HomeMy WebLinkAboutPermit Electrical 2007-1-23
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number (',/)'YYI d. 0 Of -( ')nO,':>,h
1 LOCATION OF INSTA.LLAI ION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable J.nd e'\plre If work IS
not started wlthm 180 days of ISSUJnce or If work IS
Suspended for 180 ddYs
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2 cmhjuFo.~U!,ISI 4L~IJO~ <!N~::;
Electrical Contractor -z;Jrtlbo r Clr-\tr Z/tcbrk
Addre" '\=b ~X 17~
CIty VVlLt.A
Phone ~'-I-l{'lZ3
Supervisor License Number
Lf770 S
Expiration Date /0 -1- 07
Constr Contr Number J 5(P308
7-ILI-o'l
VC:>JljlIl!- (,J4d.,!;'<:
.o.ddress )-(, t.( ~ (' ,E/v7f/'l,'.tc- \? I-Vl'\
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CItV '5' .f'r~j) <::II Phone )'17 - 2 2. ~
I
OWi\ER INST .\.LL", nON
The installation IS bemg made on property I own which
I~ not mtended tor sale, lease or rent
Ownels Signature
/
InspectIOn Reques[ 726-3769
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Dale 1I9:~/o '7
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3 'COMPLbIE FEE SCHEDUU BEU)W:-:; "';,' '~'~-':i':, :~~
_ ~ 'Th r'~ ~~ ,_ 'I.~~.J) ,'" - .~:
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~e'\ Resldent!.J] - ~lI1gleJor I\lu,lh-F Jrnlh p~r d;"'ellmg ~'nlt "~
, "- ~ "-- ~ ~ _\ ~~ _ ~ ~ < rJt
A
Service Included
1000 sq ft or Ie>,
Each add]t]onal 500 sq
portion thereof
$10600
ft or
$ 1900
Each Manufact'd Home or
Modular Dwelling Service or $5000
Feeder N011CE
-1,"', (,--::.,,-/<-<~ -!->-,;:~J;\_r ,,;:~,,~~~-h.,,-,'~>,""'~~~:"
B SerYlces'jlr.lmedcr.s jV,lnstnllH!O,n,r",llerJtlOns orjReloQatw.lI ~o,
"'- ~~" 1 "" ~),.. ~,!;;:1\ull..,_-.?jJJ-\,_,l...J\; tf1.4Lb'ln1[~yUn.{v:/;,..A
"DO A AIIITHORIZED UNDER THIS P.~6~~o!IT IS NOT
.. mps qr ess $-,.) 0
201 Amps t~~M~~~~~ED OR I:, AtjI\I~Ll~;~~O'oFUti
401 Amps ~~60"0 1iriip0AY PERIOlJ $12500
601 Amps to 1000 Amps $16300
Over 1000 A.mpsNolts $37500
Reconnect Only $ 50 00
\ (~: -,\ ~ ~" """"" >'~ " '\1~' J:.., ~'l5'p..;::~,"~~:v~'t""\";>rt,~';f>"~~
C : Temporrtn Sen1Ce'i orlt:eedlr'i ~\~~>"'~ ~~~ ~~+",~;:,":.{:'~~~h:~
,..... ., ~ ".>'<1 ",< "l'"",'V",JI:;T..~'&"'~'"""'" ",~*~",""*~"-l>,..'v_~
InstallatlOn, ~lterJ.tlOn or Reloc.atlOn
200 Amps or less
201 Amp' to 400 Amp'
40 I Amps to 600 Amps
$ 50 00
$ 69 00
$10000
Over 600 Amp' or 1000 Volts see "B' above
_ ~,,~ ~,,1' ~ ( ~,{fi;,;;~"~,,,'jth j'..' "~':f.
D ~ Br.lnch C;lrCl!lt~ ~,~ i:- [:~-,,-: 'r:~"<~, '*-~... ~::t~~~'"- ~'i':'f~l~1,,;
I\TTE~ITlOI\1 U elllJl. I \'h J'-1\,A'I...,.::J yuu llJ
New ~lter.llOn or E'\tenslOn Per"'P,lRel t n eqon Ut 11" I
follow rules aaopleo 'II ,le vr "11 ':::? Dc)
One Clrc~lt t f ~t r.~ ter ""-I.t--- ..u$eJ3 ODe ~~~.....J4
E dd I" , Irr.: In") .rr.'1", . ,............ I ~ QI -
ach A ]tJona ~JrCU]t or "]t,, 0 'J.. '(;)' R 952 h()' 0
Service or;FRdWp';lf~t001-001 ..,.,oug$ 300 fL? ()
0090 You may obtain caple,s of the rUlEfs 0'
elf _ ..l~ ....,:. 1{ri-..~';;~"1't.?\j.;'{c.nh{\r"''':- \.
