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Home My WebLink AboutPermit Electrical 2016-10-31 (2)SPRINGFIE ,b CITY OF SPRINGFIELD Building / Residential Permit PERMIT NO: 811-SPR2016-02724 This Perm or the shall 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 IVR Phone: 1 -888-299-2821 Message Phone: 541 -7 26-3769 permitcenter@springfield-or. gov ONEGON www.springfi eld-or. gov PROJECT STATUS STATUS DATE: lssued 10t31t2016 ISSUED: APPLIED: ',0t3112016 10t31t2016 ntilfinal EXPIRES: IVR REF #: 04t29t2017 81'.1047105047 SITE ADDRESS: 1385 32ND ST, Springfield, OR 97478 ASSESOR'SPARCELNO: 1702303405300 PROJECT DESCRIPTION: E - New detached garage SCOPE: Electrical Only TYPE OF STRUCTURE: Residential OWNER: ADDRESS: HAYNES WILLIAM H & CAROL J 1385 32ND ST SPRINGFIELD OR 97478 Phone Number: Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER ccB 000000 08t01t2025 INSPECTIONS REQUIRED IVR Code / lnspection Type 4225 Service or Feeder 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work is complete, By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Current Development Department, Building Safety. I further certify that only contractors and employees who are in compliance with ORS Chapter 701 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. For Commercial Plumbing permits, please calt Springfield Utility Board Water Division. New backflow prevention requirements may apply. (541) 726-2396. This Permit, or copy thereof, shall remain at the jobsite until final inspection. ATTENTION: O regon law requlres you to Owner or Contractor Signature Date follow rules ad opted by the Oregon Uti lity Notification Ce nter. Those rules are set forth mffiwiffit$Br in OAR 952-001-0010 through OAR 9S2-OO1- 0C90. You may obtain copies of the rules by calling the center. (Note: the telephone nurnber for the Oregon Utility Notiiication Center is 1 -800-38Z-Zg44l. 6 sc&iffiil,,Springfield Building Permit 10t31t201 2.1852PM I www. springfield-or. gov TRANSACTION RECEIPT 811-SPR2016-02724 1385 32ND ST CITY OF SPRINGFIELD 22s Fifth sr Springfield,OR 97477 541-726-3753 permitcenter@springf ield-or. gov DATE: 10/31/2016RECEIPT NO: 2016002916 RECORD NO: 81 1 -SPR2O1 6-027 24 Branch circuits with service or feeder each circuit Continuing Education Fee Services 200 amps or less State of Oregon Surcharge (12o/o ot applicable fees) Technology fee (5% of permit total) 224-00000-426102 224-00000-425606 224-00000-426102 821 -00000-21 5004 1 00-00000-425605 1 004 1004 '1099 2099 14.00 2.50 98.00 13.44 5.60 TOTAL DUE:133.54 Cash 007980 HAYNES WILLIAM H & CAROL J 133.54 TOTAL PAID:133.54 COMMENTS 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. Pioperty Owner Statement Regarding Gonstruction 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)) U,( r LL t ft\ )< , /1ft? lJ L5 Print Name of PermitApplicant Signature of Permit Applicant Permit #: Address: 5/0 - 27 Z7 /? z{7w,) rssued ovt H Date: //A h / // b/-/' 2 5/ 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. ,ol W ,will be performing work on property I own, a residence that t 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. This Copy for Permit Offices {lectrical Permit A licetion DEPARTMENT USE ONLY Permit no.- 272? 225 ['ifth StreetrSpringfield, OR 91477.PH(541)726-J753.FAX(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 ifwork is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoningapprovalverified? EYes ENo CATEGORY OF CONSTRUCTION E Residential E Covernment E Commercial JOB SITE INFORMATION AND LOCATION Job site address: nTrS 3t& ; \ City: $,9s-1^.^{-_la State: Or-np:174?8 Reference Taxlot. DES OF WORK (tlB Dn-r\-,€- L7 PROPERTY OWNER Name:\n Address: i Starc: US ZtP:7') Phone -C ?(-Fax: E-mail This installation is being made on residential or farm properfy owned by me or a member of my immediate family. This properfy 479.540( is not intended for exchange, lease, or rent. OAR r)and S nature CONTRACTOR LLATION Business name: 6i ^: n e, 1- 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: SPRINGFIELD ., l'li W' 3Date: /A FEE SCHEDULE Cost ea. Total costNumber of inspections per item ( )Qty Residential, per unit, service included: $163.00 $1,000 sq. ft. or less (4) $Each additional 500 sq. ft. or portion thereof $ 31.00 $ 39.00 $Limited energy (2) $Each manulactured home or modular dwelling service or f'eeder (2)$ 77.00 Services or feeders: inslallation, alteration, relocation $ 98.00 $9e200 amps or less (2) $201 ro 400 amps (2)I $114.00 $193.00 $401 to 600 amps (2) $249.00 $601 to I .000 amps (2) $570.00 $Over 1,000 amps or volts (2) $ 77.00 $Reconnect only (2) Temporary services or feeders: inslallation, qlteration, relocalion $200 amps or less (2)$ 77.00 $ 105.00 $201 to 400 amps (2) 401 to 600 amps (2)$154.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alleration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee Each branch circuit ?$ 7.00 $14 b. Fee fbr branch circuits without purchase ofa service or feeder lee: First branch circuit (2)$ 77.00 $ Each additional branch circuit $ 7.oo $ Miscellaneous tees: service or feeder not included Each pump or irrigation circle (2)$ 77.00 $ Each sign or outline lighting (2)$ 89,00 $ Signal circuit or a limited-energy panel. alteration. or extension (2)$ 89.00 $ (A) Entcr subtotal ofabove fees (Minimum Permit Fee $89.00) $89.00 $ Each additional inspection: (l) D (B) Enter l27o surcharge (.12 x [A])$ lg^a: (C) 1-echnology Fee (5% of [A])$ -q.a, (D) Continuing Education Fee $2.50 $2.s0 TOTAL fees and surcharges (A through D)$ 4 10 -2584 - J (4 I I t20 I 6/ COM) Cify: S:,^i,^.f;,,1"I $