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Home My WebLink AboutPermit Electrical 2005-12-1 . . The fO. 1I0wing project as su~~ ~ollOwing ..ng. . and does not reqUire ~~d use . , val_, r:l./O). J D~ ~ ,. . '/~ . S?l~~:~rj @~.J1 . . ~" 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689'j'18\ ELECTRIC PERMIT APPLICATION -OJhij~ City Job Numb r .. .. 1. Loc"A?nONOF INSi4LLATION i116~~'<)/dh' .!JUt- LEGAL DESCRIPTION 7J (2/J3 c# 3/1 0 5360 . JOB DESCRIPTION r/lttL-fUn0' Permits are no~nsferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ',:,j~' ..". :',' "~~.':,,., fr"':"~:",:,,,;~, "..:;;. ~'..' <,-'~ ~".,.' ..: '< '''':'v, '., > > .,~ '?~ ", ' , ." " "', ..:",,' ,CONTRACTOR INSTALLATION ONLY 2. ',' .:t :",'\" .,~:,;.t;.', ";~<::< ::,~. ;;.,.,,{....j:..:~~,:!;,,".,>~,:i.;.~7.~::.\,;..;."'.:. .:.,~: .i;-,i~-.::,,'..:;::~7i.;,;~,..':.J.;,,<Jt;.;;;/1.; Electrical Contractor (!. ~rV<t III S E:. /e..e.! /Vc.. Address po. 1/93 fS c>X City (!/{~..., l<Je:.) I Phone f"9..s - '79 t. ~ Supervisor License Number ,J..97tJ- S Expiration Date Jt)- d/- a.7 Constr. Contr. Number 15 '} 5 _~ 7 Expiration Date 9 -IS - ()f? Signature of Supervising Electrician (lhvt ~ ~ ' Owners Name~ >{~ ReiD Address /JL1l '2A 91)71 IA flU_ ~ phoneq5-(g(Q C The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Date /;:( / II nJlJD5 '~"',. . . "', "'" ,",.. .~,":., ,'.".':""~,' B, .~':: :." '" : v' '". .~~.. """"~~,,,_'.': :f':,'f~;~",'.''<''%,''\''':';:':'!'',.':'("'''"/>,'',,;:,,>,,, "..CO"'~I:1'LE1'E. p. 'EESC. 'H' ED.U'TE.BEL..O. T:v"""'r"'.'.""'. .,.".""...,...".....,,,,., 3. :L." ': .~,~~.. . :.,:': ,4 "', :_;~",:. '.. ,; ..'.':,~ :" ".<. ~:,.,.,.~,:,/.~ ~ ~"'_ ':,v" ~ ,:.""~,~ .~:~::;':~:::,:;rd~~~~!Ei,~~~:~:~1?~;:.1~)::2;~:;f';;.~~;~;'~i:;~1i; '. ~"', <:" "" ,", '. ," ,.::,:: '.:~:';:~;'. :'. _,', ::.; ':~~-.'/"'..'~.~"lr~<\::r: <~-:: '.'_~~ . . -:i' :.:", 'r~:' -;::::~':~.if~-F:r'.r,:J "_'j' ;<,;-.:.'-,: ':~~ :', <t.~':-\:1/ ;',:{:;:>:'~~~':~-;t:\ A. ;, New. Resid~ntiar~Singl~Qt.l\ll1lti-l'arnil~;I>efdJyelling.unit~'r',;'; h,!' . . . '._' ," '" '",. ", .' :=,' '-," . .,,', ,_ .,','0':"", . " '.<:'i:.:" ,..,," ",. . "'~:'" .'.,u. . ".,....-,.,,,.. ."~..~,,,...:"""~'N,..~..' ""'_ "..l.,:<.~,~'.".'",;.. .', ,P." '.,.,~.' ,,' ,."..:,~:~';';..j!'.: Service In~I~de.~,\ITIOI I. ft. ' I . N. Oregon law . 1000 sq. . or ~~srul"" ~I reOUlr$,1.06 no t . . . . .' Aunr)t"'G ~.., ycm 0 Each addltlOnal:?9~Js,qcft. or~ v by the Oregon I It'/' portion th~reof ')52' ent",r. Those ru/p~ <>$ 1~.Oo' Ity . . " '.J -001-0010 th "', e set forrn , '"'\ , rOugh OA Each Maiiufa~t:d:Iiom~~robta; . R 952-001~ Modular Dwellmg Ser;vIs;e or n COpIes of thG5~;"10'-O~ b "~, "'t; \,;enter. (f\Ir\f~. ~I. . J> O. ':I V Feeder numbEH for the r - '~', ~' II;; :dephone . B. ;i~\~:t?~~K~r.;~!I~/t,~;~ttr.~!~~J$jp1~j#j 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNo1ts $375.00 ReconnectPrJ~.,CE: $ 50.00 . . .'... ,,],,'.lIji:\.;,QPO'ltA".' ,."".,...., ".... . ...... ..... c .~:T~hip~~~irSet~i1t~ltr'$Ni!r'~j');n;)\i:)G~F ' , . ;:\,.'")it't:J"~.HO~lttrtuN6:~';~XPIR,.., WORK InstaIlatig~M.MliM(p!@'{]JfllSaAi~~/S PERMIT IS NOT 200,Amp~ or~e180 DAY PERIOD. ANDOIQ:"DR 201 Amps to 400 Amp~ $ 69.00 401 Amps to 600 Amps $100.00 O~~r 600::'-mps or 1000 V o]ts see "B" above. D. ,~ranc~:.Sit~u New Alteration or Extension Per Paney One Circuit / Each Additional Circuit or with Service or Feeder Penn it 113. cfb &.a-V $ 43.00 6< $ 3.00 . :;.: ~ . .,::,.'';: ,: ,.:- ....' .> . >;',:':::.: 'i'. -_~. ';- :.'""',,, 7. "~~,'>: .:'.~': ,~<-,',.'\~i'~Hn...,.:;::,!!_':,,:,.,..-:..:;,'."~-"'::'::-," .~:: :"', '" . , ~', ,~' :'~",:~<. ":' E. ,.l\:lisceIlaneous (S.ervicejfeeder'~otincludedi'2E1ch Inst~liaHo~' {',\ '-~ ., ':''-.'. . y.' '.'" -l,,' : ",' .: ,-:',. .'.c':':;-; :. "<. . :,:;,\i:.: ;~,,~. ,,:. .:. ";,:...', ':/., .';> ".y,:, /;: . '~'.~; '~~~'k~":~' .:;',~ .~;: '::',~,.: ..' -<~ <' j::: ,';- ','.' '.. '::,":\,,~".