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Permit Electrical 2013-11-18
SPRINGFIELD - t 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 C Phone: 541-726-3753 o eo Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02382 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 11/18/2013 EXPIRES: 05/17/2014 STATUS DATE: 11/18/2013 APPLIED: 10/25/2013 SITE ADDRESS: 5702 Peridot WAY,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1802041401216 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: EL-New SFD-lot 16 Morningview OWNER: MCKIM DAVID 8 DEBORAH Phone Number: 541-514-9284 ADDRESS: 996 ELKAY DR EUGENE OR 97404 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EVERYDAY ELECTRICAL SERVICE INC CCB 136371 08/12/2015 541-912-2957 General Contractor DAVID C MCKIM CCB 200167 06/13/2015 541-514-9284 INSPECTIONS REQUIRED i Inspections 4000 Temporary Power Service 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 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 - Notification Ceer... Tp �� saresetforth NOTICE:QTICE. nt in OAR 95 (Qa1 30 u through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. Y ie may obtai opies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the centcl tNote: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • • Springfield Building Permit 11/18/201 4:15:36PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St • TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-02382 www.springfield-or gov 5702 Peridot WAY permitcenter©springfield-or.gov RECEIPT NO: 2013002398 RECORD NO: 811-SPR2013-02382 DATE: 10/31/2013 (DESCRIPTION ' ACCOUNT CODE/TRANS CODE AMOUNT-DUET ' Each added 500 sq.ft. or portion 224-00000-426102 1004 110.00 Residence wiring 1,000 sq.ft. or less 224-00000-426102 1004 147.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 39.18 Technology fee(5%of permit total) 100-00000-425605 2099 16.33 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 382.01 L-. PAYMENT TYPE PAYOR- CASHIER:JLARSON r - " COMMENT' r - : ` '.;' ' r ':AMOUNT PAIDS- Check MCKIM DAVID& DEBORAH 382.01 2505 TOTAL PAID: 382.01 • • Electrical Permit Application DEPARTMENT USE ONLY SPPINGFIELO 159Y=" ; vx OF SPRINGFIELD OREGON SSY-^ Pennitno.:f�?tt ze t3 oz3Fi2-- 225 Fifth Street*Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689 Date: %( //e/f 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. 'LOCAL GOVERNMENT APPROVAL t 11g' *:FEE SCHEDULE . iag'€ Zoning approval verified? ❑ Yes ❑No Number of inspections per item () Qty, Cost Total ea. cost , CATEGORY OF CONSTRUCTION Residential,per unit,service included: ❑Residential ❑Government ❑Commercial ),000 sq. ft. or less(4) / $134.00 $ INI4r`;JOB, SITE INFORMATION".ANDT LOCATION ^':: q Each additional 500 sq. ft. or portion Job site address: C,7 p Z ref 1 i t T thereof $ 25.00 $ City: yPHI State: o € ZIP: Limited energy(2) $ 32.00 $ Reference: Taxlot.: Each manufactured home or modular $ 63.00 $ DESCRIPTION OF WORK dwelling service or feeder(2) ' Services or feeders: installation, alteration, relocation /'l C`'/ S j 0 200 amps or less(2) $ 81.00 $ PROPERTY OWNER 201 to 400 amps(2) $ 95.00 $ Name: r)k,i s" V, /_vwt 401 to 600 amps(2) $158.00 $ 601 to 1,000 amps(2) $205.00 $ Address: `7'l 6 ,-)r . City: �., .,z State: ZIP: Over 1,000 amps or volts(2) $469.00 $ �/ Reconnect only(2) $ 63.00 $ Phone: 5n#917/ - 7l8G1 Fax: - - Temporary services or feeders: installation, alteration, relocation E-mail: 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 479.5400)and 479.5600). 401 to 600 amps(2) $126.00 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above CONTRACTOR INSTALLATION Branch circuits: new, alteration, extension per panel Business name: EIJQ1t�('Aj E�l'�.c' f i L a. Fee for branch circuits with purchase of a service or feeder fee: Address: N92.. 99 O'y(/(fit PIG (.-Q_ 91q1/81 Each branch circuit $ 6.00 $ City: �U'Afj'1�'UA Cf)y State: OK ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone:$c(I-9/Z v y7 l Fax: - -L First branch circuit(2) $ 55.00 $ E-mail: 'r OKy 0.•g ro N/e- �co..,rte.i4-e 0c-1— /� Each additional branch circuit $ 6.00 $ CCB license no.:y /7b 31/ BCD license no.: ZO_dlh(I(_ Miscellaneous fees:service or feeder n of included Signing supervisor's license no.: 1102 g$ Each pump or irrigation circle(2) $ 63.00 $ • Print name of signing supervisor: lic in L. A(Jena Each sign or outline lighting(2) $ 63.00 $ Signature of signing supervisor: /fj Signal circuit or a limited-energy panel, $ 63.00 $ -I alteration,or extension(2) . Each additional inspection:(1) $58.00 $ . r1INKYi a ` A01pL it Aar USE, .. . .. (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): $`3ia ra' 440-2584-J(9/08/COM)