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Home My WebLink AboutPermit Electrical 2005-12-8 I . 0 ':-iW'e~C' ,,,'be"," ..,. :~7=PM.fi;"~~;' "'(""'~"" .'AX;~~.~~.. f*f~ CiIY~~,~~~~~::..._,p~'.. _.,... ,.' .. . _., ~",.',o\~~"';i~~:",".x6~ii~~i,D:"-,,_~ .~, I. )hOCATION:OFJNSTALLATlON" 3. COMPLEl'E;gJilltiF!.If~r"~'~J:",,~~~,~.7"' ~~~-~PN-\:()\rM tf.>m \ :. ~,~--~<',.~2~1~;'~":'~":"'~'-"'~"-"::"" .,:~ LEGAL DESCRll'TION A. , New,Reside'ntiiW-cSingle'od\tiilticFamilv,per.dw,ming'uiiiL"t. \l1t0\~ Cf}J1DO Se;vi~~I~c~d:;'-""''"c >,"'", ." ."-~-., . - .<='0 JOB DESCRIPTION 1000 sq. ft, orless $106.00 \ \' 1\ _ --l\'-' \ "" Id (\ Each additional 500 sq. ft. or \:},i\Q _ \." ~0~ .. ~ '{ NY portion thereof $ 19,00 Permits are non-transferable and lpA-e if work is Each Manufact'd Home or not started within 180 ~ays ofissu;~ or if work is h1.!!dular Dwelling Service or $50.00 Suspended for 180 days. NOTllidelIer 2. r(;Q.NT.kA&ORiN~'fft.1;T.A:fJON-oNiy TAHUTISl~~~~~E~IBfi;1f:ijfftt~~~~so; .R~fati~,;~,,;,; ... . ..... . " . HUHiLtulmoHFtl1lS PERMIT"IS NOT " -- - ._-" - MnB Electric Inc. COM~~IA~~I~ABANDONED FOR ANY 1~ ~~fJ;F4l13l).mps Electrical Contractor Ad~ 957 Northridqe Avenue City Spfld 741-7369 726-8601 4874 S Phone Supervisor License Number Expiration Date 10107 Constr, ContT. Number 162191 Expiration Date 11/19/06 Signature of Supervising Electrician /], 'v: r//~: . Owners Name ~ \-\~ Address \)() ~_ ~\o.., City J", 'Y\ f'fIf.J Phone - -V\ OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolls Reconnect Only $ 63.00 $ 75.00 $125.0.0 $163,00 $375.00 $ 50.00 c. -:Te~pon~b~'Sehi~~~;~rfFe=ed~rS~T:;~'. ':'~~:' .....~.~?...,.,' =~.?~~.';-,':::~~' ~,-~,' , _ _, ..", .~_.. ~ ._ ..........u '"_.......~..~. -~~ - IDstallation~ Alteration or Relocation 200 Amps or less $ 50,00 201 Amps to 400 Amps $ 69,00 . 401 Amps to 600 Amps '(eS '101.l to $100,00 ~1f\\oJ(eC\\JI 111'1Il\! RJ(~r 600;l'\IDps or}OOOrYolls~see "~above. h:1"iEJl}1 :lliJ';;'cl}iG,r~~;t;~''r:.l'lM<6',j;Ji.t.~.. ''1>j)>i\",n~ :';""'-?~?'~~:' ,.... 10-' ... ' . . _ :f3$ ~~ " ... ,- - ........,. ~ ~ .. -"~" '...... I \'I (I.l~" ~ - . 1'"\10 - "''90< _..,..... ~ ,-,.~.,-~,- 1010 rc'''\' . ."' n1>-" ",' I Cat\d"iew Alteration orJExtenslOn,Per Panel ,,\~,.y, Not' , ,...."' ~ ~Ol ) \ v ~.. S 0' \nl;:; ,..... \ \..(.,...J 0"1'1 ~pi\e eircu!~'8'11 cop"e, '0 e'1' o"c~ $ 43.00 _ ~. '" 0 ,,(Each "Aaditiona1 ,(;;ircuit' iii' with, I I :11.011 OOn 1. ~~r \.- ~ \ ' j...J " Ser;vice 'oFFeCderPermit,-\.\f \'.... cr\\' '~; ~ - p, o~eqO\l :..r 'i3~..l-t!. ,,)..-,r+:." .\l!.1:--....'f..s;:Qi..,,.,...... i~~'"'"":':""'; _ .-, ,~., ';, " ",:...~;,.-;..-'-;.;.;>'~,.-;.' nurE~ ., MisceUiiieous:(SemceJfeeder,nol'inc1uded) -Eacb'-IDstamitioD \.." ,- " . ."'.. '-, '':.1. _,'_ . .' ,"...;~ ~ ,." .. ":'-:~ '.,!""",:":,,..:=:<..;--. $ 3,00 Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Comm...cial /". ._ .'~ 45,00 Minimum Electric Permit luspection Fee~ Surcharges 4 ' sciBT6T'ALoj;.~(j:tfE{,<;Tt::;::;,' "'. --: .A~ (tJ . '.'. " ....~ :'.. ~\' ..:_~.~.-.; -,:_:::=-::':;:~ . ....." .~. \. . 7% State Surcharge . . \ ~ ] 0% Administrative Fee 4\. ScJ f)'L~ TOTAL Shared Drive(T:)lBuilding FormslElcctrical Permit Application J-03.doc ,- . " $P;:;:::t'.._C.r=Ie:~O =';::'J~~: - . ~. _ r. ~~5it~~~~~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number f1om. fJ. DOS"; 0 17 oS- Phone 741-7369 726-8601 4874 ~~l~1f c. .