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HomeMy WebLinkAboutPermit Electrical 2014-2-13 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 kCi - Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00322 www.springfield-or.gov permitcenter@springfield-or.goy PROJECT STATUS: Issued ISSUED: 02/13/2014 EXPIRES: 08/12/2014 STATUS DATE: 02/13/2014 APPLIED: 02/13/2014 SITE ADDRESS: 1223 C ST,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703351413700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Service mast repair • OWNER: JENSON PAULA Phone Number: ADDRESS: 584 53RD ST SPRINGFIELD OR 97478 _ 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 4200 Reconnect Service 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 requires you to Oregon law req on Utility NOTICE: ATTENTION: the Oreg Nolo rules e adopted ose 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 You may obtain copies of the rules one by COMMENCED OR IS ABANDONED FOR 0090. the center. (Note: the the ANY 180 DAY PERIOD. calling number for the Oregon Utility No Center is 1 800-332-2344). • Springfield Building Permit 2/13/2014 9:47:19AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St et TRANSACTION RECEIPT Springfield,0R 97477 OREGON 541-726-3753 811-S PR2014-00322 www.springfield-or.gov 1223 C ST permitcenter©springfield-or.gov RECEIPT NO: 2014000303 RECORD NO: 811-SPR2014.00322 DATE:02/13/2014 'DESCRIPTION„. _ _.,_ -:.,..__,_.:A000UNT_CODE/TRANS CODE; _ ^ 'AMOUNT_DUE. Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 Service reconnect only 224-00000-426102 1004 69.00 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 LPAYMENT TYPE ' -P-PAYO ,• CASHIER:CCARPENTER • COMMENTS' — .. .;AMOUNT PAID_ a; .; 1 Credit Card JEM ELECTRIC INC 93.60 328967 TOTAL PAID: 93.60 • • • • Electrical Permit Application SPRINGFIELD DEPARTMENT7.1SE ONLY J �-"UOKSPRING E ,D OREGON W �ro - Permit •no.: 5/q'3 Z 2 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753♦FAX(541)726-3689 .' ' ''`'. Date: 2)/3/ / Y 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. v;'c =, L10CAL.,GOVERNMENTtAPPROVAL_ t .t °, * '- t ,,t�.s:e ltigt ,FEE.-SCHEDULE' v„„=t`g"1 , ]'a Zoning approval verified? ❑ Yes �. r a� `7 u 4 ' ` ` s `Cot 1',Total ❑No I3Number oG inspections per item O,i: )t,y V ea rr s, 1:11. ,, H`'% :CATEGORY1OF°„CONSTRUCTION, ,*"° ,_ate? `";; Residential,per unit,service included: ❑ Residential ❑Government ❑Commercial „ ' JOBi�SITE'JNFORMATION AND;=LOCATION'',: , 1,000 sq. f. or less(4) $147.50 $ Each additional 500 sq. ft.or portion Job site address:. !2.9.3 C 54- thereof - $ 27.50 $ City: 5pccA State: Or ZIP: 97q7 7 Limited energy(2) $ 35.00 $ Reference: Taxlot Each manufactured home or modular dwelling service or feeder(2) $ 69.00 $ ,�<.� '�`P�t{. ��DESCRIPTION OF ,WORK�+ tqv�axtY °_`�-r-��i' g ( ) We 4-4c1,-. C .CUvLC E _ 0 b��� Services or feeders: installation, alteration, relocation 200 amps or less(2) $ 89.00 $ .,1`�m"=�:4*liuF..,y°°may+',::PRO PERTtY,I`OWNER S` , ;W-`t^.* 201 to 400 amps(2) $ 104.50 $ Name: Wet, Si'-$a -_.--' 401 to 600 amps(2) $174.00 $ Address: /-J / S S t2 _ 601 to 1,000 amps(2) $225.50 $ City: C y F, A State: (r� ZIP: 57%9') Over 1,000 amps or volts(2) $516.00 $ Phone: - - '/ I Fax: - - Reconnect only(2) j $ 69.00 Sky 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 479.540(1)and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000,volts,see services or feeders section above gr 1 33:6,RCONTRTACTOR',INSTALL-ATION . :" t 3fttig Branch circuits:new alteration, extension per panel J Business name: e:LC4_ �1-6Gh✓tn a.Fee for branch circuits with purchase of a service or feeder fee: Address: 3i--5-(-4 0 5 .J t/1 s o T' � Each branch circuit $ 6.50 $ City: 5 pc-g_ I State:: O r- ZIP:q?q 77 b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - I Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: / ,f35 I BCD license no.: 50 3--9:2 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 4706 5 Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: c (.(,(,e_)ce.,--- Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisor: / ) $ 80.00 S oty V alteration,or extension(2) Each additional inspection:(I) $80.00 $ z . "zs a .a�-1'y",.�°APPLICARV:Ga 'M ,F jam (.4) Enter subtotal of above fees y(�/�c�0 (Minimum Permit Fee S80.00) $ (S'/ (B)Enter 12%surcharge(.12 x [A]) $C70 C) (C)Technology Fee(5%of[A]) - $ Ud TOTAL fees and surcharges(A through C): $/ter7 G 440-2584-1(4/01/2013/C0M) _ /