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Home My WebLink AboutPermit Electrical 2007-10-24 ZON ~ INITIALS W \-..r-- DATE \\ - :2\-<,:)\ SOURCE \~~ ~ Date I t) - ~ t./ - 07 ... ... 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ~_OW1 'Z-007 - Of '-133 1. 3, .3~0~:~' - ff~"---~t'-;"'~"'" '''''~'~'''''''.'''''--''._''7.:''''>''''----- '''''''~'''l''''''''''''- LEGAL DESCRIPTION: .'" ',. ", " , A, 11 61- ' rcrJ<-( -- ,- 'Oz-. ~,OO.'''' Service Inci~d~d'" - , ,-~"--,'-.., ".~_..,,_c, -, ~~ 1000 sq, ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 JOB DESCRIPTION: <L\o $ 21.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days,. $55,00 B, City t:-U(--C-Nc- q74'l1~'one 642l11ov-( 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 70.00 $ 83.00 $138.00 $180,00 $413.00 $ 55.00 Electrical Contractor 0 1'4::TS-o;v l."'L&--c..N.1 <- s.;....t L Address "j:> 0 t3 \J I" '2 Z '3'7 Supervisor License Number / c.~ C\ctS c. Signature of Supervising Electrician ~(Q)rRCIE. Installation, ~f~tion 'Ot Relocation . 200 Amps or l~fJT PERMIT SHALL EXPlmHlfJTHE \AI 20fAm, ps to ~8~98IZED UNDER T, HISS f7Jf:~CMIT I;'r~~~( 401 Amps to ~9~fr;NCED OR IS ARANUG~~<}) rOR I Over 600 Am s or 100g ~&~ fe~~9~ove. D, Expiration Date I 0 - ( ... { D Constr. Contr, Number ,I fo (S { 't Expiration Date q - at - 0 ~ \I -7,~a-w~ Owners Name d~ ~~L...lQ Address ~ New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit (I c:;:::-~ $ 48,00 ..., (\ $ 4.00 E. City Phone 14-{ "1Kl~ Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 OWNER INSTALLATION Limited EnergylResidential $ 28.00 The installation is being made on property I own which Limited Energy/Commercial $ 50.00 is not intendedAfITE~;-I~ <6f~~on law requires YOU~nimum Electric Permit Inspection Fee is $50,00 + Surcharges o S' l~!:\w lI'ules adopted by the Oregon UtlllW ~O a...O wners Ign Notification Center, Those rules are set f01t . -0~ , {j'" ~r''' D01 001" thrnllQh..OAR 952-001 G 8% State Surcharge l.J- ~ ~~9;n ;;;; may obtain copies of the rules by 10% Administrative Fee .s '"'0 caliin~ the center, (Note: the tel~~ho~e 5% Technology Fee ~_ 00 mh f lbe Oregon Utility Notlflcatlon Inspection ReaUe~'t:Bfi~~te'~iS 1_800-332-2344). TOTAL f.o ( SD Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc 'I; '"-:.:-.,.'. " ........,.' ". '. . . .::. . :'. ;.; ,>;. :-: ,.; .;. '.~. , :. . ~; .>. '.:' ~ ~.::;; ::'..':.:':-';: >.;:-: :.( Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3372 PARKER LN ASSESSOR'S PARCEL NO,: 1702193402900 Springfield PROJECT DESCRIPTION: Install air conditioner, Owner: SKORDAHL JOEL R & CLORICE L Address: 3372 PARKER ST SPRINGFIELD OR 97477 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01433 ISSUED: 09/20/2007 APPLIED: 09/20/2007 EXPIRES: 05/02/2008 VALUE: TYPE OF WORK: Heating System TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor OREGON ELECTRIC SERVICE HOME COMFORT HEATING & AIR License 161518 84164 Expiration Date 09/2812008 06/2512011 Phone 541-343-1681 541-345-2838 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VB n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction}\jOT!CE: Notes: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Paee 1 of 3 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspou ts/Drains: ATTENTION: Oregon law requires you to ~Oll.~w r~les adopted by the Oregon Utility In og~~~'502n Center. Those rules are set forth -001-0010 through OAR 952-001- 0090,. You may obtain copies of the rules b calling the center, (Note: the telephone Y number for the, Oregon Utility Notification Center IS 1-800-332-2344). Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project ~ Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Boiler/Comp Up To 100,000 btu Minimum/Adjustment Mechanical + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid $20,00 $5,00 $2,50 $4,00 $14,00 $36,00 $5,00 $2,50 $4.00 $48,00 $2.00 9/20/07 9/20/07 9/20/07 9/20/07 9/20/07 9/20/07 11/2/07 11/2/07 11/2/07 11/2/07 11/2/07 Total Amount Paid $143,00 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01433 ISSUED: 09/20/2007 APPLIED: 09120/2007 EXPIRES: 05/02/2008 VALUE: Value Date Calculated Receipt Number 2200700000000001480 2200700000000001480 2200700000000001480 2200700000000001480 2200700000000001480 2200700000000001480 2200700000000001670 2200700000000001670 2200700000000001670 2200700000000001670 2200700000000001670 To Request an inspection call the 24 hour recording at 726-3769. All inspections 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, ~eouiredJnsnections 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, Pal!e 2 of 3 CITY OF SPRINGFIELD. Status Issued Building/Combination Permit PERMIT NO: COM2007-01433 ISSUED: 09/20/2007 APPLIED: 09/20/2007 EXPIRES: 05/02/2008 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 Pal!e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01433 COM2007-01433 COM2007-01433 COM2007-01433 COM2007-01433 Payments: Type of Payment Check cReceint 1 RECEIPT #: 2200700000000001670 Date: 11/02/2007 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By OREGON ELECTRIC SRVC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 21313 In Person Payment Total: Page 1 of 1 ] :58:23PM Amount Due 48,00 2.00 2.50 4.00 5.00 $61.50 Amount Paid $61,50 $61.50 1112/2007