-:~.e';por:;rr_~~~~f~~erS;:_"~:_~ _~.'''':'': :i2f::;-:,0 1 0 I 07 AUTHOR ~MIT SHALt''!. lation, Alteration or Relocation' COMM ' -lED UNO CrfresFH $ 50,00 162191 ANv 'n~NCED OR I&W flEftWflf~ORK $69,00 t." UAY PERI(jfJI ~ A Nor $100,00 11/1 q/06 O~er6o.0~p~1 _Volts see "B" aboye. . _ ~,"."-'." ~.C';' ,''::"---;~~]:'r''l;-!': .:;i :-_';~' '~- '-;~~a-_"''''',,,~,!:~~,,:',,~_; h -~~::-~ D. ',,;Branch' -<lrcuds3:.:'<;:'.':'~'-,-;~-':- .;.".:'W.........;. _,;.:.~,;......_"?_,.......~.f "':- '"'".....""f".:.-~:;'<':d;-"', ,..,: _ .,-' '.': ":",,,--., . ,\l.-,,-!,-.;...:t.~'3:.t?!.~~...:.;~_.;;." _~.:...z;t':,;;-?-"-.~;::".,!:;.,,'1.::.:-~t:<~f)...J.1't. 1. &l?f1f!QNl'f.li-'siALflTiON:,~: . 35 3 ;])....<.~.l "hnr':Y ~~.t.... U LEGAL DESCRlPTION 17, o.~ . 6. 4t; . JOB DESCRlPTION 62-;)..L>0 /.k~ f)~ (lirl'~~ Pennits are non-transferable and expire if work is not started within 180 !iays of issuance or if work is Snspended for 180 days. r~.:;--:-:~:-~--:::-v. ~,_" ..... . --:-;'.- ~-~ '--., 2. : :c;QNF~crO!UNST.A!LATIONONLY - ....._~ ..' ~ -. . - - . . . . . Electrical Contractor MnB Electric Inc. Address 957 Northridqe Avenue City Spfld Supervisor License Number Expiration Date Constr. Contr, Number Expiration Date . . - "IUN''Q;I, foll..w r I ' , '2gon law re . Ai.':>!". 'N ' u e~ adopted by th qUires you to vwuers. _awe C--' e n,.n~_ . in OAR 952' 0 -, "~I. I nose rul ~-., VI/Illy Address . 01,On""l'" es are ~'" f~.t" vv"u. tuu may b . .... u"'8fl UAR 9 " ,/, CitY'"I.~~ thn.-. 0 lain cOPliou~'f'h_ 52-001_ "~'"'u f --, ,,",. ("'ote. II '0 'VI"S oy C, u' 1,", ' . le tele h OWNER(lNSTALLATIONUtil/ty Notif one "...., J~ I 0....U ~r'.. ,catton Th' II' . be' d "~,2.~,,~, 1 h' e msta atlon IS mg roa e on property own W Ich is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 /ajq I~- Date 3, 'ifQMPL~l';, J[-#jiS9!:!fii.'i{4PJ{ffO~2~~~~~}({j!'f~0::-% A. ,:_~~'-R~ld~'~i~l;l~iri~i'~~~f~.~~~i;iii;~-~;~it~~elifii.g"~li}~ . .',...:........,.~::..--._' ''..c_.: ,..1-;-;';.' ....;(~..'-"',,-. .-.,.....:::'.....~.4;, -; - -~~'-::->.; Service Included 1000 sq. ft. or less Each additional 500 sq, ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50,00 -'":--.:;-~...~:.-.-;:-":'"!':"".:.:7. -':'"'". "'.'; (..~,~;-.s---.,.;t~,,-, --:'..-, '..:-:..,~.....'~'-.I B. Servjces'orFeeders~~In~i1lation~~~lterations:OJ:R~location:rI :~' .~._ -..:" ; ,.~-<-~.-,.~~.~___..._~~:--:._.-.';';':;:::'.:...:1;;.';;~..-": 200 Amps or less 20 I Amp~ to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63:00 $ 75,00 $125.0.0 $163.00 $375,00 $ 50,00 New Alteration or Extension Per Panel One Circuit ' I Each Additional Circuit or with Service or Feeder Permit $ 43,00 43- $ 3,00 .'.7-"~~''''--.-''"--:- 7;'~~'.:'- ~ ,_""'~ ~"''':.'-, .'., .. .;~~:;:;'._-;i-;~'.:;;-"---_' E, Miscelh,"~iis ~Servic~feeder"n~t '!n~luded) '-'~ch':ln:sta!1lPiiu . . ... ,. L... '."_ - '. -.,-", ..,'- .. ..'...... ........,.....--...,.). Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited EnergylCommercial $ 45.00 Minimum Electric Permit Inspection Fee is 545.00 + Surcharges 4. SlJBWTALOH1J;"6'liji;:t:Tf.iF .\',::~~' .. ..;--.... '....., 45".- 7% State Sureharge ) 0% Administrative Fee ,~. Is' .I-.h S7> dJ,;;, (,.:;.