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HomeMy WebLinkAboutPermit Electrical 2014-3-27 • SPRINGFIELD - - 225 Fifth St __t: CITY OF SPRINGFIELD Springfield,OR 97477 ter Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 . Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00646 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/27/2014 EXPIRES: 09/23/2014 STATUS DATE: 03/27/2014 APPLIED: 03/27/2014 . SITE ADDRESS: 908 KELLY BLVD,Springfield,OR 97477 • SCOPE: Fire Damage ASSESOR'S PARCEL NO: 1703341104400 - TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: E-Temproray power for fire repairs OWNER: LAMARCHE JOAN ELIZABETH Phone Number: ADDRESS: 908 KELLY BLVD . SPRINGFIELD OR 97477 CONTRACTOR INFORMATION II 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 _ Y Inspections 4000 Temporary Power 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 ATTENTION: Oregon by the Oregon Utility • follow rules adopted Notification Center. Those rules are set forth , in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone NOTICE: • number •for the Oregon Utility Notification THIS PERMIT SHALL EXPIRE IF THE WORK Center is 1-800-332-2344). AUTHOER T N OT COMMENCED RIZED OR UND IS ABANDONED THIS PERMI FOR IS ANY 180 DAY PERIOD. ' Springfield Building Permit 3/27/2014 11:27:31AM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT Spr geld?OR 97477 OREGON 541-726-3753 811-S P R2014-00646 www.springfield-or.gov ' 908 KELLY BLVD peanitcenter©springfield-or.gov RECEIPT NO: 2014000664 RECORD NO:811-SPR2014-00646 DATE:03/27/2014 (DESCRIPTION, " ACCOUNT CODE/TRANS CODE AMOUNT DUE .J Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 11.00 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 Temp services 200 amps or less 224-00000-426102 1003 69.00 TOTAL DUE: 93.60 ! CASHIER:CCARPENTER COMMENTS ':- W ' '' 'AMOUNT PAID. ;PAYMENT TYPE •:PAYOR, - _ Credit Card JEM ELECTRIC INC 93.60 441522 TOTAL PAID: 93.60 Electrical Permit Application DEPARTMENTUSE ONLY ]z'^�rk `ii1 "�-. " ,.1,:mg g- .-A s8' ' -/Fic # w .r,+. .rr-i. 2 CITY YOF FSPRINGFIELD;,OREGON r, �-"`-- ':� Permit no I �/ H( / 225 Fifth Street•Springfield,OR 97477•P541)726-3753•FAX(541)726 3689 s*, �7 /> Date: 7/!�-1/ / 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. ;:k;?LQCALcaoVERNMENT=APPROVAL I: : ; T"F "",',i,.FEE ISCHEDULE},ti w ,x*r'?, , :'j Zoning approval verified? ❑ Yes ❑No YNumber of inspections per item O';'{° Qty" ¶Cost f' '.Total ,'i 1',Y r �CATEGORY�sO ,,:.:CONSTRUCTION to ,.'" e�' lea•, .• •,cost' Residential,per unit,service included: Residential ❑Government ❑Commercial i t•`'JOB±SITE;JNFORMATION AND,=LOCATION 'i ,_ 1,000 sq. ft. or less(4) $147.50 $ c 9? £�//y' '3 /4d Each additional 500 sq.ft.or portion $ 27.50 $ Job site address: ``��ff l thereof City: (14-4 State: Or ZIP: 77407 Limited energy(2) $ 35.00 $ Reference: /70 J5L/ I/ Taxlot o yt{p O Each manufactured home or modular $ 69.00 $ MT t `h' y- 3!1D ESC RIPTION 4OF'WORK°; *,yivD �' wm7 dwelling service or feeder(2) e(ti a n pa Services or feeders: installation, alteration, relocation �tl( l 200 amps or less(2) $ 89.00 $ ;I iA,, G,M;4 `T,',u ¥fXcP ROI?ERTY,?DOWNER jai: a-' .rrni. 201 to 400 amps(2) $ 104.50 $ f 401 to 600 amps(2) _ $174.00 $ Name:. arc Ltn it co Address: t r.-A e CC-, geO e 601 to 1,000 amps(2) $225.50 $ City: I State: I ZIP: Over 1,000 amps or volts(2) $516.00 $ Phone: - - Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, re location This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 9�$1 i 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 £e" 1:47:4;C-0NTRACTORvINSTALLATION t, + 6,.Y. "- st`.'' Branch circuits:new alteration, extension per panel .�Business name: V4 E1/eG r r iC a.Fee for branch circuits with purchase of a service or feeder fee: Address: ,S8'521 J E Each branch circuit $ 6.50 $ City: S V4 � tate: ©f I ZIP:q 7'1 7g b. Fee for branch circuits without purchase of a service or feeder fee: Phone:S -Mp -/Q 7'/ I Fax: - - First branch circuit(2) $ 60.50 $ E-mail: Each additional branch circuit $ 6.50 $ CCB license no.: /ha 35 I BCD license no.: 070-51?Z. Miscellaneous fees:service or feeder not included Signing supervisor's license no.: 1-006 S _ Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: L ey-Q-3 , Each sign or outline lighting(2) $ 69.00 $ Signal circuit or a limited-energy panel, Signature of signing supervisor: �)'''�-•---- alteration,or extension(2) $ 80.00 $ / Each additional inspection:(1) $80.00 $ VVV .1F.I.WIZ.P.Ttrak`i,`APPLICP,N TA'SE, •:,"%`--r_x",7.SIE,(.1:c .`'v (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) Fr (B)Enter 12%surcharge(.12 x[A]) $ I-6° (C)Technology Fee(5%of[A]) $ Yen) TOTAL fees and surcharges(A through C): $ �62/.- 440-2584-1(4/01/2013/COM)