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Permit Electrical 2013-5-10
• SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 • Phone: 541-726-3753 -"'",,OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00930 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/10/2013 EXPIRES: 11/05/2013 STATUS DATE: 05/10/2013 APPLIED: 05/10/2013 SITE ADDRESS: 1367 PLEASANT ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703253207500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Two Circuits OWNER: WILSON HOWARD A JR 8 KAREN D Phone Number: ADDRESS: 1367 PLEASANT ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JEM ELECTRIC INC CCB 161235 09/07/2014 541-729-1074 INSPECTIONS REQUIRED • Inspections 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 Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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 rd is located at the front of the property, and the approved set of plans will remain on the site at all times during constr 'tio' ,,,,' Own-r .• S�ntracto'Signature Date • ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by • -;OMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone 1°0 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 5/10/2013 2:00:57PM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT Springfield,OR97477 OREGON 225 Fifth St 541-726-3753 811-SPR2013-00930 www.springfeld-or.gov 1367 PLEASANT ST permitcenter @springfield-or.gov RECEIPT NO: 2013000924 RECORD NO:811-SPR2013-00930 DATE:05/10/2013 DESCRIPTION'F i 'a '` * =.- sr'i § _'n,;ACCOUNT,CODERRANSICODE :-.; .,%. "{'ANIOUNTDUE-"i Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00 Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 i 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 6.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 �P.AYMENT-TYPE •r-f.-PAYOR"4-?cpSHIER:duRSOH COMMENTS „s .Ctsr_;_ as- op. .. w„__r.. �:.::,•.'... Credit Card JEM Electric 93.60 929375 TOTAL PAID: 93.60 • • • Electrical Permit Application r oEPpRTi THE C CITY OF SPRINGFIELD, OREGON Permit no &7/ 7.0/3 0093v 225 Fifth Streets Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 Date: 5-7/V7 3 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. , ' :gtr A"E F}k:ERtiN[EN alITONI �• M =SCHEQUearei rd Zoning approval verified? 0 Yes ❑No e,. mbf n a yo e _ *N-17 ti' '' ti -- Residential,per unit,service included: ❑Residential 1 ❑Government ❑Commercial 1,000 sq.ft. or less(4) $134.00 $ .Jaa scrrrFatrcarz tcia.:t " � }� �3� f'jl� Each additional 500 sq.ft or portion Job site address: �}l/ S thereof $ 25.00 $ City: �,(r) ,{ I State: Q I ZIP:�'� - Limited energy(2) $ 32.00 - $ Subdivision JJ""'"��` Lot no.: Each manufactured home or modular dwelling service or feeder(2) $ 63.00 $ Services or feeders: installation, alteration,relocation 200 amps or less(2) $ 81.00 § - c=am -� ;` 201 to 400 amps(2) $ 95.00 $ . ft-We PFZAO ER �OWKE4 z � . 3 Name: /i G ci_ /&eti CO.Ap t.. - 401 to 600 amps(2) $158.00 $ 136.2 ,'ltd J;_, 51-- 601 to 1,000 amps(2) $205.00 $ Address: M p 7 . City: 6p9-6_, I State: ©(r I ZIP: '7 7')7 Over 1,000 amps or volts(2) $469.00 $ Phone: - - I Fax: - - Reconnect only(2) $ 63.00. § E-mail: Temporary services or feeders: installation,alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 63.00 $ owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 87.00 § property is not intended for sale, exchange, lease, or rent. OAR 479340(1)and 479.560(1). 401 to 600 amps(2) _ $126.00 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above "s : P"- (WitiF, tirti 2 digit LbA,T a;_ .4- "V'z Branch circuits:new alteration, extension per panel Business name: ,T6tA-( f'f i.VJ-`' .' a.Fee for branch circuits with purchase of a service or feeder fee: • Address: 33611 1 k r Q L Each branch circuit $ 6.00 $ City: �Q, �^ State: or ZIP: 97,17'n b.Fee for branch circuits without purchase=of a service or feeder fee: Phone: / -571 7,49-/07 f Fax: / 5V/- 746 cia? First branch circuit(2) a $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: /6/a3 5 BCD licenssee/no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 4/706 S Each pump or irrigation circle(2) • $ 63.00 $ Print name of signing supervisors SAP yid--^ Each sign or outline lighting(2) $ 63.00 $ C),_a .-' Signal circuit or a limited-energy panel, $ 63.00 $ Signature of signing supervisor alteration,or extension(2) Each additional inspection:(I) $58.00 $ • _PFalGQCk1Z& f (A) Enter subtotal of above fees $ (Minimum Permit Fee$58.00) (B)Enter 12%surcharge(.12 x[A]) • $ (C)Technology Fee(5%of[A]) $ • TOTAL fees and surcharges(A through C): $ 440-25844(9/08/COM)