-: '" ,~~:' Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges -<l9.{JZJ 10>. "l3 ...<. / < i:J 0 _57-33 . ,t.... ,', .... :. ',{'....,'.' ';. ~..:":: ~;. 4. :5 SUBTOTAL OF ~.OyE';\; ':", . : . '.'~:..:.l<,. :';, .,' . "'"..,"-,'. 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Elecuical Pennit Application I-03.doc ,~ ,._~~~laD, . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01646 ISSUED: 12/02/2005 APPLIED: 11/28/2005 EXPIRES: 06/02/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line SITE ADDRESS: 1110 CUSTOM WAY ASSESSOR'S PARCEL NO.: 1703263408300 Springfield TYPE OF WORK: Heating System TYPE OF USE: New PROJECT DESCRIPTION: Install heat pump and associated ductwork Residential Contractor Type Electrical Mechanical Contractor C PERKINS ELECTRIC INC EUGENE HEATING & COOLING , ~.". ,..., ,_ __~ \"\AI ronllirAS VOU to 1\,. -''"'~- U..."r+ . , - dPh .,. 'Nn'''a:;11"'1r.\ 5'A'IY.915 6767 , , ' -r atiopt8- one: umuer: ..' - - ..'l_'~ccnter. Tho'se rules are set forth i , . ';~1 ~~2-C01-00i 0 through ~~R_ ~~.~:~~"':~ . ", "nL1 may 001allll,;UfJ1v':> V' .,.- . -' .' . I CONTRACTOR INFORMAriONr,:nter. (Note: the tel~~ho~e ,.., lor the Oregon Utility Notlllcatlon nun\o.~r _~., ....~."' (V" '11\ LIC~I!~~er is Ex,plration.:))ale Phone 159537 04/15/2008 541-895-4466 149452 10/22/2007 541-726-7654 .. Owner: Address: THOMAS REID 1110 CUSTOM WAY SPRINGFIELD OR 97477 BUILDING INFORMATION. - # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: If' # of Bedrooms: ~ VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: :aa~;: ~~I~CE: ~;:.~;~:;I.~~rport EnergyTpHfltPERMIT SHALL EXPIRE _(Q,.~~IW~rK Sprin~~IMiiaUltD UNDEAt~HIS Pt(blMlpditMQTd: G~H.HI.~n~~~ ~fll: ,^,2,^JI~r.'rIE~ f~~ DEVELOPM I REQUIRED PARKING Total: Handicapped: Compact: R-3 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 rU~LIC IMPROVEMENTS I . Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: - Notes: Pae:e 1 of 3 ;.- _ '-~Il!iI~nJIlUooDJ. . Status . Issued _ 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line .' Description . Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Heat Pump Minimum! Adj ustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid I Valuation DescriRtion , $ Per Sq Ft or multiplier Square Footage or Bid Amount . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005;'01646 ISSUED: 12/02/2005 APPLIED: 11/28/2005 EXPIRES: 06/02/2006 VALUE: Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number 1200500000000001766 1200500000000001766 1200500000000001766 1200500000000001766 1200500000000001766 2200500000000001651 2200500000000001651 2200500000000001651 2200500000000001651 - .. $10.00 $4.50 $3.15 $12.00 $33.00 $4.90 $3.43 $43.00 $6.00 12/1/05 12/1/05 12/1/05 12/1/05 12/1/05 12/2/05 12/2/05 12/2/05 12/2/05 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. $119.98 I Plan Reviews I Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. " Pae:e 2 of 3 .. . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005-01646 ISSUED: 12/02/2005 APPLIED: 11/28/2005 EXPIRES: 06/02/2006 VALUE: Status Issued 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 ofany 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 "fth Street . Springfield, Oregon 97477 541-726-3759 Phone . t!.fll!l.~g,,~"'l> '.._ "." ! , ~ty of Springfield Official Receipt ~velopment Services Department Public Works Department RECEIPT #: 2200500000000001651 Date: 12/02/2005 11 :26:55AM Job/Journal Number COM2005-0 1646 COM2005-01646 COM2005-0 1646 COM2005-01646 , Description Add, Alter, Extend Circ Add, Alter, Extend Circ EaAdd + 7% State Surcharge + 10% Administrative Fee Ptlyments: Trpe of Payment CreditCard Paid By C. PERKINS ELECTRIC Received By nJm Item Total: Check Number Authorization Batch Number Number How Received Amount Due 43.00 6.00 3.43 4.90 $57.33 Amount Paid wendy 323766 Phone Payment Total: $57.33 $57.33 ':( :l - 'a, , , . , :( :i -, 'a ') 12/2/2005 Page 1 of 1 '(