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Home My WebLink AboutPermit Electrical 2014-09-30PROJECT STATUS: Issued ISSUED: 09/30/2014 EXPIRES: 03/29/2015 STATUS DATE: 09/30/2014 APPLIED: 09/30/2014 SITE ADDRESS: 1125 21ST ST, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703254305400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service Change from 100 amps to 200 amps, OWNER: FRIZZELL KAREN A Phone Number: ADDRESS: 112521ST ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lir Exp Phone Eleclncal Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4210 Service Change 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. 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. "Ww' 4 /1', w3 1 Owner or Contractor Signature 4Date 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 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 1-800-332-234,1). Mi T ICE: 1 JIG PERMIT SHALL EXPIRE IF TWE WORK I I10RIZED UNDER THIS PERMIT IS NOT 'f PIENCED OR IS ABANDONED FOR SO DAY PERIOD. Springfield Building Permit 9/30/2014 9:17:OOAM Page i of 1 225 Fifth St F-41; CITY OF SPRINGFIELD Springfield,OR97477 Phone: 541-726-3753 EGON Building /Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-02109 www. springfield-or.gov permitcenter@spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 09/30/2014 EXPIRES: 03/29/2015 STATUS DATE: 09/30/2014 APPLIED: 09/30/2014 SITE ADDRESS: 1125 21ST ST, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703254305400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service Change from 100 amps to 200 amps, OWNER: FRIZZELL KAREN A Phone Number: ADDRESS: 112521ST ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lir Exp Phone Eleclncal Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4210 Service Change 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. 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. "Ww' 4 /1', w3 1 Owner or Contractor Signature 4Date 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 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 1-800-332-234,1). Mi T ICE: 1 JIG PERMIT SHALL EXPIRE IF TWE WORK I I10RIZED UNDER THIS PERMIT IS NOT 'f PIENCED OR IS ABANDONED FOR SO DAY PERIOD. Springfield Building Permit 9/30/2014 9:17:OOAM Page i of 1 is CITY OF SPRINGFIELD 225 I'Ah St TRANSACTION RECEIPT 3pdngfield,OR97477 541-726-3753 811-SPR2014-02109 vrvnv.spdngfield-or.gov 1125 21ST ST permitcenter@springrield-or.gov RECEIPT NO: 2014002154 RECORD NO: 811-SPR2014-02109 DATE: 09/30/2014 DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE Electrical Continuing Education fee 224-00000-425606 1032 2.50 Services 200 amps or less 224-00000-426102 1004 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 91.00 10.92 Technology fee (5% of permit total) 100-00000-425605 2099 4.55 TOTAL DUE: 108.97 'PAYMENT TYPE PAYOR CASHIER: RROLMAN COMMENTS AMOUNT PAID Credit Card Karen Frizzell 015725 108.97 TOTAL PAID: 108.97 Electrical Permit Application SPRINGFIELD 225 Fifth Street* Springfield, OR 97477*PH(541)726-37531FAX(541)726-3689 - DEPARTMENT //USE � ONLY Permit no.: � -` � ��t� Date: ab /11 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 I ❑ Goverment ❑ Commercial JOB' SITE INFORMATION AND LOCATION Job site address: City: I State: C ZIP: Reference: $ 28.00 Taxlot.: C5L DESCRIPTION ,OF WORK' rVl Ce ti Tct dA 40 -lo 'ZJv 4-40 PROPERTY O NER Name: Address: �\ZS i\S� S♦�� ) City: S r J alj State: G ZIP: 91411 200 amps or less (2) Phone: Sq]. 01 1 tt Fax:v- E-mail: K6l(-trJ Lj S rt(S r'/ C A1c.•, 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: 2t/on-(ti CONTRACTOR INSTACLATION Business name: Karci ,?-e 1 (�„m� Address: City: State: ZIP: Phone: Fax: E-mail: CCB license no.: BCD license no.: Signing supervisor's license no.: 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. 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) $ 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) $527.00 $ Reconnect only (2) $ 71.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) 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, exlemionperpanel 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)4T_1 62.00 $ Each additional branch circuit 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 $ APPLICANT UM__e (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (6% of [A]) $ �I (D) Continuing Education Fee $2.50 $2.60 TOTAL fees and surcharges (A through D): $