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HomeMy WebLinkAboutPermit Electrical 2014-09-09SPRINGFIELD 7 -- t OREGON mw .springfieldor.gov 14r L�7-��:7ILLela 1;11 Building / Residential Permit PERMIT NO: 811-SPR2014-01947 225 Fifth Sl Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@spdngfield-on9ov PROJECT STATUS: Issued ISSUED: 09/09/2014 EXPIRES: 03/07/2015 STATUS DATE: 09/09/2014 APPLIED: 09/09/2014 SITE ADDRESS: 175 DEADMOND FERRY RD, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703140001300 TYPE OF STRUCTURE: Residential ----PROJECT- DESCRIPTION:--Nowcadet-heater-and- OWNER: BENJAMIN W JORDAN FAMILY TRUST ADDRESS: 522 BROOKDALE AVE Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Electrical Contractor PACIFIC ELECTRIC LLC CCB 199661 04/22/2015 641-206.7700 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 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 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 constructs 1. Owner or Contractor Signature Date ATTEN(ION: 01monn I :v i_,MI61es you to follow rules adol t ud'oy dte Orogen Utility Notification Center. Those I ides are set forth in OAR 952-001-0010 through OAR 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). <<: !S PERA4IT SI SALE EXPIRE IE THE WORK IORILED UNDER THIS PERMIT IS NOT {_NCID OR IS ATIANDONED FOR `'n DAY PERIOD. Springfield Building Permit 9/9/2014 2:00:22PM Page 1 of 1 CITY OF SPRINGFIELD LRIGFIELD---- TRANSACTION RECEIPT 225 FiSt Spnngfeld,OR 97477 OREGON 811-SPR2014-01947 541-726-3753' w w.spdngfield-0r.gov 175 DEADMOND FERRY RD permitcenter@spnngfield-or.gov RECEIPT NO: 2014001978 RECORD NO: 811-SPR2014-01947 DATE: 09/09/2014 'av 1 OU t D 7rR O4 NT" U 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 ,MEWt, Credit Card Allan D. Sustello / Pacific Electric LLC 98.44 087887 TOTAL PAID: 98.44 �' • I 1 1 7ITYQF SPRINGFIELD OREGON DEPARTMENT USE ONLY Date: '" 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION, Residential ❑ Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION `trJ Jobsiteaddress: 1oco_N�)4 Fetr " city-. -rf- — _Stale: - _ ZIP: -- - Reference: ' _ Taxlot.: SC IPTION :OF WORK a1 W Iffier- — IleaJ aJL v)&Q __$-36.00--$------- PROPERTY :OWNER Name: � Address:v w 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: 6- e t � % C. e 1'ecyfi Address: q9`3" _ �_"_ Lk t City: State: Cg. ZIP: %-7t(U Phone: '94 Z06 -;7'7G0 1 Fax: E-mail: CCB license no._license no.: - �f Signing supervisor's license no.: �(ab 5 Print name of signing supervisor: Signature of signing supervisor: 440-2584-J (5/21/2014/COM) FEE SCHEDULE Number of inspections per item O -Qty. east cost Residential, per unit, service included: 1,000 sq. ft. or less (4) $161.00 $ 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) $ 01.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 $ I 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) $ 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, extension perpanel 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 1 $ Each additional branch circuit ' $ 7.00 1 $ 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; (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ r (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): $ s I