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Home My WebLink AboutPermit Electrical 2019-01-185PRINGTIETD OREGON Web Addressr www.springfield'or.gov Building Permit Email Addressi permrtcenter@spnnqfield-or.gov Permit lssued: January '18, 2019 TYPE OF WORK Category of Construction: Single Family Dwelling Type ot Work: Replacement Submitted Job Value: $0.00 Description of Work: Replace old existing 200 amp panel with new 200 amp panel JOB SITE INFORMATION ' Worksite address 104,1 S 34TH PL Springlield, OR 97478 Parcel 1802062400300 Owner: Address PLOUSE RICHARD W 1041 S 34TH PL SPRINGFIELD, OR 97478 LICENSED PROFESSIONAL INF ORMATION Business name OVVNER - Primary License ccB License number 000000 Phone PENOING INSPECTIONS lnspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical 4225 Service or Feeder lnspection status Pending Pending Pending Pending SCHEDULING INSPECTIONS' Various inspections are minimally required on each proiect and often dependent on the scope of work. Contact the issuing jurisdiction indicated on the permit to determine required inspections Ior this project. Schedule or track inspections at www.buildingpermits.oregon.gov Schedule by phone call 1-888-299-2821 use IVR number: 811075967039 Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store Pormits must be postod in clear visw on the worksite. Permils expire if woJk is not started within 180 Oays ot issuance or if wo* is suspsnded for 180 Days or longsr dep6nding on the issuing agency's policy. All provisions of laws and ordinances govorning this type of work will bo compli6d with whether spocified horein or noL Granting oI a permit doos not prosumo to givg authority to violate or cancel ths p.ovisions of any othsr stato or local law rggulating construction or the performance of construction. ATTENTION - CALL BEFORE YOU DIG: Orsgon law requires you to follow rules adopted by the Orogon Utility Notitication Center. Those rules aro set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of ths rulos by calling ths Csnter at (877) 668{001 or dial Ell. All persons or ontities porforming woik undsr this psrm;t are requirgd to be liconsad unloss sxempted by ORS 701.010 (Structural/Mochanical), ORS 479.540 (Eloctrical), and ORS 693.010{20 {Plumbing). Pnnled on 1/18/19 Page 1ol2 sld_EurldrngPerm _pr tg Residential Electrical Permit Number: I'l 1 -19-0001 25-ELEC IVR Number: 81 1075967039 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54r-726-3753 lnspection group Elec Res Elec Res Elec Res Elec Res Permit Number: 8'l 'l -'19-0001 25-ELEC Page 2 ol 2 Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Quantity 1 Total Fees: Fee Amount $ 109.00 $ s.4s $ 13.08 $127 .53 Pnnted on: 1/18/19 Page 2 012 std_BuildingPennil_pr PERMIT FEES SPRINGTIILD ,% OREGON www.sprin gfield-or. gov Worksile address: lM l S 34TH PL, Springfield, OR 97478 Parcel: 1802062400300 Transaction Receipt 81 1-19-000125-ELEC Receipt Number: 469161 Receipt Oate: 1/18/19 Developm€nt and Public works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@springfield-or.gov Transaction date 1t18119 Units 1.00 Ea Description Services 200 amps or Iess State of Oregon Surcharge - Elec ('12% of applicable fees) Account code 224-00000 426',t 02- 1 033 Fee amount $109.00 Paid amount $109.00 1t18t19 1118t19 1.00 Ea 1.00 Automatic Technology Fee 821-00000-215004-0000 100-00000425605-0000 $13.08 $5.45 $13.08 $5.45 Payment lvlethod Credit card authorization 286350 Payer: richard plouse Payment Amount:$127 .53 Cashier KatrinaAnderson Receipt Total:$127.53 Printed 1/18/19 329pm Pege 1 ot 1 FIN_TransaclionR6ceipt_pr City of Springfield Fees Paid CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Street.Spritrgfield, OR 97477. PI I(541)726-f,753. FAX(541)726-3689 Ent DEPARTMENT