HomeMy WebLinkAboutPermit Electrical 2019-10-10SidI NSri[til
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0ilidsi{Building permit
Residentia I Electrical
Permit Number: BLJ--L}-OO2326_ELEC
IVR Number: 811033892719
Type of Work: New
City of Springfietd
Development and public Works
225 Fifth Street
Springfietd, OR 97477
547_726_3753
Email Address: permitcenter@springfield-or. gov
Web ACdrcss: www.springfield_or.9ov
Permit Issued: October 10, 2019
De
' .,ry of Con,,i:-Lrction: Single Family Dwellingrittc(l Job r.,,.lrrc: $0.00
"'ption of Work: New subpanel and branch circuits
Worksite Address
2558 GRAND VISTA DR
Springfield, OR 97477
Parcel
1703243 10 1 100
Owner:
Address:
WALTON LIVING TRUST
2558 GRAND VISTA DR
SPRINGFIELD, OR 97477
Busincss Name
M2 t'I I CTITIC IIC Prima ry
License
CCB
License Number
2L8413
Phone
541-401- 1565r
Ir' 't ' I
4l l::rra.(,,.
49 ' r:ll i{:ti- cal
421' i'icc'.lc".l S,trvice
42\ ) :,',t.rrl.ir Circu,ts
Inspection Group
Elec Res
Elec Res
Elec Res
Elec Res
Inspection Status
Pending
Pending
Pending
Pending
Pertr,
the i
All p
Grar.
reg '
A.I ]
fort
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v.rirri,s iilspectiox:t arc rnirrirrrally 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.
Sch erl u le or track i nspections at www. build ingpermits.oregon,gov
(-,r I .r tcxt. thc rvord "schedule" to 1-BBB-299-2821 use IVR number: 811033892719
!.lcl'rcCLrlc using the Oregon ePermitting Inspection App, search "epermifting" in the app store
r:> l,irr: if w,,rk is not startc(r !vithin lBo Days of issuance or if work is suspended for 180 Days or longer depending on
irrcl ;. rIrr:y's Itolicy.
':!i(r,rs of I;r.s :rnd or Jinanccs governinn this type of work will be complied with whether specified herein or not.
) ' .: ot.. inir (, )(:s not t)rcsumc to giv,, authority to violate or cancel the provisions of any other state or local law
- ({rilrriLt. ri(r,1 or tl\-r t-riorrfirrrcg r 1 rrtstruction,
IaN: a:r,!o,r llqll,ll,ircsyoutofollotrrulesadoptedbytheOregonUtilityNotificationCenter'Thoserulesareset
. ( 'F ! 2-O I I -0J10 through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (5O3)
)nri lr ,rntiti..s perfornring work undcr this permit are required to be licensed unless exempted by ORS 701.O10
r irl/':lcclrarrical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing).
Pr in:Page 1 of 2 C : \myReports/reports//production/01 STANDARD
TYPE OF WORK
JOB SITE INFORMATION
LICENSED PROFESSIONAL INFORMATION
PENDING INSPECTIONS
SCH EDULING INSPECTIONS
Perrrrit Nunrber: 81 1-19-O02326-ELEC Page 2 of 2
Fee ncscription
Branch circuits vrith service or feeder each circuit
Servircs 20C amps or less
Tecl"r nolog.y Fcc
Stati: of Oregon Surcharge - Elec (12olo of applicable fees)
Printea .'r: 10/1 !/19
Quantity
Total Fees:
Fee Amount
$32.00
$ 1 12.00
$7.20
$17.28
$ 168.48
4
1
C :\mvReports/reports//production/01 STANDARD
Page 2 ol 2
PERMIT FEES
*?*N1rl"rL,
fie60il
ry',r",v. s P ri n gfield-or'gov
Worksite address: 2558 GRAND VISTA DR, Springfield, OR97477
P ar cel'. 17 032431 0 1 1 OO
Transaction Receipt
81 1-1 9-0C2326-ELEC
Receipt Number: 472664
Receipt Date:10/10/19
City of Springfietd
Develcpmcnt anC public Works
-^--._:a, Fifrh streetrPrrr i9rlCld, OR97477
s4 1_726_3753permitccntcr@spri n gField_or. gov
Fees Paid
