HomeMy WebLinkAboutPermit Electrical 2006-8-15
CITY OF ~)I'RINGFIELD, OREGON
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
C'tyJobNumber ~?A7I/~ - (rD/';("c.t
I
r LOCATION OF INSTALLATION- I
3!P('6 ~(C.'"
Date
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3 I CO~PL!!TE FEE SCHEDULE BELOW
LEGAL DESCRIPTION
1(02- 0(;, I), o,<{O()
JOB DESCRIPTION
A I New Resldentlal- Smgle or Multi-Family per dwelling UOIt.
Service Included
\ ~~ Gr-cu.-<-::l
1000 sq ft or less
Each add.tlonal 500 sq ft or
portIOn thereof
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder
$106 00
$ 1900
Permits are non-transferable and expire If work IS
not started Wlthm 180 days of Issuance or If work IS
Suspended for 180 days
$50 00
2 I CONTRACTOR INSTALLATION ONLY I
Electncal Contractor 11'Y)" ~ ~\ec:\ t'lc-1f',-
Address Qs7 rh-thl'\d.",e...,A~
CIty ~ ld Phone ~&J' 8'60 L
8 I Service~ or Feeders -Installation, Alterations or RelocatIOn
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolls
Reconnect Only
$ 63 00
$ 75 00
$12500
$16300
$37500
$ 50 00
SupervISor LIcense Number <-f 'i? 7 't =::,
c I Temporary Services or Feeders
/0/07
/
Constr Contr Number0l0-:"i~ 7C--,
c.~ ~ / v,;?,fq I' ,
Exp'fallon Date / 1/1"1/00
/ /
SJgn~tu/re OfSU, ervls1',ng Electnclan ,
New Alteration or ExtenSIOn Per Panel
One CIrCUIt
Each Additional CirCUit or with
/1 /1 Service or Feeder Permit
Owners Name L.d.>u.L fnel A.......-~
Address 3<- I g ~ (CLe- ~ E I M,scellaneous (ServIce/feeder not mcluded) -Each InstallatIOn I
CIty -.5f ~ Phone 72(, - g ({for Pump or "flgatlOn $ 50 00
AFE"JTION 0 Slgn/Outilne Llghtmg $ 50 00
regorl law reqll'rp<:, "".. tn
OWNER INST ALLA TI01l'o 1""'1 rUIGF adopted by the Or;~~~er,;:~~gy/ReSldentml $ 25 00
The mstallatlOn 15 bemg made"'on propertG flOwn whrch I Llmltdr fJ\.ergy/Commerclal $ 45 00
_ "J' - ~se ru es are set forth
IS not IOtended for sale, leaselOr ren1'52-001-001 0 tl1rouMmlmnm,F.leclfl< PermIt Inspecllon FeelS $45 00 + Surcharges
~'l """"111 i.::J:i.::-uV 1-
';190 You may obtalrl caples of tbAJO.UA.",,", - --l
co", th 4 [SrJlN'trlH'LOFABOVE ,(,r ..-
c.,r,ng e center (Note the telephoh3 't~
number_for the Oregon Utility l\8%fSlale<SlJrchar e 3 100
'-''''"l'''l I~ 1-800-332-234j1iJ , l'I~T~~E' vf
5~:d'L::t:1!I~e~,p~.M!J SHALL EXPIRE I, T~, cz~
TPTAU AUTHDRIZED UNDER THIS PERMIT I>{~~<-
, I'''''Hpr~lr_cn no Ie: IIBANnONED rUf{
Shared DnWfJJ)fl1ullahlg..tlefttJsrele\;tHcaf PermIt AppllLatlOn 1-06 doc
ANY 180 DAY PERIOD
EXpiration Date
InstallatIOn, AlteratIOn or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
$ 50 00
$ 69 00
$10000
Over 600 Amps or 1000 Volls see "B" above
D I Branch ClflUlts
$ 43 00
4'5 ".
$ 3 00
Owners Signature
Inspechon Request 726-3769
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00864
ISSUED 08/14/2006
APPLIED' 07/11/2006
EXPIRES 02/14/2007
VALUE:
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
SITE ADDRESS 3618 CHEROKEE DR
ASSESSOR'S PARCEL NO 1802061201400
Spnngfield TYPE OF WORK Heatmg System
TYPE OF USE
New
ResIdential
PROJECT DESCRIPTION Install gas furnace and heat pump
Owner CARA MCCAULEY
Address 3618 CHEROKEE DR
SPRINGFIELD OR 97478
Phone Numher 541-726-8461
I CONTRACTOR INFORMATION I
Contractor Type
Electrlcdl
Mechdmcdl
Contractor
MNB ELECTRIC INC
COMFORT FLOW
LIcense
162191
460
ExpiratIOn Date
11/19/2006
06/27/2007
Phone
54t-726-8601
541-726-0tOO
BUILDING INFORMATION I
VN
# of Stones
HeIght of Structure
Type of Heat
Water Type
Range Type
Energy Path
Spnnkled Bmldmg
Lot SIZe
Sq Ft 1st Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Gdrdge/Cdrport
Sq Ft Other
Occupant Load
# of Umts
Pnmary Occupancy Group
Secondary Occupancy Group
Pnmary Constl uctlOn Type
Secondary ConstructIOn Type
# of Bedrooms
R-3
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Sethack
S,de I Sethack
S,de 2 Set hack
Rearyard Setback
Solar Setbacks
Overlay Dlst
# Street Trees Rqd
Paved Dnve Rqd
% 01 Lot Coverage
Total
HandIcapped
Compact
Street Improvements
Storm Sewer AvaIlable
SpeCIal Instruction
I PUBLIC IMPROVEMENTS I I
ODilia",' requires you 0
ATTENTION Ore, S,dewalk, Type ty
d tn(J 0" t _ v
f 11 w rulc~ a 0') v , 1
o 0 Ce'ltcr 1 i'JccDownspoutslDrams
Notil cat'on ,,'
O,\n ,,"_'l 001-081C I, '
In r Ii .........(....