USE ONLY Permit no (1{oo lzf-tr' a-,IJ 1q L' This permit is issued under OAR 9l&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 E No CATEGORY OF CONSTRUCTION E) Residential D Govemment ! Commercial JOB SITE INFORMATION AND LOCATION Job site address: 1041 S 34th Place City: Springfield State: OR ZtP:97478 Reference Taxlot.: 1802062 DESCRIPTION OF WORK replace old existing 200 Amp panel with new 200 Amp panel PROPERTY OWNER Name: Rick PlOuSe Address: 1041 S 34th Place City: Springfield State: OR Zw:97 478 Phone .541-228-0315 Fax: E-mail: rick@doublerproducts.com 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 .s40(l) and 479 .s6o(t). Signature: \ ('i: \"<". , -..1 CONTRACTOR INSTALLATION Business name \-.'\(gAddress; City C)State ZIP Phone Fax: E-mail CCB license no BCD license no- Signing supervisor's license no.: Print name ofsigning supervisor: Signature of signing supervisor FEE SCHEDULE Cost€4.Totalcost Residential, per unit, senice included: 1,000 sq. ft. or less (4)$'t 81.00 s Each additional 500 sq. 11. or portion thereof s 3s.00 s $ 43.00 $ $ 85.00 s Serviccs or feeders: r$ tallalion. alteralion. re locat ion 200 amps or less (2)1 s 109.00 s 109.00 201 to 400 amps (2)s127.00 S 401 to 600 amps (2)$2i5-oo $ 601 to 1,000 aJnps (2)s277.00 $ Over 1,000 amps or volts (2)$635.00 $ Reconncct only (2)$ 86.00 $ Temporary ser.yices or feellers'. inslallation. aheration. relocatbn 200 amps or less (2)$ 85.00 s 201 to 400 anps (2)s 118.00 $ 401 to 600 amps (2)$172.00 s Bnnch circuits: nelr, alteration, extension per ponel Each branch circuit S 7.42 s Firsl branch circuit (2)$ 86.00 $ Each additional branch circuit $ 7.42 $ Miscellrneous fces: sentice orfeeder not included Each pump or inigation circle (2)$ 86.00 $ Each sign or ourline lighting (2)s 99.00 $ Signal circuit or a limited-€nergy panel, alteralion, or extension (2)$ 99.00 $ Each additional inspection: (l)s99.00 $ DEPARTMENT USE (A) Enter subtotalofabove fees (Minimum Permit Fee $99.00)$ 101 (B) Enter l2olo surcharge (.12 x [A])$ t,.a9 (C) Technology Fee (5% of [A])${.'(5 TOTAL fees and surcharges (A through D)$ G-7,5 Date: lqo.Number ofinspections per item ( ) Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Over 600 amps or 1,000 volts, see services or feeders sectio[ above a- Fee for branch circuits with purchase ofa service or feeder fee: b. Fee for branch circuits without purchase ofa service or feeder fec: Last edited 7/l/201t BJones -.----;;-* '-. a6a!:r:.s--t4 y = ^-.- ^ 4-:-:-;=:<r -uri:J -Lirul, L!,llLl=,-l-l: =-= -:-:,(jllLrr= r-!IC,11'1.,::::-=l l=r -=,.-r=: J'-JlL l,'- L'ci'r,': -=.r:r: J cwn i:srd: r"t Jr q.lr r::r.t: r,1 :i,: c:,ill:i=i :Ju:. -: ;-,i, ii -1:-,e::r :r.-::;a:-,, I Name E:piraijoft D3te I will inforrn my general contractor L\at all subcontractors who work on t're structure must be licensed wii,h t5e Consti-uction Coniractors Board. ot 1 wiil be performing work on property I own, a resjdence that I reside in, or a residence that I will reside in. lf I hire subcon'rractors, I wili hire only subcontractom ljcensed with he Construction Contractors Board. lf I change my mind and hire a general contractor, I will select a conb-actor who is licensed with the CCB and will immediately give the name of the coniractor to the office issuing this Building PermiL I have read and understand the lnforr-natjon Notice to Homeovyners About Consiruction Rasponsibilitjes, and I hereby certiry that the informatioi'r on this homeowner statement is true and accurate. i( rck?\cu,,e- Print Name of Pennit Applicani l=^{k--\a^^^}!-\-\8 \q Signature oi Pemit Applicant Dare 0r\- tol-Oo0 tlo -elR- Address lssued by:Date+v Permii # q14zl \\'),u\tt l-his Copy ior Permit Oii.'J I I lln I .-.>@ \. 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