HomeMy WebLinkAboutPermit Electrical 2014-09-26SP12INGh1ELU
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OREGON
w v.springfield-or.gov
CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SPR2014-02006
PROJECT STATUS: Issued ISSUED
STATUS DATE: 09/26/2014 APPLIED:
SITE ADDRESS: 1108 5TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703263403000
PROJECT DESCRIPTION: Grounding Rod
OWNER: HARTSOCK FAMILY TRUST
ADDRESS: 1207 OLYMPIC ST
09/26/2014
09/17/2014
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@spdngfield-ocgov
EXPIRES: 03/25/2015
SCOPE: Electrical Only
TYPE OF STRUCTURE: Residential
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lie No Lie Exp Phone
LYNNS ELECTRIC COMPANY (C)Electrical Cont 20-131C 07/01/2017 541-726-7895
INSPECTIONS REQUIRED
Inspections
4120 UFER Ground
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 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.
Owner or Contractor Signature
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMfl1 LNGLD OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Date
1:1,,11 ION: ro(Twres you to
�.he Oregon Utility
;r. rc!es are set forth
ihl'ough OAR 952 0O1-
,; `� 1'ou m ,;r c�riain copies of the rules Eby
c in(Nloiie: thetelephone
nutnhm for lho Oi,'Ton Utility Notification
Center is 1-800-332 2344).
Springfield Building Permit 9126/2014 3:47:05PM Page 1 of 1
Electrical Permit Application gp INCFIEL6
225 Fifth Street+ Spring0eld, OR 97477+PH(541)726-3753+FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.:
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
p Residential
10 Government
10 Commercial
JOB SITE INFORMATION AND 'LOCATION
Job site address: 9
�4�
City: � State oz—
I ZIP: wm
Reference: / ®32 V TaxlotziO60
DESCRIPTION
-OF WORK-`
Limited energy (2)
PROPERTY OWNER.,t o ; `' �'
Name: vlftrsrAi �,r� �.
(C- "*�. j—
Address:
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: sS '£(i i (__
Address:
City: G 1G
I State:Ii2,
I ZIP: 7y35
Phone:51/j-M_e)
FaxSV/746.7LS'?--
E-mail: ,bgg/14a 24 & Nrcowt
CCB license no.: (02,g 1 BCD license no.: ZU-1 I
Signing supervisor's license no.: )?6_7-5
Print name of signing supervisor: L
Signature of signing supervisor:P Mel A'0
IJ
440-2584-J (9/08/COM)
FEE SCHEDULE
Number of inspections per'6cro O
Qty
_
Costea;�
TOtal
cost :-
Residential, per unit, service included:
1,000 sq. ft. or less (4)
$134.00
$
Each additional 500 sq. ft. or portion
thereof
$ 26.00
$
Limited energy (2)
S 32.00
$
Each manufactured home or modular
dwelling service or feeder (2)
$ 63.00
$
Services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 81.00
$
201 to 400 amps (2)
$ 95.00
$
401 to 600 amps (2)
$158.00
$
601 to 1,000 amps (2)
$206.00
$
Over 1,000 amps or volts (2)
$469.00
$
Reconnect only (2)
$ 63.00
$
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2)
$ 63.00
$
201 to 400 amps (2)
$ 87.00
$
401 to 600 amps (2)
$126.00
$
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
I—Ts
6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
$ 55.00
$
Each additional branch circuit
S 6.00
$
Miscellaneous fees: service orfeeder not included
Each pump or irrigation circle (2)
$ 63.00
$
ach sign or outline lighting (2)
$ 63.00
$
Signal circuit or a limited -energy panel,
alteration, or extension (2)
$ 63.00
$
Each additional inspection: (1)
$68.00
$
.USE_'•'-'
_-
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
$
(B) Enter 12% surcharge (.12 x [A])
$
(C) Technology Fee (5% of [A])
$ r
TOTAL fees and surcharges (A through C):
$