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Home My WebLink AboutPermit Electrical 2005-5-4 CITY OF~~rRINGFIELD, OREGON ,.-.' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL P~T APPLICATION A City Job Number u., 0 . 5'LLO. Date t) " . t 1. D" . 3. l:tl~~Mi~.I,f,l\~J:i?~.{t;'~€.~I~~liJl\tl~i~li.\1.111l ~ \'<$>.,\ A. t~..'.'''.''..e.iw.i.I~es.'. 'J.lf~ftf~~;rig?'rar.l?L."..'.~~*f1iin.(i'b."".<.' I .. .. TN.." 'I~~,:--_ "~1~:""~~c;;.n'n. Service Included ~(\)O' ~ .,0.... <$>0.1' &. \. '$ 0.1'", 1000 sq, ft or less ~ ~ p,/:l~" $106.00 Each additional 500 sq. ft~'6J: ~.Y (\) 0.1' i~o- portion thereof (\)'~ :<:)(\),.,.~9,00 ~.~~ Each Manufact'd Home or \. \ ~ ~~ Modular Dwelling Service or ~O' o~ Feeder ,\$50.~ ~i ::::::~: ~:nse NU~~ ()11:~ f;;~r~~E~i~~;;':~:;on'" · ->"Y~~ , Not,fn';t1lltion CfrG~I9S~fu regon UtilIty $ 50 00 Constr. Contr. Number J S { p (fl <g'~~~~~ 952-00j600.ft1J>~~dn8J~~e9set fann $ 69:00 . YOU ma}4CDb~Sdt)pM~ 52-0ll1' $100.00 :::::nO;::p.NiSing EI~ctrician "~~~:;E~r_t~l;;t~.e rUles. Q~" abov.. New Alter;tion -~~nsion Per Panel One Circuit \ $ 43.00 Each Additionitl Circuit or with l Service or Feeder Permit $ 3.00 NOTICE: THIS PERMIT SHALL EXPIRt01fi}W~tWmtf~ Fee Inspection Request: 726-3769AUTHORIZED UNDER THIS ffffi~LT IS NOT COMMENCED OR IS ABANDOi\lEn ~nll , . . ... . ""SHaMd Dnve(T:)/BUlldmg Forms/Electncal PermIt ApplIcation I-03,doc \dio &\41 ANY 180 DAY PERIOD, LE\"~~4'b ~ - \ Wv -\ y,:~ JRB DESCRIPTIO~ 1*. ~ 1MJl.(:J5 Permits are non-transferable an not started within 180 days of is Suspended for 180 days. expire if work is . ance or if work is 2, Electrical Contractor ~ Address \> O. 'P>0-J- :25l~( City 6lA cp1L- Phone 1.f(U.-5t./..1 cf ~.v~ ~n ?~. '!)AD\ E. The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: c&'~ B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only " ~. \. $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 4~.~ "6.0 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4. ' 4\0~ t 7% State Surcharge ~e.aAIlNs.IIII-...a!' . , . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00526 ISSUED: 05/04/2005 APPLIED: 05/04/2005 EXPIRES: 11/04/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4512 DAISY ST ASSESSOR'S PARCEL NO.: 1702324304201 Springfield TYPE OF WORK: Heating System TYPE OF USE: Addition PROJECT DESCRIPTION: Two Circuits for Heat Pump and Air Handler Residential Owner: WILLIAMSON JANICE M Address: 4512 DAISY ST SPRINGFIELD OR 97478 Phone Number: 541-726-2401 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor ROBS ELECTRIC INC License 156678 Expiration Date 08/14/2005 Phone 541-686-5444 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: NOTICE: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 7111: f~fHvilf '";i1Mi..i.. CAt'IMt 'r:- AUTHORIZED UNDER THIS P COMMENCED OR IS ABANDONED FOR Frontyard~ljtP,ck: Uverlay Dist: Side 1 Set~~R: tsU DAY PERIOD. # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: ATTENTION:Oregon la~~t&PrWgs: Solar Setbacks: follow rules adopted by the' Oregon Utility ~,I_.'~'I'--"'-'-' ~ --I. -I . ~ __..J':, -.=...-.. CO_..I........ ._.;!:'~q,Il.I.~*""l.....,,~...'e'.... '.1. " in OAR 952-001-00 J'S Street Improvements: 0090, You may obtain copies of the rules by . c81lling the center, (Note: the telephone Storm Sewer Available: numbsrforthe 0 UtTtv N 'f' . Special Instruction: . rsgan 8 i,y at. Icatlon Center.s 1-800-332-2344). ~' ~~ENTINFO~ATION REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 . . ....4.891lM$UIIIl'~Q . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2005-00526 ISSUED: 05/04/2005 APPLIED: 05/04/2005 EXPIRES: 11/04/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $4,60 5/4/05 2200500000000000531 $3.22 5/4/05 2200500000000000531 $43.00 5/4/05 2200500000000000531 $3.00 5/4/05 2200500000000000531 Total Amount Paid $53.82 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 Req.uired Inspect~~gLl 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 ofthe 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 Paee 2 of2 2f5,Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 2200500000000000531 Date: 05/04/2005 12:13:01PM Job/Journal Number COM2005-00526 COM2005-00526 ,~ COM2005-00526 :l' 'I, COM2005-00526 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Trpe of Payment CreditCard Paid By ROBS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received llh 068719 Phone Payment Total: Amount Due 43.00 3.00 3.22 . 4.60 $53,82 .'.,' ,". 0\ ( Amount Paid $53.82 $53,82 ." \ , , ~ . , , , - , \' ~ , , ~ , 5/4/2005 Page 1 of 1