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Home My WebLink AboutPermit Electrical 2014-09-12SPRINGFIELD 225 Fifth St a ' ' CITY OF SPRINGFIELD Springfield,OR97477 x, X33 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01983 mm.springfield-or.gov permitcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 09112/2014 EXPIRES: 03/11/2015 STATUS DATE: 09/12/2014 APPLIED: 09/12/2014 SITE ADDRESS: 532 PACIFIC AVE, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703274100600 PROJECT DESCRIPTION: Service Change OWNER: GROSSNICKLAUS ALISON J ADDRESS: 532 PACIFIC AVE SCOPE: Single Family Residence TYPE OF STRUCTURE: Residential Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Liecmcal comractor HAHUINGLLLCIHIUINO CCB 132089 02/01/2016 541-688-5006 INSPECTIONS REQUIRED Inspections 4210 Service Change By signature, I stale 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. 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 932-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telophone number for the Oregon Utility Notification Center is 1-800-332-23,1/1). Date SIS PERMIT SHALL EXPIRE IFTHE WORK 'li IORIZED UNDER THIS PERMIT IS NOT IVCED OR IS ABANDONED FOR 'Y i 80 DAY PERIOD. Springfield Building Permit 9/12/2014 2:24:51PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St � , TRANSACTION RECEIPT Spdnggeld,OR97477 2"' OREGON 541-7263753 811-SPR2014-01983 ww .spdngfield-ocgov 532 PACIFIC AVE permits nler@spdngfield-ocgov RECEIPT NO: 2014002027 RECORD NO: 811-SPR2014.01983 DATE: 09/12/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE ' AMOUNT DUE' Electrical Continuing Education fee 224-00000-425606 1032 2.50 Services 200 amps or less 224-00000-426102 1004 91.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 10.92 Technology fee (5% of permit total) 100-00000-425605 2099 4.55 _._ .... _... ._.. TOTAL DUE: 108.97 Credit Card dames R. Harding 03776D _ 108.97 TOTAL PAID: 108.97 Electrical Permit Application SPRINGFIELD 225 Fifth Street+Springfield, OR 97477+PB(541)726-3753+FAX(541)726-3689 ?' DEPARTMENT USE ONLY Permit no.: 65 l LI Date: 1,514M This permit is issued tinder 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 GOVERNMENTAPPROVAL Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION esidential ❑ Government ❑Commercial JOB SITE INFORMATION AND LOCATION Job site address:j 3Z "PCA C I'f t (� City:__ ) t%d t t. State: 0 ZIP: y7y Reference:�j —I Taxlot.: DESCRIPTION OF WORK{' Limited energy (2) $ 36.00 PROPERTY OWNER Name: :N w a ' $ 71.00 Address: city�ORW State: _ ZIP:q:: 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: 11 1 CONTRACTOR INSTALLATION Business name: PaI1611(] CC;r(1 C. y f)G Address: F -0Q TjUX (P/)_c3 City: Cpr9e State: Of I ZIP: 97)16;?-- Phone:5 753'�Jlp`J Fax:S�/ �5�-9/3U E-mail: I (- 6P- CCB license no.: /3)D V'j BCD license no.:,26 -'V-5 I& Signing supervisor's license no.: _5-1995 Print name of signing supervisor: Cry (t5 'q(;(( /r I Signature of signing supervisor: V U FEE SCHEDULE . Number of inspections per item O Qty, eat • I costI 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 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: nety, alteration, exlensionperpanel 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 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 tees (Minimum PernritFee$82.00) �Q I Iib (B) Enter 12% surcharge (12 x [A]) $ I (C) Technology Fee (6% of [A]) $ , (D) Continuing Education Fee $2.50 $2.60 TOTAL fees and surcharges (A through D): $ , t v 440-2584-1(5/21/2014/COM)