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Home My WebLink AboutPermit Electrical 2019-09-03B u ild in g Pe rm it Residential Electrical Permit Number: 811-19-002033-ELEC IVR Number: 811048067638 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Web Address: www.springfield-or.gov Email Address: perrnitcenter@springfield-or.gov Permit Issued: September 03, 2019 Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Fireplace outlet, room outlet, garage lights & outlets, bathroom fan Type of Work: New Worksite Address 2797 3RD ST Springfield, OR 97477 Parcel 1703233405000 Owner: Address: ROTH JEFFREY J & STACY P 87310 CEDAR FLAT RD SPRINGFIELD, OR 97478 Business Name OWNER - Primary License CCB License Number 000000 Phone Inspection Inspection Group Inspection Status 4999 Final Electrical Elec Res Pending 4999 Final Electrical Elec Res Pending 4500 Rough Electrical Elec Res Pending 4250 Branch Circuits Elec Res Pending 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 Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811048067638 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire If work Is not started within 180 Days of Issuance or If work Is suspended for 180 Days or longer depending on the Issuing agency's policy. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (503) 232-1987. All persons or entitles performing work under this permit are required to be licensed unless exempted by ORS 701.010 (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing). Printed on: 9/3/19 Page 1 of 2 C:\myReports/reports//production/01 STANDARD .•.. Q. ·- a, (.) a, 0:: C 0 ;:; (.) cu ,n C cu ••• I- 0 w ..I w I C") C") 0 N 0 C? 0, 'I"" I 'I"" 'I"" co r-- r-- v r-- 0 ) a:: 0 ~ O> ..: 0 "'Cl Q) I;:: O> C: ·c: C. i .. C 0 ::::, 0 0 . E l,; l'O Cl) "Cl ~ .. C 0 ::::, 0 0 . E l,; l'O Cl) GI if ! z, §0 0 0 C\i s l'O "Cl C 0 +I CJ : a, c ~ l'O C') ~m 0 0 ori Cl) 0 0 ori Cl) C') C') 0 .,.... I N 0 .,.... <D N ~ 0 0 0 9 v N N "' Q ) -2! - 0 ~ C: 111 iii cc 0 ~ E 0 :5 <{ 0 0 a, .,.... - ~ 0 0 0 9 ~ 0 U") .,.... N I 0 0 0 0 9 .,.... N CX) 0 Q ) iii 111 w 0 0 0 0 ~ U") 0 <D U") N "'f 0 0 0 0 6 0 3l LL >, O> 0 0 C: .c 0 {!!. 0 :; E .s :::, <{ 0 ~ "E :::, 0 ~ c Q ) E >, 111 a.. a.. >- u ~ o(! -, ~ 0:: LL LL w -, :c b a:: C: 0 ~ N ·c: 0 £ :::, 111 "E 111 0-c :t:::N "C 0 Q ) 0 •... a, U o "O 0 .c Q) ~ c Q ) E >, 111 a.. •... Q. _, Q. -~ 0:: C 0 ., s ., C I!! ~I ;:;: 0 ., g> Q. C: 0 ~ Q ) "C C: <{ 111 C: ·c: ~ E le c tr ic a l P e r m it A p p lic a tio n DEPARTMENT USE ONLY CITY OF SPRINGFIELD, OREGON 225 Fifth Street+Springfield, O R 97477+ PH(S41)726-3753+ FAX(541)726-3689 Date: q 31 l This perm it is issued under O A R 918-309-0000. Perm its are nontransferable. Perm its expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ----- -cc LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? 0Yes 0No Namber of inspections per item ( ) Qty. Cost 'l)ttal ea. cost ... CATEGORY OF CONSTRUCTION Residential. per unit, service included: ®Residential I D Government I D Commercial JOB SITE INFORMATION AND LOCATION 1,000 sq. ft. or less (4) $186.00 $ Job site address:7JC,7 ~~!:) ~.- Each additional 500 sq. ft. or portion $36.00 $ thereof City: ~Pr)) I State: d<-.. I ZIP:q 7 'f T. Limited energy (2) $44.00 $ Reference: I Taxlot.: Each manufactured home or modular DESCRIPTION OF WORK . dwelling service or feeder (2) $89.00 $ f,:")~O ,,i,. :-:- (!)t_7rJ ~:+- ...,,.,i.~ I /?,i. :1f'1 ,.e-j Services or feeders: installation, alteration, relocation "'-"'~ C:JWzl:v~ I 1/-..J~ ~,A- .,,.-1 ~- 1'7~~ I .~ lJ 200 amps or less (2) $112.00 $ -~ PROPERTY OWNER , ., 201 to 400 amps (2) $131.00 $ Name: . "\"P ..... n°Z.£'-( ~r 401 to 600 amps (2) $221.00 $ Address: ::J.:1 '17 ~,- s, 601 to 1,000 amps (2) $285.00 $ City: 7F7<-t) I State: /5\J2_J z1~7'-\T) Over 1,000 amps or volts (2) $654.00 $ Phone:9\t ~ ~ I Fax: - - Reconnect only (2) $89.00 $ E-mail: ••• \ ~· YR~ - ~~ ~~ ~(, f\.,e:?.- Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less (2) $89.00 $ owned by me or a member of my immediate family. This 201 to 400 amps (2) $122.00 $ property is not int~~'· o, rent. OAR 479.540(1) and 47 . 6 (l 401 to 600 amps (2) $177.00 $ Signature: . l - Over 600 amps or 1,000 volts, see services or feeders section above - I UK" INSTALLATION ./ Branch circuits: new, alteration, extension per panel . 7 a. Fee for branch circuits with purchase of a service or feeder fee: Business name: - - u ,/ - Address: r----..A A. 7 ~ Each branch circuit $8.00 $ City: c-7 - I State: I ZIP: b. Fee for branch circuits without purchase of a service or feeder fee: Phone: - - I Fax: - - First branch circuit (2) ' $89.00 $ E-mail: Each additional branch circuit I $8.00 $ CCB license no.: I BCD license no.: Miscellaneous fees: service or feeder not included Signing supervisor's license no.: Each pump or irrigation circle (2) $89.00 $ Print name of signing supervisor: Each sign or outline lighting (2) $89.00 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, $89.00 $ alteration, or extension (2) Each additional inspection: (I) $102.00 $ DEPARTMENT. usetll!; - (A) Enter subtotal of above fees $ (Minimum Permit Fee $102.00) (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of[A]) $ TOT AL fees and surcharges (A through D): $ \l C,. ~·~ Last edited 7/1/2019 BJones ·, Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) ' This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed arch_itect and engineer applicants, exempt from licensing un·der ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: D I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date D I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or ~ 1 will be performing work on property I own, a residence that I reside in, or a residence that I will 7f ~eside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. ~ - Print N a m e of Permit Applicant ~~- Permit#: Address: Issued by: _ Date: _ This Copy for Permit Offices