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Home My WebLink AboutPermit Electrical 2019-12-11SPRINGFIELD $ OREGON Web Address: www.springfield-or. gov Building Permit Residential Electrical Permit Number: 81 1-19-OO2758-ELEC IVR Number: 811011318234 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address : permitcenter@springfield-or.9ov Permit Issued: December 11, 2019 Category of Construction: Other Submitted Job Value: $0.00 Description of Work: Electrical for new ADU Type of Work: New Worksite Address 1308 F ST Springfield, OR 97477 Parcel 1703362208000 Owner: Address: ROTHMAN DAVID E 1306 F ST SPRINGFIELD, OR 97477 Business Name OWNER - Primary License ccB License Number 000000 Phone Inspection 4999 Final Electrical 4500 Rough Electrical 4250 Branch Circuits Inspection Group Elec Res Elec Res Elec Res Inspection Status Pending Pending Pending permits expire if work is not started wlthin 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 provasions 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-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (503) 232-L987. All persons or entities performing work under this permit are required to be licensed unless exempted bY ORS 7O1.O1O (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 593.o10-O2O (Plumbing). Printed onr L2llL/19 Page 1 of 2 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: 811011318234 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store C: \myReports/reports//production/01 STAN DARD [ ^r, TYPE OF WORK JOB SITE INFORMATION LICENSED PROFESSIONAL INFORMATION PENDING INSPECTIONS SCHEDULING INSPECTIONS Permit Number: 811-19-002758-ELEC Page 2 of 2 Fee Description Branch circuits with service or feeder each circuit Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (t2o/o of applicable fees) Printed on: L2lLU79 Quantity Total Fees: Fee Amount $96.00 $ 112.00 $10.40 $24.96 $243.36 L2 1 Page 2 of 2 C:\myReports/reports//production/o 1 STAN DARD PERMIT FEES SPRINGTIELD {rt OREGON www.sPringfield-or. gov Worksite address: 1308 F ST, Springfield, OR97477 Parcel: 1 703362208000 Transaction Receipt 8t l-19-002758-ELEC lVR Number: 81 10t1318234 Receipt Number: 473260 Receipt Date:12111119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 perm itcenter@spri n gfi eld -or. gov Transaction Units date 12111119 1.00 Ea 12t1'U19 12.00 Qty 12t',t1119 1.00 Ea Description Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge - Elec ('l2o/o ol applicable fees) 224-00000-4261 02- I 033 224-00000-4261 02- 1 033 82't -00000-21 5004-0000 204-00000-42560s-0000'tzt11t19 1.00 Automatic Technology Fee Fees Paid Account code Fee amount $112.00 $96.00 $24.96 $10.40 Paid amount $112.00 $96.00 $24.96 $10.40 Payment Method: Check number: 1634 Payer: ROTHMAN DAVID E Payment Amount:$243.36 Cashier: Katrina Anderson Receipt Total:$243.36 Printed: 12l11/19 1:23 pm Page 1 of 1 Fl N_Tra nsactionReceipt_Pr [r.r CITY OT SPRINGFIELD, OREGON Electrical Permit 2!i Ftnn $rcctoSFiryfi.l{ OR nln.tffi(54ll't2C375toFAX(Slt)ltrHi689 Ttfu pcr6ia b i$ucd rndcr OAR,9lh30t}{00lt Pcrmia rc nontrut'cn&. Pcruitt crtrlirc if rortL rot rhrtcd rihir l& drys of ircuracc or if rort ir surpcded for ltO dey* SPETf,GFTELD ;{tr LOCAL GOVERilIENTII Tot@apprcval verified?es fl N" CATEGORY OF CONSTRUCTPII n#*iA.",i"f E Goveromcnt tr Commsrcial STTE Alto Job sir address: / 3OB tjfud Cit),:staeP/(m.17471 Referelncc: t't Taxlol: DESCRIPTK)il OF WORK ,1ua u PROPERTY Owl{ER Name: DaVe- Rohrnar'1 Address: t3O6 7 Sfreet 4 Statc: 6 K m,9)1177 Phonc:s Fax: E-mil: This installation OAR Business name: Addrqs: State:ilP: Phone:Far-7 E-mail: CEB licensero.:BCD liccnse no.: Signing sqrernisor's liccnse no-: Print name of signhg sq€rvisoc Signatre of signing srryervisor: FEE SCHEDULE Nrnbtr of iupoctfrmr pcr itco ( )qY-u. Gr- Totrl cod Rcdehntid, pcr nnit scrvicc irduded: 1,0([ sq. n. orlcss (4)*srff.00 S Each dditional 5(X) sq. ft. cportion thcrcof s:t5.00 s Limitcd e,ncrry(2)s44.00 S Each mmufaaurcd hoc omodular arding scrvicc or fudcr (2)3Ar-00 $ 2fl)arys orlcss (2)$1u.00 t ll4z 201to400aryo(2)sr3l.00 $ 401 to 6fi) amps (2)$i22r.00 $ CIt to l,0t0qs(2)s2t5.00 3 Ovcr 1,0(X) qs or volts (2)s65{.00 $ RccotrGtmly(2)$!r.m 3 Tc4orery rcrvkrcr or ftedcn: instollation altaatior, rclmtioa 2(X)a4s orlcss (2)$t9.00 s 201 to 4m errps (2)31220 $ 'l0l to60Oqs(2)sr77.00 3 Over6{X)arys q 1,0fl) vohs, scc salticca or feedcrs sectio r6ove Bruch circrifr: new, aheratiot\ atansion p' pnel a Fce for broch circnir *ftl pndasc of r scrvbc c fccdcr fcc: Each brech cfucuit IL st.00 Qlo b. Fcc for b,ranch circuits without Pllrchlsc of a servicc cldcr fec: First brmct circuit (2)sat.00 S Esch edditi@l brach circtir sE.00 S Mircctrrpor fa: scmicc or@e not bchdd Each prry orinigatio cfucle(2)$t Jo s Eac[ sipcodinc lig[thg (2)$9.m s Sipal cinuit q a limitedaergy pmel altcrmiou or occosion (2)srr.00 3 Erch edditioul ixPcaioa: (l)$TOLG $ DEPARTHENT rrsE (A) Errt.r$b,ot l ofaborrc Scs 0Urumr PcndtFcctl0t0C)'a0% (B) Entcr lX6 smchargs (-12 x [AJ)sltqu (C) TcchmlogFcc (sPl. of [AD $D D TOTAL fecs amd surchrgss (A tkottghD):$ ).t1,1( , + lkrc {.k.(',*to'' 1-o fi7n "/{ DEPARTTEffT USE OTTILY pqmito"., fr _A)"+ES:L Date: I I It r1 Iflt cdited 7fll2019 Eloocs Scrvitrs or fccdcrs: instollation, attaution, rdocotion )VAL r d or frrm ormeoumed family. 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 (2ll I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. T. {?rJil^^"*,^ Print rmitApplicant Applicant ta\,'. \r r of Date This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB#Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that lwill reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf I change my mind and hire a general contrac{or, 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. Permit #: t\\1lssued by: i G(L Date. }?SID Address: \n-t\t\30 This Copy for Permit Offices l ir)/\; ),/ l\ Y \rt</'/t\'ev1^<r)z \2\