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Home My WebLink AboutPermit Electrical 2019-12-300REG0r{ Web Address: www,springfield-or.9ov Building Permit Residential Electrical Permit Number: 81 1-19-OO2539-ELEC-Ol IVR Number: 81 1021383938 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address: permitcenter@springfield-or.gov SPRINGFIELD .w Permit Issued: December 30, 2019 TYPE OF WORK Category of Construction: None Specified Submitted Job Value: $25,000.00 Description of Work: Garage conversion into habitable space. Type of Work: None Specified Worksite Address 6895 C ST Springfield, OR 97478 Parcel 1702353202900 Owner: Address: Owner: Address: BELLINA GIANNINA MARIA 6895 C ST SPRINGFIELD, OR 97478 BELLINA JOSE A 6895 C ST SPRINGFIELD, OR 97478 None Specified PENDING INSPECTIONS Inspection 4999 Final Electrical 4500 Rough Electrical Inspection Group Elec Res Elec Res Inspection Status Pending Pending Permits expare if work is not started within l80 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-OO1-001O through OAR 952-O01-0090, You may obtain copies of the rules by calling the Center at (5O3) 232-L947, All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701,010 (Structural/Mechanical), ORS 479.54O (Electrical), and ORS 693.O10-020 (Plumbing). 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 prolect. Schedule or track inspections at www.buildingpermits.oregon. gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811021383938 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Printed on: L2l3Ol19 Page 1 of 2 C ; \myReports/reports//productron/0 1 STAN DA RD JOB SITE INFORMATION LICENSED PROFESSIONAL INFORMATION SCHEDULING INSPECTIONS Permit Number: 811-19-OO2539-ELEC-01 Page 2 of 2 Fee Description Branch circuits without service or feeder Technology Fee State of Oregon Surcharge - Elec (L2o/o of applicable fees) Printed on: 12/30/L9 Quantity Total Fees: Fee Amount $ 10s.00 $5.2s $ 12.60 $ 122. B5 3 Page 2 of 2 C | \myReports/reports//productron/0 1 STAN DA RD PERMIT FEES SPRIN6TIELD se OREGOI{ www. springrield-or. gov Worksite address: 6895 C ST, Springfield, OR 97478 Parcel:'t 702353202900 Transaction Receipt 81 1 -1 9-002539-ELEC-01 IVR Number: 81 1021383938 Receipt Number: 473400 Receipt Date: 12130/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 perm itcenter@springfield -o r.9 ov Transaction Units date 12130t19 3 00 Qty Description Branch circuits without service or feeder State of Oregon Surcharge - Elec (12o/o ol applicable fees) 224-00000-4261 02- 1 033 821 -00000-21 5004-0000 204-00000-425605-0000 12t30t19 1,OO EA 12t30t19 1.00 Automatic Technology Fee Fees Paid Account code Fee amount $105.00 $12.60 $5.25 Paid amount $1 05 00 $12 60 $5.25 Payment Method: Credit card authorization: 01 09't d Payer: BELLINA JOSE A Paymenl Amount:$1 22 85 Cashier: Katrina Anderson Receipt Total:$122.85 Printed; 12130/19 1 1:40 am Page 1 of I Fl N_Tra nsaction Receipt_pr CITY OF SPRINGFIELD, ORBGON Electrical Permit A lication 225 Fifth Streeto Springfield, oR 97477rPH(541 )726-3753oFAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. FEE SCHEDULE Number of inspections per item ( )Qty Cost ea. Total cost Residential, per unit, service included: 1,000 sq. ft. or less (4)$r86.00 $ Each additional 500 sq. ft. or portion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders: instollatiou, alteration, relocation 200 amps or less (2)$l12.00 s 201 to 400 amps (2)$I31.00 $ 401 to 600 amps (2)$22r.00 $ 601 to 1,000 amps (2)$285.00 $ Over 1.000 amps or volts (2)$6s4.00 $ Reconnect only (2)$89.00 $ Temporary services or feeders: iustallotion, alteratiotr, relocation 200 amps or less (2)$89.00 $ 201 to 400 amps (2)$122.00 s 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 $8.00 $ b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2)\$89.00 $ Each additional branch circuit L s8.00 $lb Miscellaneous fees: service orfeeder not included Each pump or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$89.00 $ Signal circuit or a limited-energy pancl, alteration, or extension (2)$89.00 s Each additional inspection: (l)$102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)'[o{ (B) Enter l2%osurcharge (.12 x [A])$ lL-(dO (C) Technology Fee (s% of[A])s 9-?,, TOTAL fees and surcharges (A through D):$7UV afr C LOCAL GOVERNMENT APPROVAL Zomngapproval verified? E Yes E No CATEGORY OF CONSTRUCTION ffiResidential ! Govemment ! Commercial JOB SITE INFORMATION AND LOCATION Job site address: 68I S C bT city: €fAtD6F\O State: q)Z 7;IP,1)\ \8 Reference:Taxlot. DESCRIPTION OF WORK AM,A6( TDOOCLf]tr.,o PROPERTY OWNER Name LLINA Address ,C city: fi{l^{-\F,t+)State: 0L ZP. 9+Y}E Phone:Fax: E-mail: This installation is being made on residential or farm property owned by me or a meqber of my immediate family. This property is not intendefl for sale, exchange, lease, or rent. OAR 479.540(t\ and 479.56p( I ). Signature:-Jfi,ly' COIITRYCTOR INSTALLATTON Business name:L, Address City:State:ZIP Phone:Fax: E-mail: CCB license no.BCD license no. Signing supervisor's license no. Print name of signing supervisor: Signature of signing supervisor: \d DEPARTMENT USE ONLY Permit no.\q s (Date \q Last edited 7/l/2019 BJones PropertY Owner Statement Regarding Construction Responsibilities oregon Law requires residential construction permit applicants who are not licensed with the Conltruction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.32s (2ll I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities, anO t trereby certify that the information on this homeowner statement is true and accurate. Sosn buvll I\JA Print Name of Applicant Applicant \\IZ 1,1 Date This statement is required for residential buitding, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under oRS 701.010 (7)' need not this statement. This statement will be filed with the permit'submit 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 I will 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 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. Permit #:qtc lssued by b Date: OK- el tLftq This Copy for Permit Offices (l,wLil Address: