HomeMy WebLinkAboutPermit Electrical 2018-09-28SPRINGFIELO
oR6GON
Web Address: www.spriogrieE or.90v
Building Permit
Rssidential Electrical
Permit Number: 81 1 -18-00231 2-ELEC
IVR Number: 81 1097926541
City of Springfield
Development and Publrc works
225 Fifth Street
Spnngfreld, OR 97477
547-126 3153
Email Address: permitcenter@springfleld or.gov
Permit lssued: September 28, 2018
TYPE OF WORK
Category of Construction: Single Family Dwelling
Submitted Job Value: $0.00
Oescription of Work: New service
Type of Work: New
JOB SITE INFORMATION
Parcel
'1703351414800
MILLER ANGELA
330 NORTH FREMONT
SAN IUATEO, CA 94401
LICENSED PROFESSI RMATION
Businass name
GREEN ELECTRIC LLC - Primary
Licens€
CCB
License number
208771
Phone
541-28545/.7
PENDING INSPECTIONS
lnspsction
4999 Final Electrical
4225 Service or Feeder
lnspection group
Elec Res
Elec Res
lnspection status
Pending
Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing
jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Schedule by phone call 1-888-299-2821 use IVR number 81'1097926 1
Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store
PERMIT FEES
Fee Description
Services 200 amps or less
Technology Fee
State of Oregon Surcharge - Elec (12olo of applicable fees)
Total Fees:
Quantity
1
Fee Amount
$109.00
$5'45
$ 13.08
$127 .53
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting oI
a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating constructaon
or the performance oI construclion.
ATTENTION - CALL BEFORE YOU DIG: Oregon la\fl rcquires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules are set forth in OAR 952{01{010 through OAR 952{01-0090. You may obtain copies of the rules by calling the Center at
(877) 568{001 or dialS'll.
All p€rsons or entities performing work under this permit are requir6d to be licensed unless exempted by ORS 701.010
(Structural/Mechanical), ORS 479.540 (Elect.ical), and ORS 693.010{20 (Plumbing).
Pnnled on 9/28/18 Page 1 ol 1 sld_BuildingPemil_pr
, t,z
Worksite address
1069 C ST
Springfield, OR 97477
Owner:
Address:
Permits must be posted in clear view on the worksite. Permits expire if work is not staned within 180 Days of issuance or if work is
suspended for 180 Days or longer depending on the issuing agency's policy.
ffi 8r r-t 8{02312-ELEC
Receipt Numberi 468'183
Receapt D.te: 9/28/t8
oeve opment and P!blrc lrorks
225 Fifth str*t
spn.9neld, oR 97477
a4t-726 3753
perm tcenter@span9ne d-or qov
Transaction Receipt Cily of Springfield
www.spnnqaeld-or 9ov
Worksile address: 1069 C ST, Springfield OR 97477
Parcel 1703351414800
Fees Paict
912U1A Services 200 amps or less 224-00000-4261 02-1 033 s109 00 $109 00
9t2a11A
9t28t1A
100 Ea
1 0O Aulomali€ Technology Fee
Stats ol Orggon Surcharge - Etec 11216 ol 821,00000,215004-0000
10G000001125605 0000
$13 08
$s 45
$13 08
$s 45
Paymenl Method Cash
TransacrDn commeni $r40 cash
change S12.47
E127 53
Cashler KatrinaAnderson $127.53
FN-T6.s.c1pnRe€lpi-,1
1.00 Ea
CITY OF SPRINGFIELD, OR.EGON
Electrical Permit Ap lication
Address: ! lo
Citv
b w-n"wt tl
Fa)i
BCD license no
3
Over I,000 amps or volts (2)
pump or irrigation circle (2)
s63s.00
s 86.00 !
s 99.00
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ffi225 Fifth Street. SpriDgfield. 0 R 97,177 a PH(541 )726,3 753 t FA X(54 I ) 726-3689
This permit is issued uoder OAR 918-309-0000. Permits are nontransferable. Permits expire if work is trot started withitr 180
days ofissuaoce or if work is suspended for 180 days.
Residential. per uDit. senice included:
Services or feeders: insrallation. alteration relocation
s
S
15
S
s
s
E-mail
This installation is being made on residential or farm properq
owned by me or a member of my immediate family. This
propenv is not intended for sale, exchange, lease. or rent. OAR
479.540(l ) and 479.560(l).
Signature:
Business name
Address h/
statet O{-ZD
Temporar] services or feeders. installation. aheration. rclocation
200 amps or less (2)s 86.00 5
s
Over 600 amps or 1.000 volts. see services or feeders section above
Branch circuits: ne,i alteration extension pet panel
a. Fee for branch circuits witb purchase ofa senice or feeder fee
Each branch circuir !
First br"nch circuil (2)!
Each addidonal branch circuit
Miscelleneous fees: s€nice or feeder not included
$ 86.00Phon
i Siening supervisor's license no
I Print name of signmg supervrsor
Signatue of signing superv
. Lach
Signal circuir or a limired-energ) panel
altemlion. or extension (:l
Each additiotral insp€ctiotr: (l )
DEPARTMENT USE
(A) Enter subrcral ofabove fees
(Minimum Permit Fee 599.00)1,1
\2-t?
DEPARTMENT USE ONLY
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? ! Yes E No
CATEGORY OF CONSTRUCTION
E{esidential ! Government I Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: lQ[ ( L (+
City: !17n'yy[;7.[/State: dh ztPt qtt++
Reference lTaxlot.
I
DESCRIPTION OF WORK
PROPERW OWNER
\rame 'lLer
ZrP:Qaq ICitr5n^ Art ctko State: (rt
Phone: 6tO ttto GLI-L Fa>(
t'{a),LdttE-mail71+€.,5
CCB license no
CONTRACTOR INSTALLATION
FEE SCHEDULE
Total
costNuEber of itrsp€ctiors per ite6 ( )
1,000 sq. ft. or less (4)
Qtr'
s181.00
Cost
ea.
s 3s.00Each additional 500 sq. ft. or ponion
Limted energ) (2)s 43.00
Each manufactured home o, modular
dwelling service or feeder (2)s 86.00
200 amps or less (2)$ '109.00
201 to 400 amps (2)l 5127.00
401 to 600 amps (2)
601 to 1.000 arnps (:)
Reconnect onl) (2)
$277.00
S
$ 1,18.00201 to 400 arnps (2)
s172.00401 to 600 amps (2)
s 7.42
s 7.42 s
5 99.00Each sign or outline lighting (2)
s99.00
S(B) Enrcr l2% surcharge (.12 x [A])
$lD.<1TOTAL fees and sucharges (A through D)
Lesr edited 7/l/201E Blones
(C) Technolos Fee (5% of [A])S
Permit no.:/I rc?\D-
1""., ,rli El t e I
$
$
s2is.oo ls
$ 86.00
b. Fee for branch circuits without purchase ofa service or feeder fee:
S