0080 YOJ rrzry 0../ ~ 1 ~, co ~
call lC t'l~ eel" -I
nU~~:1 f~y 'l\W C~
Cc ~\..., ,~ ~j
_hLlhCE
I HIS pE:RrvilT SHALL EXPIRE IF THE WORK
IJTHORllClJ UNDER THIS PERMIT IS NOT
'Ie NC~D CiR IS AFJANDONED FOR
Notes
" I ~ l-11~~
P d2e I of 3
.
-.
-
"
Status
Iss u ed
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO. COM2006-00864
ISSUED' 08/14/2006
APPLIED 07/1112006
EXP[RES: 02/[4/2007
VALUE'
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
54t-726-3676 Fax
541-726-3769 InspectIOn Lme
I ValuatJOn OescrmtJon I
DescriptIOn
Tvpe of ConstructIOn
$ Per Sq Ft
or multIplIer
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
l..Fpp< P.."r1 I
Fee DescriptIOn Amount Paid Date Paid Receipt Numher
-Mechamcallssuance Fee- $1000 7/14/06 1200600000000001068
+ 10% AdmmlStratlve Fee $450 7/14/06 1200600000000001068
+ 8% State Surcharge $360 7/t4/06 1200600000000001068
Apphance Vent $600 7/14/06 t200600000000001068
Furnace - up to 100,000 htu $12 00 7/14/06 1200600000000001068
Gas Outlets t-4 $400 7/14/06 1200600000000001068
Heat Pump $12 00 7/14/06 1200600000000001068
Mlmmum/Adjustment Mechamcal $11 00 7/14/06 1200600000000001068
+ 10% Admmlstr.tIve Fee $450 8/14/06 2200600000000001132
+ 5% Technology Fee $225 8/14/06 2200600000000001132
+ 8% State Surcharge $360 8/14/06 2200600000000001132
Add, Alter, Extend C1rc $43 00 8/14/06 2200600000000001132
Mmlmum/Adjustment Electnc.1 $200 8/14/06 2200600000000001132
Total Amount Paid $11845
I Plan Reviews I
To Request an mspectlOn call the 24 hour recordlUg at 726-3769. All IUspectlOn requested before 7.00 a.m.
Will be made the same worklUg day, IUspectlOns requested after 7.00 a m. WIll be made the followlUg work
day.
I ~p,nL'lrprl Ini.nprt'gw
G.s ServIce After hne IS mstalled and hne has heen connected to a mmlmum of one apphance mcludmg required
testmg Presure test done at this pomt
Rough Mechamcal Pnor to Cover
Fmal Mechamcal When all mechamcal work IS complete
Rough Electnc P, lOr to Cover
Fmal Electnc When all electncal work IS complete
Paee 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO' COM2006-00864
ISSUED: 08/14/2006
APPLIED' 07/1112006
EXPIRES' 02/14/2007
VALUE:
225 Fifth Street, SprIngfield, OR
54t-726-3753 Phone
541-726-3676 FdX
54t-726-3769 InspectIOn Lme
By SlgnatUl e, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certIfy that all
mformatlOn he. eon IS true and correct, and I further certIfy that any and all work performed shall be done m accordance WIth
the Ordmdnces of the CIty of SprIngfield and the Ldws 01 the State of Oregon pertammg to the work descrIbed herem, and
thdt NO OCCUPANCY wIll be made of any structure WIthout permIssIOn of the Commulllty ServIces DIVISIOn, Blllldmg Safety
I further certIfy that only contractors and employees who are m comphdnce With ORS 701 005 will be used on thIS project
I further agree to ensure that all reqUIred mspectlOns 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 remam on the sIte at all
hmes dUring constructIOn
Owner or Contractors Signature
Date
Pa~e 3 01 3
225 Fifth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
c.", of Spnngfield OfficIal Receipt
l "Iopment Services Department
PublIc Works Department
Job/Journal Number
COM2006-00864
COM2006-00864
COM2006-00864
COM2006-00864
COM2006-00864
Payments
Type of Payment
CredllCard
cRecemtl
RECEIPT #,
2200600000000001132
Date' 08/14/2006
Descnptlon
Add, Alter, Extend Crrc
MinImum/AdJustment Electncal
+ 8% Slale Surcharge
+ 10% Administrative Fee
+ 5% Technology Fee
PaId By
MNB ELECTRIC
I tern Total
l:heck Number Authorization
Received By Batch Number Number How Received
Ikw
755473 In Person
Payment Total
Page I of I
9 46 43AM
Amount Due
4300
200
3 60
450
225
$55 35
Amount Paid
$55 35
$55 35
8/] 4/2006