E M"celldneoOsl(:;er"[ce/feetlef)oo1 mclfided) -Edch'lnst,lllltlOn
" "i'lumberforthe Ot."!gon1Jtllrty Notl1icattorf "
Pump or ]ITIgatlOn Cenlefls 1-800-'i3;:$~50'00)
Slgn/Outlme LIghtlOg $ 50 00
LImited EnergvfResldennal S 25 00
LImIted Energy/CommercIal $ 45 00
I\'hnlOlum EleltTlL Permit InspectIOn Fee l~ S.t5 00 - SurchJrge~
~~ .. '"\
40[ , t51J
3,1::}
if "10
"'~~~
4 SUETOT.flL or AEon:;
:
,
h'
1, (% State Surcharge
10% A..dmmlstratlve Fee
S10 Te.o-, R-<--
TOTAL
ShJled Onve(T )/Bul1dmg FOnJ1SI Ekctm.l1 Penmt ApplH..:ltlOn I 0--, doc
Status
Issued
=ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO. COM2007-00036
ISSUED: 01/08/2007
APPLIED: 01/08/2007
EXPIRES. 07/18/2007
VALUE'
225 F,fth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Owner
Address
.C\..p..&II.....<J ,--
SITE ADDRESS 2643 CENTENNIAL BLVD Spnngfield I, TYPE OF ~ORK \ Mechl'.m~aL9,nl)a"ty
ASSESSOR'S PARCEL NO 1703254400505 io:lm~ rul~" "'\"GIJ(~? o. ,I \ s a"'re set forti
~ I hO.:'.(" I U P
"otl.'ccT1YJPE OF, USE" 'A:lterallon R 952_0Resldenllal
'\l I _ ....f"\"ir'\ hgf"\Ilr1!'1\ If\ v
PROJECT DESCRIPTION Install new gas furnace and all condltlOnmglSy'stem' tGas plpm to the furnace and gas
I V{'\I '-' -- T tne n.JI~\) :.1
range "'OCO You llay obtalll Copies 0 h e-
J v _ _ 11\1.....+0. thp tpleo on
ca\llflY I ,,, ~V, 'O'-r<>9' 011 Utility NOtlflcatloll
lUmtle: l'f !fl€ ~ ,
C'3Il,81IS 1_f'rO-,32-2344)
WALSER DAVID M & DONNA J
86313 FRANKLIN BLVD
EUGENE OR 97405
I CONTRACTOR INFORMA T10N I
Contractor Type
Electncal
MechaUlcal
Contractor
TURNBO CARTER ELECTRIC INC
BEYMER HEATING & SHEET METAL CO
License
156308
4483
ExpiratIOn Date
07/14/2009
11/14/2008
Phone
541-607-1556
541-688-5004
BUILDING INFORMATION'
Frontyard Sethack
S,de 1 Sethack
SIde 2 Sethack
Rearyard Sethack
Solar Sethacks
# of Stones Lot Size
Height of Structure Sq Ft 1st Floor
Type of Heat Sq Ft 2nd Floor
Water Type Sq Ft Basement
Rauge Type Sq Ft Garage/Carport
Energy Path NOTICE. Sq Ft Other
Spnnkled Bu\lwrPERMIT 31!i\\LL EJPccUpaiitlIblt3d~'/O~~
'UJ......I."". " " . ,rl.'Uth I MI~ rcnlVll1 Iv 110U I
I DEVELOPMENT INFORMATION" DONcn t:nQ
lJUlillilLlWLU v,IIS ABAN REQUIRED PARKING
Overlay Dlst ANY 180 DAY PERIOD Total
# Street Trees Rqd HandIcapped
Paved Dnve Rqd Compact
% of Lot Covel age
# of UUltS
Pnmary Occupancy Group
Secondary Occupancy Group
Pnmary Construcllon Type
Secondary ConstructIOn Type
# of Bedrooms
I PUBLIC IMPROVEMENTS I
Street Improvements
Storm Sewer Avatlahle
Speclallnstrnctlon
SIdewalk Type
Downspouts/Drams
Notes
Pa2e I on
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00036
ISSUED: 01108/2007
APPLIED: 01108/2007
EXPIRES: 07/18/2007
VALUE.
