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Home My WebLink AboutPermit Electrical 2005-10-25 SfP't,'1 t: ~\~ t?t~l iZLi:t 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO"""" 'ZOO S" C>fl/7D /~.~ '" bAvul W~ (~.-- 2:Z, 'l a, ~''''^ & e- 1,,/ s? P'h Phone 9'] J - /Cf 3 J Pump or irrigation NOTmi!Outline Lighting THIS ~ttS~~ExmJM IF THE WORK $ 25.00 AUTHrnaliHHU.!tiQiRJhUiJ~ERMIT IS NU I $ 45.00 =~~~\ti~t~n~~~J>~~~ + Surcharges 4, SUBTOTAL,OFABOVE< L{ .S- '. ""<, ',;"., "'.'; " _3/J Lire ~Z~ 1. LOCA1TON OF INSTALLATION , , ' z:z. \{ e, 1500'\."" : C:- )AI LEGAL DESCRIPTION 1 70"3 l s-, L JOB DESCRIPTION IOf~C AJb I c.lrc...^..;+~ Permits are non-transferable and expire if work is j' not started within 180 days of issuance or if work is Suspended for 180 days. . CONTRACTOR INSTAi1ATIONONDY -- 'EJ:,~: ~~( Address 957 r]OIi1lt;e1 t>& t.k 2. ,_......... Electrical Contractor rr; N & C;ty '-.~ "\'\-'tuD Phon.(Q, Supervisor License Number ~\r7 ~l ~ Expiration Date /D -. 0 '7 Constr. Contr. Number I" c:> \ q \ Expiration Date /l-19,-o(P Signature of Supervising Electrician Address City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 b., ~~lft~::~ r t\'1e 'ollowing Date /0 - 2S-_~u~itte?;~~c land use. . ..... ..... "Tne\oll()wingp~~:;~ot fe~U\fe. "'I-' _ r? 3. C01l1PLET~rBEIP'f1Lf1~DpLE BE'LOIVt.J.A'== -- .'. . toval, '. .... .. . ~ aPP zoning \ 0 - J...I..P -- 0 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact~b . Modular Dwe~mlb~rvlcg ~. Oregon law req!J,~&Q,O'OU to F d rUll"S adoptnr) h. '1- 0 J> :tI ee er Non l' fi!Y<:r,-fl1J Ie; reoon Uti!"1 '....'.i."... :.-i'.' 'f.< IIcar..9.fJ.C. enter. ThoscruJ' .' _.'01, . . I.y. .' 'lnClllJ:'l(l1.::",' ...... ",. eSiiifAAA'fJ-j B.'.s,~r\'iCeSOT~(l~~~i~r1illat:,lItlP~.S ,Qfp~~O~ non: '."'. '.' 0090You" ~. ........ - .\:Jnvt\l-i 0':)<-001- , may obtain coo,' as ~,' '~~ I ' . . v f fJn /,'-'''''' t.... 200 Amps or l~lImg the center. {Noto"" 6r.!oorL"G~ uy tJ.um.ht.::>J'" f ~ \. [il~ f.;I'-'Dhora 201 Amps to %f\J\J.l-tmpSor th~ Oreonn IJ:!lit'l~~BHr_ I r~ 401 Amps to 600 Ampsenter IS 1-80n-,'=l'1?~3h~8..00-1'kr] 601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts $375.00 Reconnect Only $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 D, $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit / Each Additional Circuit or with Service or Feeder Permit $ 43.00 l{1 $ 3.00 'J' ".g $ 50.00 $ 50.00 7% State Surcharge ' 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01470 ISSUED: 10/19/2005 APPLIED: 10/19/2005 EXPIRES: 04/25/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2249 BONNIE LN ASSESSOR'S PARCEL NO.: 1703251210100 Springfield TYPE OF WORK: Heating System TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace heat pump and furnace Owner: DAVID WILSON Address: 2249 BONNIE LANE SPRINGFIELD OR 97477 Phone Number: 541-933-1433 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor License Expiration Date MNB ELECTRIC INC 162191 11/19/2006 J CO ENTERPRISES INC 156807 09/09/2007 BUILDING INFORMATION I ui~es 'lou.\? \a\N ~eq n \jtI\\W # f~~' Vo'\"". o.~egon ~ne o~ego IE. !-.L~&r''': o ~\'V'" ted 'o'll s a~e ~Ol ~lzt =o~'~~~~ "'t"l-.ose ~u\eo"n rSg'(Fi)~st Floor: I U\ te~, ,\ \ n /"",P oJ _ r.\' . . 5fl:cen "\ 0 \n~oug , \n~m'(ttS2n(1 Floor: \\'I01t~i-G~'y~_OO"\ -00 in cO?\es 0 e\~~lttlBasement: ~,,tgJ\1\.1>~~ f(\a'l o'o\a \NO\e', \~e \ a~\"ljt@arage/Carport E,~9.ph%': e cen\ec n \..1\\\\\'1 N Sq Ft Other: spri~if&l~~t~e o~egoo 0!lJ~2-23AL()ccupant Load: . .rl'\he~ , ..... '\-8 I DEVELOPM~NT I~f6~ATION I Phone 541-726-8601 541-689-1667 # of Units: Primary Occupancy Group:. Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: Storm Sewer A yailable: Special Instruction: I PUBLIC IMPROVEMENTS I Sidewalk Type: \-\E WOR\( ~~~\~~~M\l SRM:hs~~~~\i IS NOi ~U1HOR\lEO UoN~~: ABANOONEO fOR OMMENCEO n ~N~ \80 o~'( PER\OO. "'i Notes: Pae;e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Fee Description ~Mechanical Issuance Fe~ + 10% Administrative Fee + 7% State Surcharge Furnace - up to 100,000 btu Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/ Adj ustment Electrical Total Amount Paid CITY OF SPRINGFIELD: ' Building/Combination Permit PERMIT NO: COM2005-01470 ISSUED: 10/19/2005 APPLIED: 10/19/2005 EXPIRES: 04/25/2006 VALUE: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number 1200500000000001569 1200500000000001569 1200500000000001569 1200500000000001569 1200500000000001569 1200500000000001569 2200500000000001490 2200500000000001490 2200500000000001490 2200500000000001490 $10,00 $4.50 $3.15 $12.00 $12.00 $21.00 $4.50 $3.15 $43,00 $2,00 10/19/05 10/19/05 10/19/05 10/19/05 10/19/05 10/19/05 10/25/05 10/25/05 10/25/05 10/25/05 $115,30 I Plan Reviews' To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. L..Jl.eouirerunsnections I Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01470 ISSUED: 10/19/2005 APPLIED: 10/19/2005 EXPIRES: 04/25/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 of 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 Contractors Signature Date Pae:e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 6J:GF;.iij. ... ..... LJ&..., d ....__.. ~--- City of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 2200500000000001490 Date: 10/25/2005 10:13:53AM Job/Journal Number COM2005-01470 COM2005-0 1470 COM2005-01470 COM2005-01470 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum! Adjustment Electrical Payments: Type of Payment Paid By CreditCard MICHAEL GOWINS Item Total: Check Number Authorization Received By Batch Number Number How Received djb025140 In Person Payment Total: Amount Due 3.15 4.50 43.00 2.00 $52.65 Amount Paid $52.65 $52.65 '( :' 'j '{ :1 - " 10/25/2005 Page 1 of 1