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HomeMy WebLinkAboutPermit Electrical 2014-10-03SPRINGFIELD - 225 Fifth St ' CITY OF SPRINGFIELD Springfleld,OR97477 C Phone: 541-726-3753 aaeGON Building / Residential Permit Inspection Phone: 541-726-3769 - Fax: 541-726-3676 PERMIT NO: 811-SPR2014-02159 w .spnngfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 10/03/2014 EXPIRES: 04/01/2015 STATUS DATE: 10/03/2014 APPLIED: 10/03/2014 SITE ADDRESS: 175 DEADMOND FERRY RD, Springfield, OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703140001300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Add 3 circuits, kitchen, dinning and back room. 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 541-206-7700 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 slate 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. A A c� �lr�AMl 101'3�01 T Owner or Contractor Signature Date to �oqu{tes`I �C... t,t10N' Ote�3on {aw e Ote9° sett 1 o to�hp50htutesaYe 1 P�TG h OAS o52•e oby {o11oW rale G op1pthtou5 Plotit{cat{oto °ogles of to-, lbeJeW +None to09O yOqAO ih ac me ecJ°n Ott \23 hl{{cation nultnUeeilov Oenf e®1-boo.332 1C �EXp\RE \P"!NE SO p'S S PFPpq\� SP\P\ \N\S Po JVD 0vi D awo aoo p0RVOD. Springfield Building Permit 10/3/2014 2:47:02PM Page 1 of 1 - CITY OF SPRINGFIELD LEr, TRANSACTION RECEIPT 225 FiM St Spnngfeld,OR97477 641-726-3753 cor+ 811-SPR2014-02159 224-00000-426102 w .spdngfield- r.gov 175 DEADMOND FERRY RD permitcenter@spdngfield- r.gov RECEIPT NO: 2014002193 RECORD NO: 811-SPR2014-02159 DATE: 10/03/2014 1 Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 6.00 Branch circuits without service or feeder - 1sl circuit 224-00000-426102 1004 62.00 Branch circuits without service or feeder - each additional 224-00000-426102 - 1004. 14.00 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 Credit Caro PACIFIC ELECTRIC LLC VU.44 360600 TOTAL PAID: 98.44 ' i CITY QF,SPRT�TGFIELDREGQTI 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 rAPPROVAL Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION Residential ❑ Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION': Job site address: p n City: n State: Qe,ZIP: Each additional 500 sq. 0. or portion thereof Referen e: dMILA 00 Taxlot.: LDI aDo DESCRIPTION OF WORK acv, S C.tCCut S ,+ ktrt. ptnntn $ 36.00 PROPERTY OWNER Name: LOISf Qt\ Address: 5zZ &-ookdodf-. ✓E City: fin Reid State:p,2 ZIP:974(77 Phone• f 78i. SIoOJ� 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(l) and 479.560(1). Signature: CONTRACTOR INSTALLATION Business name: ae tc-t C C(pGi flG I Address:' 35- tC Sue, ��} City: c- State: ZIP: /7qa? Phone:s Z06-7700 IF= E-mail: CCB license no.: BCD license no.: C_ R57 - -Signing Signing supervisor's license no.: 5 cf(p© S Print name of signing supervisor: ,yg30® W (ter � Signature of signing supervisor: t 440-2584-J(5/21120141COM) FEE SCHEDULE "Number of inspections per item OQty. Cost ea. Total - cost Residential, per unit, service included: 1,000 sq. ft. or less (4) $151.00 $ Each additional 500 sq. 0. 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) $ 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: new, alteration, extension per panel 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) I $ 62.00 $ Each additional branch circuit Z $ 7.00 $ 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) $82.00 $ APPLICANT:`,USE (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (6% of [A)) $ (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): $