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HomeMy WebLinkAboutPermit Electrical 2013-11-12 . SPRINGFIELD 225 Fifth St ''` -t°°- CITY OF SPRINGFIELD Springfeld,OR 97477 •his'`( Phone: 541-726-3753 DREG°" Building / Residential Permit Inspection Phone: 541-726-3769 . Fax: 541-726-3676 • PERMIT NO: 811-SPR2013-02490 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 11/12/2013 EXPIRES: 05/11/2014 STATUS DATE: 11/12/2013 APPLIED: 11/12/2013 • SITE ADDRESS: 186 65TH PL,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702344201100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 4 circuits OWNER: HELVIE JOHNS 8 PHYLLIS M Phone Number: ADDRESS: 186 65TH PL SPRINGFIELD OR 97478 CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone Electrical Contractor JEM ELECTRIC INC CCB 161235 09/07/2014 541-729-1074 L 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 card it' located at the front of the property, and the approved set of plans will remain on the site at all times during constructio JILL if i t , ll- 1a - 13- vi OI ner • o tra or 1,,nature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth NOTICE; in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification Center is 1-800-332-2344). • ANY.-I80 DAY PERIOD. Springfield Building Permit 11/12/201 12:06:43PM Page 1 of 1 'SPRINGFIELD CITY OF SPRINGFIELD se... 225 Fifth St {r`C TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2013-02490 www.springfield-or.gov 186 65TH PL permitcenter©springfield-or gov RECEIPT NO: 2013002481 RECORD NO: 811-SPR2013-02490 DATE: 11/12/2013 1DESCRIP,TION - ACCOUNT CODEITRANS CODE-; ` AMOUNT DUE;I Branch circuits without service or feeder-1st circuit 224-00000-426102 1004 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 19.50 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 ' - AMOUNT.PAID' �f AYMENT TYPE PAYORcnsRlErs:JLARSON_ - COMMENTS-- - ., _.-__ ,.�_:-.._.:.._—. Credit Card JEM ELECTRIC INC 93.60 153894 TOTAL PAID: 93.60 • Electrical Permit Application sPa:��F:E�o DEPARTMENT ONLY y ,T'?x iniapt:-- + :"* ttss s�r ,:,; f9 p« '' r1a`,r ' igCI TY OF SPRING ( LDS OREQ`6N - t -'""� 'fr Permit no. o i '_ ;ttit li,iv'%. ; �&,4,,,,,?TM.r 3t fs . e.,.f4i t.,r,... w. w "p, , g//`zo ZLI9O X25 Fifth Street•Springfield,OR 97477♦PH(541)726-3753♦FAX(541)726-3689 Date: /////' Z,/ 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. " ,:n LQCAL? GOVERNMENTWAI?PROVAL4 :t w ;FEE,rSCHE.,ULE KtiggtA bz 4`s a approval ❑No kNumber of inspections per item O 'b: Qty, i. OS ,.:.' costlx1' Zoning a roval verified? ❑ Yes -'- ., ' ,p r;CATEGORYAOFE-HCONSTRUCTION n?t ",I Residential,per unit,service included: ['Residential I ❑Government I ❑Commercial M 1,000 sq.ft.or less(4) $147.50 $ JOB;SITE:INFORMATION' AND;LOCATION .; ; 1` Each additional 500 sq. ft.or portion Job site address: /V2 6 C ' ' ' Par e thereof - $ 27.50 $ City: (Sp-4'N, I State: Or ZIP: 975/7 S Limited energy(2) $ 35.00 $ Reference: I Taxlot.: Each manufactured home or modular $ 69.00 $ '-`?_»? , ; ,1DESCRIPTION„'OF}',WORK'. 3d; dwelling service or feeder(2) 1I )l J(-A- t/, q C. .I Services or feeders: installation, alteration,relocation lxtl F �'(.L Gtc�t,.l 200 amps or less(2) $ 89.00 $ 'i"'E it 7 rr: > -e wva+ 201 to 400 amps(2) $ 104.50 $ �-3s"'"n'�.RS,a :;vP� Pf30PERTgY�,.,OVIINER IF„. ..c._.��� Name: "Am__ Nelu1)1�. 401 to 600 amps(2) $174.00 $ Address: /�,/,(rr 65_It` 1v/o Cam. ' 601 to 1,000 amps(2) $225.50 $ City: I g I State: ©c I ZIP: c7 7"1 t 0 Over 1,000 amps or volts(2) $516.00 $ Phone:5y i - I Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale,exchange, lease, or rent. OAR 479.5400)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above t n',5/f; ',t%r;..$,CONTRACI1T,OR:"INSTAL"L''ATION , ` 5/s , "yi,.,j','. Branch circuits:new, alteration, extension per panel Business name: , Jj RA_ el-a-, G a.Fee for branch circuits with purchase of a service or feeder fee: Address: 38E `7 Jc5,0 a r /21. Each branch circuit I I $ 6.50 I $ City: Spcd State: Or ZIP: 1 7N 73' b.Fee for branch circuits without purchase of a service or feeder fee: Phone:5q// 7,4-(07 4 Fax: - - First branch circuit(2) [ $ 60.50 $ E-mail: Each additional branch circuit .3 $ 6.50 $ CCB license no.: /49/)3S- I BCD license no.: 020-5-2.) Miscellaneous fees:service or feeder not included Signing supervisor's license no.: y706 S Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: r� .CA-k.ere) Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: /� Signal circuit or alimited-energy panel, $ 80.00 $ g g p f /at�i �— Iteration or extension(2) pr r Each additional inspection:(1) WOO $ atlegantrital (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $ 93 6 t 440-2584-1(4/012013/C0M)