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Home My WebLink AboutPermit Electrical 2018-12-10SPRINGII€LD !3 OREGON Web Address: www.springfield-or.9ov City of Springfield Development and Public Works 225 Fifth Street Sp.|ngfield, OR 97477 54r-726 3753Building Permit Residential Electrical Permit Number: 81 1 -1 8-002854-ELEC IVR Number: 81 1015467533 Emarl Address permitcenter@sprin9neld or.gov Pe.mit lssued: December'10. 2018 Category of Construction: Single Family Dwelling Submitted Job Value: S0 00 Description of Work: Remodel bathroom moving outlet Type ot Work: Alteratron JOB SITE INFORi'ATION Worksite address 88 TST Springfield, OR 97477 Parcel 17 03262203873 Owner: Addr€ss: HOLT RANDALL L & CINDY S 88TST SPRINGFIELD, OR 97478 LICENSED PROFESSIONAL INFORMATION Business name OVVNER - Primary License ccB License number 000000 Phone PENDING INSP.ECTIONS lnspection 4999 Final Electricai 4999 Final Eleclrical 4500 Rough Eleclrical lnspection group Elec Res Elec Res Elec Res lngpection status Pending Pending Pending SCHEDULING INSPECTIONS Various inspections are minimally required on each project and oflen dependent on the scope of work. Contact the rssurng 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: 8110'15467533 Schedule using the Oregon ePermitting lnspection App, search 'epermitting" in the app slore Permits must be posted in clear view on the worksite. Permits expire if work is not staned within 180 Days of issuance or if wo.k is suspended for '180 Days or longer depending on the issuing agency's policy. All provisions of laws and ordinances governing this type olwork willbe complied with wheth€r specified herein or not. Granting of a permit does not presume to give authoaity to violate or cancel the provisions of any othea state or local law regulating construction or the performance oI construction. ATTENTION - CALL BEFORE YOU DIG: Oregon law requires you to follow rules adopted by the Oregon Utility Notitication Center. Those rules are set forth in OAR 952-0014010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (877) 668{00't or dial811. All persons or entities performing work under this permit are required to be licensed unless erempted by ORS 701.010 (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing). Pnnied on 1210/18 Page 1 ot 2 sld_Blrld ngPermrl_pr TYPE OF WORK Permit Number: 81 1 -1 8-002854-ELEC Page 2 ol 2 Fee Description Balance of minimum permit fees _ electrical Signal circuits or limited energy panel, alteration, or extension Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Quantity Total Fees: Fee Amount $ 13.00 $86.00 $4.9s $ 11.88 $115.83 1 Prinied on 12110/18 Page 2 al 2 sld_Buildifi gPermrt_pr PERMIT FEES SPRINGFIELD fi OREGON www springfield-or.gov Worksite address: 88 T ST, Springfield, OR 97477 Patcel 1703262203873 Transaction Receipt 811-18-002854-ELEC Receipt Number: 468808 Receipt Date: 12l10/18 Development and Publc Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@springfi eld-or. gov City of Springfreld Fees Paid T.ansaction dato 12t10t18 Units '1.00 Ea 12t10t14 12t10t18 '1.00 Automatic 1.00 Ea Description Signal circuits or limited energy panel, alteration, or extension Balance of minimum permit fees - electrical State of Oregon Surcharge - Elec (12% of applicable fees) Account code 224-00000426102- tO33 Fee amount s86 00 Paid amount $86.00 $13.00 $1 1.88 $13.00 $11 .88 12t10/14 1 00 Automatic Technology Fee 1 00-00000-425605-0000 $4 95 $4 95 Payer: randy holt Payment Amount:$1 15 83 Cashier: Katrina Anderson Receipt Total:$115.83 Printed 12110/18 11 31 am Fl N_TransacllonRec€rpt pr 224 -OOOOO - 426 I 02 -',! O33 821-00000-215004-0000 Paymeni Methodr Credit card authorization 420750 CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Street. s pri ngfield. OR 97{77 r PH(541)726-3753. FAX(541)726-36E9 This permit is issued under OAR 918-309-0000. Permits are nontransf€rable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days, FEE SCHEDULE Number of inspections per item ( )Qty.Cost ea, Totalcost Residential, per unit, service included: 1,000 sq. ft. or less (4)$181.00 $ Each additional 500 sq. fl. or portion thereof $ 3s.00 S Limited energy (2)$ 43.00 $ Ilach manufactured home or modular dwelling service or feeder (2)$ 86.00 $ S€rvices or fecders: instollalion. alteration. relocalion 200 amps or less (2)$ 109.00 s 201 to 400 amps (2)$'r27.00 $ $21s.00 $ 601 to 1.000 arnps (2)s277.OO $ Over 1,00O amps or volts (2)s635.00 $ Recornect only (2).$ 86.00 $ Tcmporrry scrvicca or fecdcB: iniral/alion" aheration, relocalion 200 amps or less (2)$ 86.00 $ 201 to 400 arnps (2)$ 118.00 $ ,101 to 600 amps (2)$172.00 $ Oyer 600 amps or 1,000 volts, see services o. fe€ders section above Branch circuits: rrele, altetation, ealension per panel a Fee for branch circuits with purchase ofa servicc or feeder fee Llach branch circuit S 7.42 $ b. Fee for br"anch circuits wilhout purchase ofa service or feeder fee First branch circuit (2)$ 86.00 S Dach additional braich cicuit s 7.42 $ Miscellaneous fees: renice or lbe.ler not included Each pump or irrigation circle (2)$ 86.00 $ Each sign or outline lighting (2)$ 99.00 s Signal circuit or a limited-energy paoel. altcration, or extension (2)$ 99.00 'qq Each additional inspcctiotr: (l)Ssg.oo $ OEPARTMENT USE (A) Flnter subtotal ofabove fees (Minimum Permit Fe€ $99.00)'q1 (B) Enter l2olo surcharge (.12 x [A])$ (C) Technolos/ Iree (sglo of[A])5, TOTAL fees and surcharges (A through D):$ Irtb3 h LOCAL GOVERNMENT APPROVAL Zoning approval verified? ! Yes E No pliesidential fl Govemment ! Commercial JOB SITE INFORMATION AND Job site address I r )State:-zw:\/<l 7) Refere ce Taxlot. DESCRIPTION OF WORK 0 /.t J lO 4;^.-- OPERTY OWN Name 4.1 tt +-€ Ci st"t": D li ztP:\Zq? 7 Phone t-fLt (-7Jl E-mair:ff ulrf ho({FC.*"ot{,n. l This installation is being made on residential or farm property owned bv me or of my immediate family. This propertli is not d for sa lease, or rent. OAR 479.540( 1)79.s60(l). Signature CONTRACTOR INSTALLATION Business name Address N C ity:ZIP: Phone:Fax E-mail: -I BCD license no.: Signing supervisor's license no Print name ofsignirg supervisor Signature of signing supervisor: DEPARTiIIENT USE ONLY tboo2854 (o lrBlA\ Lrsi edited 7/l/2018 BJoDes Permit no.: Date: lAddr.rr,( CATEGORY OF CONSTRUCTION ,,1 w L Fax: ( zl-l('-s.E>- n-Y t, CCB license no.: 401 to 600 arnps (2) I -,-=4-;.. -r. .-a. =r=-^.----:-.-.:'-illI i v juil! tJri,,-. E_La-;=. 'e... R =e r = i' r'i i n n 5 6 n = i au eu i o :--' F.- e-< c + i: s i r i i i t r =s aoi'tsir ucLioo Ccntracicr-s acaia itr sign tiie iclloiq.inq st:i=meit beior: a tuiiiing pemii can ce ':sr-L l-''i: !r i-ar- + I have read and understand the lnformatjon Notjce to Homeowners About Consiruction Responsibilities, and I heraby certiry th3t the informatjon on this homeow er sEtemeot is true and accur3te. J :v\,-. -:s,C: .: ,t t i'i=:r.-j: .i ,-,i car:r-.p:i:J ::iLli:.,;: ;,-,: :,. ::-,e-=j i.r-,::;c.i.r i: Name Expiration Date I will inform my generai contractor that all subcontractors who work on the structure must be licensed wiiir i\e Construction Coniractors Board. OT V7 /2-(e-P DaI: Q1,,,*h5 )a*.t/*J" 8T8- bLq1111 Permit # Address: This Copy for Permit Oific3s I lwiil be performing work on property I own, a resjdence that I reside in, or a residence that lwill reside in. lf I hire subcontractors, I will hire only subcontractorc licensed with the Constructjon Confactors Board. lf I change my mind and hire a general contractor, I wiil selecl a contractor who is ljcensed wiLS the CCB and will immediately give the name of 'r,he contractor to the ofllce issuing this Building Pemit { tr fr C*l-L-.a ) .( Signature oi Pemft Applicant I ,*,* *, dfr d;"," le I r o \ la