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Home My WebLink AboutPermit Electrical 2020-03-04OREGON Web Address: www.springfield-or.gov Building Permit Residential Electrical Permit Number: 811-2O-OOO427-ELEC-O1 M Number: 811006181057 Email Address : permitcenter@springfield-or.gov SPRINGFIELD $rt Permit Issued: March 04,2020 TYPE OF WORK JOB SITE INFORITIATION Worksite Address 1456 MODOC ST Springfield, OR 97477 Parcel 17032533 15800 Owner: Address: BEYER IAN J 1456 MODOC ST SPRINGFIELD, OR 97477 LICENSED PROFESSIONAL INFORMATION Business Name OWNER - Primary License ccB Lacense Number 000000 Phone PENDITG INSPECTIONS Inspection 4999 Final Electrical 4500 Rough Electrical 4250 Branch Circuits Inspection Group Elec Res Elec Res Elec Res Inspection Status Pending Pending Pending SCHEDULING INSPECTIONS 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: 811006181057 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expare if work is not started within t8O Days of issuance or if work is suspended for 18O Days or longer dependlng on the lssulng agency's policy. All provisions of laws and ordinances governing this type of work will be €omplied with whether specified herein or not. Granting ofa permit does not presume to give authority to violate or cancel the provisions ofany 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-O01-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 479.54O (Electrical), and ORS 693.010-020 (plumbing). Printed on; 3/4/20 Page 1 of 2 c:\myReports/reports//production/01 STANDARD City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Category of Construction: None Specified Type of Work: None Specified Submitted Job Value: $0.00 Description of Work: Adding new bathroom (tub, toliet, and sink - replace utility sink) I Permit Nu mber: 81 1-20-OOO 427 -ELEC-O1.Page 2 of 2 Fee Description Branch circuits without service or feeder Technology Fee State of Oregon Surcharge - Elec (t2o/o of applicable fees) Printed on; 3l4l2o Quantity Total Fees: Fee Amount $ 10s.00 $s.2s $12.60 $ 122.8s 3 Page 2 of 2 C: \myReports/reports//production/0 1 STAN DARD PERMIT FEES SPRINGFIELD ,b OREGON www.springfield-or.gov Worksite address: 1456 MODOC ST, Springfleld , OR97477 Parcel: 1 70325331 5800 Transaction Receipt 8 1 1 -20 -000 427 -ELEC -0 1 IVR Number: 8'l 1006{81057 Receipt Number: 474009 Receipt Date:314120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54r-726-3753 permitcenter@spri ngfield-or. gov Transaction Units date 3t4t20 3.00 Oty 314t20 1.00 Ea 3t4t20 Description Branch circuits without service or feeder State of Oregon Surcharge - Elec ('l2o/o ot applicable fees) Fees Paid Account code 1.00 Automatic Technology Fee 224-00000-4261 02-1 033 821 -00000-21 5004-0000 204-00000-425605-0000 Fee amount $105.00 $12.60 $5.25 Paid amount $105.00 $12.60 $5.25 Payment Method: Check number: 1670 Payer: lan James Beyer Payment Amount:$122.85 Cashier: Katrina Anderson Receipt Total:$122.85 Printed: 3/4/20 9:48 am Page 1 of 1 F I N_Tra nsaction Receipt_pr CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Street. springfield, oR 97477o PH(541)726-3753.FAX(s41 )726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. €x, ) DEPARTMENT USE ONLY Permit no.,lo-oo{"ra - Lu ou,", glul a-, LOCAL GOVERNMENT APPROVAL Zoringapproval verified? f] Yes E No CATEGORY OF CONSTRUCTION dResidential I Government E Commercial JOB SITE INFORMATION AND LOCATION Jobsiteaddress: Hf C fy\-4 ot_ ql State: f[Z ztY: tft//city: Spri,u^(etrl ReferenJe: ') DESCRIPTION OF WORK OnL clt'c$ ? Q.r gpo'$htrramr.cl{rtr-- 0^L C,;,rc -tF lrr J.r ERPROPERTY Name: i,an blgtr \il,0c- $ Slrl^tiq-J& city: 50,";n, hl(Q State: 0lt-'.y'rc, 17'177 FaxPhone: *t 1gOt, - ffi,10 family. installationThis IS residential farmor property immediate Thisownedornleaby intendednot for rent,OARorsale,lease,exchange, Iand7941 property 479.540().) n^elr.l . (0 v','^toffE-mail: iau^ INSTALLATION Business name: Address: OW: Y v 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: FEE SCHEDULE Qty Cost ea. Total costNumber of inspections per item ( ) Residential, per unit, service included: $r 86.00 $1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof $36.00 $ Limited energy (2)s44.00 $ Each manufactured home or modular dwelling seryice or feeder (2)$89.00 s Services or feeders: installatiott, alteration, relocation 200 amps or less (2)sl12.00 s 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)s22l .00 $ 601 to 1,000 amps (2)$28s.00 $ Over 1,000 amps or volts (2)$654.00 $ Reconnect only (2)$89.00 $ Temporary services or feeders: installation, alteration, relocqtion 200 amps or less (2)$89.00 s 201 to 400 amps (2)s122.00 5 401 to 600 amps (2)st77.00 $ 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 Qy'\$89.00 sefl Each additional branch circuit ?-$8.00 $tb Miscellaneous fees: sen'ice orfeeder nol ittcluded Each purnp or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$8e.00 $ Signal circuit or a limited-encrgy panel alteration, or extension (2)$8e.00 $ Each additional inspection: (l)$102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)$ lo5 (B) Enter 127o surcharge (.12 x [A])$ $(C) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through D)$lL?-,V Last edited 7/l/2019 B,Iones Taxlot.: Address: Property 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 l2ll This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from ticensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the aPProPriate box: 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. I have read and understand the tnformation Notice to Homeowners About Constru and I hereby certify that the information on this homeowner statement is true and rction Responsibilities, accurate. Print Name of Permit icant Signature of Permit b ao Date Ae-4,1 ru\r"rL^.r *I. trWc_H \t{ SG h/\o&o- $ Permit #: 9:q a{r t )-oDate:lssued Address 1 This Copy for Permit Offices I I own, reside in, or will reside in the completed structure and my general contractor is: tr d