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Home My WebLink AboutPermit Electrical 2014-09-19SPRINGFIELD 225 Fifth St ' - CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-02045 mm.springfield-or.gov permitcenter@springneld-ocgov PROJECT STATUS: Issued ISSUED: 09/19/2014 EXPIRES: 03/1812016 STATUS DATE: 09/19/2014 APPLIED: 09/19/2014 SITE ADDRESS: 6829 E CT, Springfield, OR 97478 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702352312000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repair two circuits due to fire. OWNER: KAULBACK GEORGE W JR Phone Number: ADDRESS: 6829 E COURT SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Electrical Contractor JEM ELECTRIC INC CCB 161235 09/07/2016 541-729-1074 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 of I required inspections are requested at the proper time, that each address is readable from the street, that the permit card is Gated at the front of the properly, and the approved set of plans will remain on the site at all times during Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility 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 number for the Oregon Utility Notification Center is 1.800-332-2344). `i IC.E: l'I S PERMIT SHALL EXPIRE IF THE WORK I IONIZED UNDER THIS PERMIT IS NOT rF HOLD OR IS ABANDONED FOR Q DAY PERIOD. Springfield Building Permit 9/19/2014 3:57:14PM Page 1 of 1 RECEIPT NO: 2014002094 RECORD NO: 811-SPR2014-02045 CITY OF SPRINGFIELD LSPRINGFIELD TRANSACTION RECEIPT 225 Fifth St Springfield,OR97477 OREGON 224-00000-426102 541-726-3753 13.00 811-SPR2014-02045 224-00000-426102 v v.spnn9field-orgov 6829 E CT permitcenter@spnngfield-or.gov RECEIPT NO: 2014002094 RECORD NO: 811-SPR2014-02045 DATE: 09/19/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Balance of Minimum Electrical Permit Fees 224-00000-426102 1004 13.00 Branch circuits without service or feeder - 1st circuit 224-00000-426102 1004 62.00 Branch circuits without service or feeder - each additional 224-00000-426102 1004 7.00 Electrical Continuing Education fee 224-00000-425606 1032 2.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 9.84 Technology fee (5% of permit total) 100-00000-425605 2099 4.10 TOTAL DUE: 98.44 PAYMENTTYPE PAYOR CASHIER:RHOLMAN COMMENTS AMOUNT PAID Credit Card Joe E. Meyers / JEM Electric Inc. 98.44 615145 TOTAL PAID: 98.44 Electrical Permit Application SPRINGFIELD'- 225 pp,aGFIELD'-225 Fifth Strcet4Spring6eld, OR 97477+PH(541)726-3753*FAX(541)726-3689 DEPARTMV_E`NT USE ONLY Permit no.:,6( l~ Date: C 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 Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION Residential I ❑ Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: r �? is C City: State: Qt— ZIP: Reference: aj5 Taxlot.: > DE CRIPTION OF WORK' . Jr PROPERTY OWNER Name: 6J0' Address: C- • City: j State: 0(— ZIP: q Z(_17e_ Phone: Fax: - - E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(l) and 479.560(l). Signature: CONTRACTOR INSTALLATION Business name: 6 (M, Address: City: State: n r- ZIP: q7N%6 Phone: Fax: E-mail: CCB license no.: 35 BCD license no.: go,522G Signing supervisor's license no.: G (o S Print name of signing supervisor:(. � -¢.1 Signature of signing supervisor: T7 440-2584-J (5/212014/COM) EEE SCHEDULE Number of inspections perRent O Qty. Coeas( Totals t. co Residential, per unit, service included: 11000 sq. ft. or less (4) $151.00 $ Each additional 500 sq, ft. or portion thereof $ 28,00 $ Limited energy (2) $ 36.00 $ Each manufactured home or modular dwelling service or feeder (2) $ 71.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 $ 601 to 1,000 amps (2) $230.00 $ Over 1,000 amps or volts (2) $627.00 $ Reconnect only (2) $ 71.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 71.00 $ 201 to 400 amps (2) $ 98.00 $ 401 to 600 amps (2) $142.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 7.00 $ It. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 62.00 $� ' Each additional branch circuit $ 7.00 $ u Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 71.00 $ Each sign or outline lighting (2) $ 71.00 $ Signal circuit or a limited -energy panel, alteration, or extension (2) $ 82.00 $ Each additional inspection: (1) $82.00 $ APPLICANT'USE' (A) Enter subtotal of above fees (Minimum Permit Fee $82.00)DON $ , (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of [A]) $ (D) Continuing Education Fee $2.50 $2.60 TOTAL fees and surcharges (A through D): $ 6%,5-