Transaction date
$t1ot19
$110119
rcl1Ol19
rcl1Ol19
Units
I,UU trA
4.00 Qty
100 Ea
.1 .00 Automatic Technology Fee
Description
Services 2C0 amps or less
Branch circuits with service or feeder each
circuit
State of Oregon Surcharge - Elec (12o/o of
applicable fees)
Account code
224-CO000-426 1 02_1 033
224-00000-426'1 02- 1 033
82 1 -OO000-21 5004-0000
204 -00000-425605-0000
Fee amount
s112 00
$32.00
$17 28
$7 20
Paid amount
s112.oo
$32 0o
$17 28
q7.^
payment Method: Credit card authorization Payer: M2 ELECTRIC LLC Payment Amount:
Receipt Total
$1 68 48
$16s.48Cashier: Katrina Anderson
Printed: 10/10/19 3:53 pm Page 1 of 1 FIN_TEnsactionReceipt
pr
\trt
Electrical Permit A cation
225 Fifth Street.Springfield, OR 97477. PH(541)726-3753. FAX(541 )726-3689
This permit is issued under OAR 9f 8-309-0000. Permits are nontransferable. Permits expire if work is not started within 1E0
days ofissuance or ifwork is suspended for 180 days.
FEE SCHEDULE
Number of inspections per item ( )Qty.Cost
ea.
Total
cost
Residential, per unit, service included:
1,000 sq. ft. or less (4)$186.00 $
Each additional 500 sq. ft. orportion
thereof $36.00 $
Limited energy (2)$44.00 $
Each manufactured home or modular
dwelling service or feeder (2)$89.00 $
Services or feeders: inslallation, aheration, relocation
200 amps or less (2)I $l12.00 s ll,/.tu
201 to 400 amps (2)$131.00 $
401 to 600 amps (2)s221.00 $
601 to 1,000 amps (2)$28s.00 s
Over 1,000 amps or volts (2)$654.00 $
Reconnect only (2)$89.00 $
Temporary services or feeders: installation, alteralion, relocation
200 amps or less (2)$89.00 s
201 to 400 amps (2)$122.00 $
401 to 600 amps (2)$177.00 $
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 ofa service or feeder fee:
Each branch circuit I $8.00 $.3L
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)$89.00 $
Each additional branch circuit $8.00 $
Miscellaneous fees: sem'ice orfeeder not ittcluded
Each pump or irrigation circle (2)$89.00 $
Each sign or outline liehting (2)S89.oo $
Signal circuit or a limitcd-cncrgy pancl,
alteration, or extension (2)$89.00 s
Each additional inspection: ( I )$102.00 S
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.00)
$
(B) Enter 120% surcharge (.12 x [A])$
(C) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through D):$lb?.Ltt
0n,
DEPARTMENT USE ONLY
Permirno.: n OjVZXI-&
Date:lo (to r1
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? E Yes E No
CATEGORY OF CONSTRUCTION
D Commercial(Residential ! Government
JOB SITE INFORMATION AND LOCATION
Job site address 2rfP, GranA l/,'cln Dr
State: ()fi zrPel7y77
Referen[e: I Taxlot.
DESCRIPTION OF WORK
\v
PROPERW OWNER
Name:r
)a'acAddress:
State:)Q nP:q2y77City:
a
Phone I Fax
E-mail:
This installation is being made on residential or farm properry
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(t) and 479.560( I ).
Signature:
CONTRACTOR INSTALLATION
Business name ru ] Ekr*a'r
Address:
State:(2(l nP:q2306City1-
Yhonedll- yAl -/ {AS Fax:
E-mail
CCB license no., )\fr111 BCD license no.: ( - l\y2
Signing supervisor's license no.: 62i't :
Print name of signing supervisor: f)4ark /h "Ch p lh"l
Signature of signing supervisor:k
Last edited 7/l/2019 BJones
CITY OF SPRINGFIELD, OREGON
City: 5Od ^,- 6C1,
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