HomeMy WebLinkAboutPermit Electrical 2013-7-19 , SPRINGFIELD 225 Fifth St
' CITY OF SPRINGFIELD Springfield,OR 97477
`Cr Phone: 541-726-3753
OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01636
www.springfield-or.gov permitcenter @springfieId-orgov
PROJECT STATUS: Issued ISSUED: 07/19/2013 EXPIRES: 01/14/2014
STATUS DATE: 07/19/2013 APPLIED: 07/19/2013
SITE ADDRESS: 2091 HARBOR DR,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1803112201200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Circuit for DHP
OWNER: ARNOLD LOWELL T&DONNA J Phone Number:
ADDRESS: 2091 HARBOR DR
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: Wien 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 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.
•
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
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 COMMENCED OR IS ABANDONED FOR _: -
calling the center. (Note: the teleph.. .o ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 7/19/2013 10:06,31AM _ Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
hi.1 .C`N+. 225 FHth$t
34_, TRANSACTION RECEIPT Springtield,OR 97477
541-726-3753
811-SPR2013-01636 .
www.springfield-or.gov 2091 HARBOR DR permitcenter @springtield-or.gov
RECEIPT NO: 2013001575 RECORD NO:811-SPR2013-01636 DATE:07/19/2013
!DESCRIPTION _ •____•—..;` ACCOUNT_CODE/TRANS CODE______ AMOUNT DUE J
Electrical Inspection For Which No Fee is Specifically Indicated 224-00000-426102 1075 80.00
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
L . .PAYMENT TYPE�PAYOR CASHIER:CCARPENTER :.COMMENTS - , . '. AMOUNT PAID - I• - _
Credit Card JEM ELECTRIC _ 93.60
990262
TOTAL PAID: 93.60
•
•Electrical Permit Application }c- t:V aEr� i?
SPNINGFlELCI
CITY OF SPRINGFIELII, OREGON ° 8- ' may Permit no.: �.1
, /(,3�
_ , ? •
225 Fifth Street♦Springfield,OR 97477♦PH(541)726 3753♦FAR(541)726-3689 11'
Date: 7/i 9/4
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.
CL ) QC•5: Go E_ `AIM • 5:;-A z`I, e 'Aa ". et=�. 4�, e't- -t- ?elr
Zoning approval verified? ❑Yes ❑No ' '6'trm& a ;t;;ectrmi tcYe`�e >W�
LAS- t' ''c.24 ..+'T.-14:: - r.....- -- _ '..a� -
-`�•`'*'`- R" - Q � L �' v Residential,per unit,service included:
• 'esidential ❑Government ❑Commercial
.- - 1,000 sq.R or less(4) $134.00 $
° r e[ tfFFCr �t rr� ;::trQa -_w-
- Each additional 500 sq.ft or portion $ 25.00 $
Job site address: �R I / .r13o r Or • thereof
City: •a a State: 6r ZIP: q7r-177 Limited energy(2) S 32.00 $
Subdivision Lot no.: Each manufactured home or modular $ 63.00 $
`maa •pi7''- a os t 4$ dwelling service or feeder(2)
.11Z-4A I t-- L 1 e2rn ! 10 Services or feeders: installation, alteration relocation
- Q"- 200 amps or less(2) $ 81.00 S
., ,. .,.` ae -w° 4.-t..3 201 to 400 amps(2) $95.00 $
,'KZ P„3 pPEE",�.�� ._�EL� �'�,.�;�. �.,u�`.sE.r.H..f.
Name: 4 (11.-Q 401 to 600 amps(2) $158.00 $
Address: at Cr 1 /15-aci c ID,-- 601 to 1,000 amps(2) $205.00 $
City: .4 j. State: O r ZIP: 97c/7 Over 1,000 amps or volts(2) $469.00 $
Phone: 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) S 87.00 $
property is not intended for sale,exchange,lease, or rent. OAR
479.540(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
�i-.- a- , t '•'' 8'F i 1(Z_- ' `i?r+"1 Branch circuits:new, alteration, extension per panel
r '� ���� OQNZFTErr.S�O° fix_-�•
Business name: LT-0/4-•(. f' 'PG s-c a.Fee for branch circuits with purchase of a service or feeder fee:
Address: 1 j- Q Each branch circuit I I S 6.00 I $
City: , 3 OVA. /State: Cr I ZIP: 971./ 1 b.Fcc for branch circuits without purchase of a service or feeder fee:
Phone: -3 , q-107 j Fax: ;'- 6 0723 First branch circuit(2) I $ 55.00 $
E-mail: Each additional branch circuit $ 6.00 S
CCB license no.: /6/83 S BCD license no.: , / - , 7[ Miscellaneous fees:service or feeder not included
Signing supervisor's license no.: ?c/t0-5 Each pump or irrigation circle(2) $ 63.00 $
Print name of signing supervisor. _T.;� '
Each sign or outline lighting(2) $ 53.00 $
` Signal circuit or a limited-energy panel, $ 63.00 $
Signature of signing supervi:41'A // JAI alteration,or extension(2)
/ v VW Each additional inspection:(1) $sa oo $
(A) Enter subtotal of above fees $�e j
(Minimum Permit Fee . 0)
(B)Enter 12%surcharge(.12 x[A]) • $ 9e,
(C)Technology Fee(5%of[A]) $ T j
• TOTAL fees and surcharges(A through C): S (!°
/Un-/NU-7 rO/na/rnwn - -