.r_, fnv it,. oronnn t)hhtV Notification I ut
..
u yCenter is 1-800-332-234,1).
Springfield Building Permit 9/9/2014 1:44:32PM Page 1 of 1
CITY OF SPRINGFIELD
ka-�-_r
TRANSACTION RECEIPT
225 Fifth St
Spdngfield,OR97477
"r' ORfGOR
811-SPR2014-01946
541-726-3753
w Y.spdngfield- r.gov
1612 CONCORD AVE
permitcenter@spdn9field- r.gov
RECEIPT NO: 2014001973
RECORD NO: 811-SPR2014-01946
DATE: 09/09/2014
1 ° i07+t
1{Gb
E
Electrical Continuing Education fee
224-00000-425606
1032
2.50
Services 200 amps or less
224-00000-426102
1004
182.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004
1099
21.84
Technology fee (5% of permit total)
100-00000-425605
2099
9.10
TOTAL DUE:
215.44
6 TfiYP' OR
O n COA71(1
O b
Cash Roger Mills
215.44
TOTAL PAID: 215.44
Electrical Permit Application SPHINGNELU DEPARTMENT USE ONLY
Permit no.: �N�4-
225
"225 Fifth Street♦ Springfield, OR 97477♦PB(541)726-3753♦FAX(541)726-3689 `" "'
Date:
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 I
❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: ( eco Rol L
$ 18
State_ 6-k
_ ZIP: 47403
Reference: 7j?} �%� 7J Taxlot.:
DESCRIPTION .OF WORK'.
o�,�
62W Idt•
PROPERTYOWNER '
Name:
Address: CLan
City:
State:
ZIP: L)6
Phone b --7-7-52]
Fax:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
properly is not intended for sale, exchange, lease, or rent. OAR
479.540(1) a 479.560(1).
Signature:
' ONTRACTOR INSTALLATION
Business name: /(I, (�1
Address:? 13a,41 —it Q t7 �G
City: pJ
State: gj
ZIP:
Phone: .- 2
$ 71.00
Pax. C
E-mail:
CCB license no jj tj
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (5/21/2014ICOM)
Residential, per unit, service included:
1,000 sq. ft. or less (4)
Each additional 500 sq. fl. or portion $ 28.00 $
thereof
Each manufactured home or modular
dwelling service or feeder (2)
$ 71.00
$
Services or feeders: installation, alteration, relocation
200 amps or less (2y
$ 91.00
$ 18
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
1 $
201 to 400 amps (2)
$ 96.00
$
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 1
1
$ 7.00 1
$
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 orfeeder 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)
$62.00
$
(A) Enter subtotal of above fees $
(Minimum Permit Fee $82.00)
(B) Enter 12% surcharge (.12 x [A]) $
(C) Technology Fee (6% of [A]) $ �t✓
(D) Continuing Education Fee $2.50 $2.60
TOTAL fees and surcharges (A through D): 1 $ /] t