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HomeMy WebLinkAboutPermit Electrical 2014-09-17ELD 225 Fifth St FOREGON CITY OF SPRINGFIELD Springfield,OR97477 :Fa'`YPhone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01373 %wi .springfield-or.gov permilcenter@springfield-orgov PROJECT STATUS: Issued ISSUED: 09/17/2014 EXPIRES: 03/16/2015 STATUS DATE: 09/17/2014 APPLIED: 06/25/2014 SITE ADDRESS: 2056 HARBOR DR, Springfield, OR 97477 SCOPE: ASSESOR'S PARCEL NO: 1803112203600 TYPE OF STRUCTURE: PROJECT DESCRIPTION: E - New SFD- replace existing MF home on site OWNER: CALOIA NEAL JOHN & HEATHER RENEE Phone Number: 541.915-9030 ADDRESS: 2066 HARBOR DR SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Electrical Contractor DAVID LEROY SYTSMA CCB 160739 07/15/2016 541-847-8560 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 Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 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 ATTENTION: Oregon larr/ rtuBs you to follow rule6 adopted by the Olegon Uiility Notification Center. Those lul r I > 2-001 in OAR 952-001-001 o throrujh OAii 965?_ 001- 0090. You may obtain copies of the rules by Calling the center. (NoteCl the telephone nurrlbe h CentisO19 1e600 332-23,14).itication Date PLRI,/iii SHAL l IXPIRF IF'IHE WORK �fT+ a un�Drf3 rIN PERMI is nioI OR fS Al3AfgDONvD FOR f�rf0o1). Springfield Building Permit 9/17/2014 2:00:25PM Page 1 of 1 Electrical Permit Application SPRINGFIELD 225 Fifth Street♦Springfield, OR 97477+PH(541)726-3753*FAX(541)726-3689 t �' DEPARTMENT USE ONLY Permit no.: 67 73 Date: / V 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 Q Residential 10 Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION '. Job site address:20 City: State: ZIP: Reference: X3/122— Taxlot.: d DESCRIPTION OF WORK' Limited energy (2) PROPERTY OWNER Name: Ja' Address: Fr2.(3C!'— city: State: OQ— ZIP:<;;>Y7 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: r City: tate: I ZIPa Phone: # — (� Fax: E-mail: CCB license no.: BCD license no.: Signing supervisor's license no.: go 0 Print name of signing supervisor: Signature of signing supervisor: w� t prv�iu% 440-2584-J (5/21/2014/COh4) FEE SCHEDULE Number of inspections per itemO 11 Qty. Cost - ea. Total I 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) $ 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, exteruionperpanel 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 Miseelinneous 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) $82.00 $ APPLICANT USE. (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ �7 (B) Enter 12% surcharge (.12 x [A]) $ j (C) Technology Fee (6% of [A]) $ I 1� (D) Continuing Education Fee $2.50 $2.60 TOTAL fees and surcharges (A through D): $ 9 16 21