~ TOTAL Shared Drive(T:)lBuilding FonnslElcctricaJ Permit Application I~03.doc . tI CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Building/Combination Permit PERMIT NO: COM2005-01705 ISSUED: 12/08/2005 APPLIED: 12/08/2005 EXPIRES: 06/08/2006 VALUE: SITE ADDRESS: 353 DEADMOND FERRY RD ASSESSOR'S PARCEL NO.: 1703154002200 Springfield TYPE OF Heating System TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace heat pump and air handler Owner: PEACEHEALTH Address: PO BOX 1479 EUGENE OR 97440 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor MNB ELECTRIC INC COMFORT FLOW License 162191 460 Expiration Date 11/19/2006 06127/2007 Phone 541-726-8601 541-726-0100 I BUILDING INFORMA TIONI " # ofUni1s: Primary Occupancy Group: Secondary Occupancy ),"rimary Construction Type Secondary Construction # of Bed,ooms: VN # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 nla I DEVELOPMENT INFORMATION' Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: " Solar Setbacks: Overlay Dlst: # Street Trees Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: " ~UBLICIMPn.u""'MENTSI Street ATTENTION: Ore(1on Im'l renu,,"',' Y~';I'~I n., "!es Rdopted by tile Oregon..,' '~, Storm Sewer AvaIlable. T:'o~e ru'I;S SI P 0-" L, ,n Special Instruction:atlon Ce:1ter,lO ~t1fOllr'" OAR SJ:'..001- in OAH S52,0010bOt 'n COr] 'S of the rull's by N Y mall 0 al 'v. otes: 0090. OU " ' 't'le blCpho'le " th ce'1tcr (Note. I .~ calmg C '0' 0:1 U.il'ty Not'hcdl,on number for the reg, . 2.2344). Center IS 1-800-3::1 Sidewalk Type: Downspouts/Drains NOTICE: THIS PERMIT SHALL E AUTHORIZED UNDER T~~~~E'~~HE WORK COMMENCED OR IS ABANDONED IT IS NOT ANY 180 DAY PERIOD, FOR I of 3 . tI CITY OF SPRINGFIELD. Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Building/Combination Permit PERMIT NO: COM2005-01705 ISSUED: 12108/2005 APPLIED: 12/08/2005 EXPIRES: 06/08/2006 VALUE: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or muItiptier Square Footage or Bid Amount Value Date Calculated . Total Value of Project I Fees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid $4.50 $3.15 $43.00 $2.00 12/9/05 12/9/05 12/9/05 1219105 Receipt Number 1200500000000001795 1200500000000001795 1200500000000001795 1200500000000001795 Total Amount $52,65 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. 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, 2 of 3 . tI CITY OF SPRINGFJELU Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Building/Combination Permit PERMIT NO: COM2005-01705 ISSUED: 12/08/2005 APPLIED: 12/08/2005 EXPIRES: 06/0812006 VALUE: By signature, 1 state and agree, that 1 have carefully examined the completed application and do herehy certify that all Information hereon is true and correct, and 1 further certilY 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 wiD be made of any structure without permission ofthe Community Services Division, Building Safety. I further certllY 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 wiD remain on the site at all times during construction. Owner or Contractors Signature Date 3 of 3 I 225 Fifth Street f~rini?neld, Or~gon 97477 . 5~1-726-3759 P ;Ione .~~ ~, ~ of Springfield Official Receipt "~elopment Services Department Public Works Department " Job/Jou,nal Numbe, COM2005-0 1705 COM2005-0 1705 COM2005-0 1705 COM2005-0 1705 Payments: Type of Payment CreditCard f '; , '0 ~! r ~ ( . ": ,. , ,: , .;. 12/9/2005 RECEIPT #: 1200500000000001795 Date: 12/09/2005 Description Add, Alter, Extend Circ Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Paid By MMB ELECTRIC Item Total: Lheck Number Authorization Received By Batcb Numbe, Numbe, How Received Ikw 7004668 009396 In Person Payment Total: I of I 1l:39:40AM Amount Due 43,00 2.00 3,15 4.50 $52.65 Amount Paid $52.65 $52.65