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Home My WebLink AboutPermit Electrical 2004-9-8 225,FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)7~Q:{~~/o ELECTRICAL PERMIT APPLICATION (0") J1 ";"{:,;0;;1 <I~;;.9 /)r. . . - , ( 7 C <I <1/ 0'0 06> City Job Number (..C iV\ 'LC'C '-I - OC 't 1 '-/ Date,' \., &05' ~ ,,/ <Is ,DiF<'"WH''''' if "nwl"f;'-;;"[""3""'J.:.;~f,. ;.e .:;,,~?!;,.;~, .......,o~ r. 05'''6 3.:.COMP:I..ET'Elf~~$~Q. ..E' ~ -ffi.'F:J<;;"'~",~;.,_,...:~. "F '\10,.";,~,:",,y>:;t:;j::::,::...i""':;.,':-;;;', in..:*'lli~.;:<~.~'lt~h:::J~~;:O:' .if-.;,-",__ 200 Amps or less 201 Amps 'to 400 Amps 401 Amps to 600 Amps d/l \) :~ 601 Amps to 1000 Amps \0 Phone 3y.,'-r-o 7!f~ Over 1000AmP~~W.\l0!1l'l~\\\\\~ Reco!W..~@l\~V O~e90f\.' \ ".\'n 0..,. o~eY '0 ,",\"\e .'" <:;e \ ~,~ ~~. p..~~ ~~ ;Jt\O'l4 t~.J';A;"\~t'ti; :' '~\ce.\\ot'\ '\_00'\0 \eS .'._ r}'._ ~O\~ t..P 9f>~9t:'lr~~~~q~O \)t\Re19~t'tio.n O"p t:O.a~ 0 INote. \,\o\\\\\..>'-" \l' 090. "'{oU :wo ~{or 'i~ss D,\\\t'J A) o ca\\\{\g m1i{~f~~~~'2.3A . (\u{\'\'oe~~t~-S6bU Amps Over 600 or 1000 Volts see "B" above. 1. l-{ 7 7 i:S,-c ~ ~ (Lit- LEGAL DESCRIPTION li03ZZL( Z- JOB DESCRIPTION C;L\.l0C: ---, ~ C I {LLl..\.....\ k > Permits are non-transferable and expire if work is ,i- not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address Z5ZS W:r(Ot1t1 by- City E v{J} Gnl I Supervisor License Number tf-73 L/ - 'S Expiration Date . J lJ !o t./ / Constr, Contr. Number i f;;h 1 jp ( Expiration Date J 0/0 c! / Sig~r~~i , - .1 / / Owners Name ,12...L:' C -1I~l2...( Address ~ 77 \'1i8C, L d~Q.jt: City S t-:);= ~ Phone 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 A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder B. SPRINO>F1ELD :!:\,~~,,*.t);:&~V "'- $ 19.00 $50.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 D. New Alteration or Extension Per Panel I One Circuit Each Additional Circuit or with Service or Feeder Permit E. TOTAL $ 43.00 . 1 Lf. 'b Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 ~im.ited EnergylResidential 1\-\E '.~("\R~ $ 25,00 t~ c,.;\\~ited.fQermvi<to~~fal\~"~\T \c. ~Ol $ 45.00 I..' .' . ~U~\\ \ '0tft"\L S PtoW\ . ~~~~~~jl;r5.00+surchar~s 7 p..\~'{ \'8(T!'t}P\'f~ ......., ... . ................. .h, 7% State Surcharge 10% Administrative Fee -? L- $ 3,00 341 , 'Ie Lf 57 3~ Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03.doc ~....,~ CITY OF SPRINGFIELD Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2004-00994 ISSUED: 08/11/2004 APPLIED: 08/11/2004 EXPIRES: 03/07/2005 . VALUE: SITE ADDRESS: 477 BROOKDALE AVE ASSESSOR'S PARCEL NO.: 1703224204100 Springfield TYPE OF WORK: Heating System TYPE OF USE: PROJECT DESCRIPTION: Install heat pump and air handler Owner: HARP FRED B & RHONDA K Address: 477 BROOKDALE AVE SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor JOSEPH BUNCH ELECTRIC INC MARSHALLS INC License 156761 25790 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: -' ~o L BU!@ID~ lOOJ@R1\1lAI,.T-I0Nl, ' ATTEN1'\v'... .. d bV the ureu,,.h ,..::..\ . ') fo\\oW fu\eS a~qR~trf;~~e rules ,He ;':3,~ " , ti>tlfication CeIM 1~~~8'~l~teAR 8;):. " . , OAR 952-0otVilo'iiiJ~;es of the n1P~ ' ~dlo. You maWa"W~lflxg5\e: the te\~p~i~ ca\ling the ~'TY.p.~:Ut\\\tv Not\jli"i~'.\~,~!! number for ~.~~~~~~~2-2344), Cenfu,.INlIllOO'JSU110ing: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: New Residential Expiration Date 08/21/2007 12/23/2005 Phone 541-344-8745 541-747-7445 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I ,. . ORK N01\((ttlewalk U'~l EXPIRE \f 1HE W N01 \\1IS RffiMll S M.il~IS PERM\1 IS ~1l1\15R\Lt~~~tmIS I" 6r>.NDONED tOR MENCED OR t'\ ~%~ \ BO D~'{ PER\OD. Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Paee 1 of2 Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00994 ISSUED: 08/11/2004 APPLIED: 08/11/2004 EXPIRES: 03/07/2005 VALUE: Total Value of Project Fees Paid I Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $4.90 $3.43 $43.00 $6.00 8/11/04 8/11/04 8/11/04 8/11/04 8/11/04 8/11/04 9/7/04 9/7/04 9/7/04 9/7/04 2200400000000001037 2200400000000001037 2200400000000001037 2200400000000001037 2200400000000001037 2200400000000001037 1200400000000001316 1200400000000001316 1200400000000001316 1200400000000001316 $119.98 I Plan Reviews I 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. I Reouired Insoections I Rough Mechanical: Prior to Cover Final Mechanical: When aU mechanical work is complete. Rough Electric: Prior to Cover 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 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 2 of 2 225 Fifth Street Springfieid, Oregon 97477 541-726-3759 Phone r.ty of Springfield Official Receipt ,velopment Services Department Public Works Department RECEIPT #: 1200400000000001316 Date: 09/07/2004 3:11:17PM Job/Journal Number COM2004-00994 COM2004-00994 COM2004-00994 COM2004-00994 Description + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge Payments: Type of Payment Paid By CreditCard JOSEPH BUNCH ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 531560 In Person Payment Total: Amount Due 4.90 43.00 6.00 3.43 $57.33 Amount Paid $57.33 $57.33 9/7/2004 Page 1 of 1