225 FIfth Street, Spnngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn LlOe
I Valuation Descrmhon I
DescnDtlOn
Tvpe of ConstructIOn
$ Per Sq Ft
or multIplIer
Square Footage
01 BId Amount
Value
Date Calculated
Total Value of Project
Fpp<, pqvLJ
Fee DescnptlOn
-Mechamcal Issuance Fee-
+ 10% AdmlOlStratIve Fee
+ 5% Technology Fee
+ 8% State Surcharge
ApplIance Not LISted
BOIler/Comp Up To 100,000 btu
Furnace - up to 100,000 btu
Gas Outlets 1-4
+ 10% AdmlOlStratlve Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Clrc
Add, Alter, Extend C1rc Ea Add
Amount Pa,d
Date PaId
ReceIpt Number
$10 00
$460
$230
$368
$1800
$12 00
$12 00
$400
$490
$245
$392
$43 00
$600
1/8/07
1/8/07
1/8/07
1/8/07
1/8/07
1/8/07
1/8/07
1/8/07
1/23/07
1/23/07
1/23/07
1/23/07
1/23/07
1200700000000000017
1200700000000000017
1200700000000000017
1200700000000000017
1200700000000000017
1200700000000000017
1200700000000000017
1200700000000000017
2200700000000000094
2200700000000000094
2200700000000000094
2200700000000000094
2200700000000000094
Total Amount PaId
$126 85
I Plan Reviews I
To Request an mspectlOn call the 24 hour recordmg at 726-3769. All mspectlons 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.
~eouiredJnsneChons I
Rough Gas After lIne IS IOstalled and reqUIred testlOg and cdpped If not attached to an applIance
FlOal Gas When all gas work IS complete
Rough Mechamcal Pnor to Cover
FlOal Mechamcal When dll mechamcal work IS complete
FlOal Electnc When all electncal work IS complete
Rough Electnc Pnor to Cover
Paee 2 of 3
Status
Issued
::::ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00036
ISSUED: 01/08/2007
APPLIED. 01/08/2007
EXPIRES: 07/1812007
VALUE:
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
By slgnatnre, I state and agree, that I have carefully exammed the completed applicatIOn and do hereby cerllfy that all
mformatlOn hereon IS true and correct, and I further cerllfy that any and all work performed shall be done m accordance wIth
the Ordmances of the CIty of Spnngfield and the Ldws of the State of Oregon pertammg to the work descnbed hel em, and
that NO OCCUPANCY WIll be mdde of any structure wIthout permIssIOn of the CommuDlty ServIces DIVISIOn, BDlldlDg Safety
I further certIfy that only contractors and employees who are m compliance wIth ORS 701005 will be used on thIS ploJect
I further dgree to ensure that all reqUIred mspectlOns are requested at the proper lime, that each address IS readable from the
street, that the permIt card IS locdted at the front of the property, and the approved set of plans WIll remalD on the sIte at dll
times durlOg construction
Owner or Contrdctors SIgnature
Date
Paee 3 of 3
225 FIftH Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
~~
Clf. of Sprmgfield OffiCIal ReceIpt
L Jopment ServIces Department
PublIc Works Department
Job/Journal Number
COM2007-00036
COM2007-00036
COM2007-00036
COM2007-00036
COM2007-00036
Payments
Type of Payment
CredltCard
cReccmtl
RECEIPT #.
2200700000000000094
Date. 01/23/2007
DescriptIOn
Add, Alter, Extend CIrc
Add, Alter, Extend CItC Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% AdminIstrative Fee
PaId By
SCOTT CARTER
Item Total
Check Number AuthorizatIOn
Received By Batch Number Number How Received
ddk
318044 In Person
Payment Total
Page 1 of 1
12 15 07PM
Amount Due
4300
600
245
392
490
$60 27
Amount Paid
$6027
$6U 27
J 123/2007