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Home My WebLink AboutPermit Electrical 2004-7-20 ,; 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)~3i ':l ELECTRICAL PERMIT APPLICATION 0.,,, City Job NumberCO"'" z,oo<t-oogB'3 Date "0- 2. 1€(i)NmlM~.!;l1..~H~S:r~t'PI(i)M@NnYt , 0./1..,,,1 --I. un:tJT.I(Do~C".E'IawreQU1re9youto Electncal Contraclor ~'-r. ~l~''l;-'e~ '2lJ Wlr~Utl.lity lOIIOWrw.;.~~ _~&btforth Address 500 .'5d.iI'J/(..1L ~~=-001~~ ~~1- "AQ9P,~QlayobYa.~t<!l~bf ' .$163,00, CityG~r-5 ftJ.5.5 Phone 7 tA15 ~1f.~~"(ttl!Jl~:"-IWtlY.~, .' '. $375,00 number for the ~awa~NoIiticatIGIt, $ 50,00 SupervIsor License Number L{r:x;?- S tenterl'. ~.;y~~Feed~ Expiralion Dale 10 - 01 - 0 L/ ' Over 600 Amps or 1000 Volls see "B" above, Signature of Supervising Electrician ' D. Brancli GircuilS ~ NOTICE: " - ,C .---:?' THIS PERMIT SHAL ~~~~~~HtVJ(mKn Per Panel ()d;. /":Y. . - '~~II"~.'~[D UNDE c I $ 43,00 -' .~, . "..r" , M(J;M}iNGtith.. \ ci Oh.1MENCED.OR 19;~<<lMlBffiIilit ' .. $..3,00 Owners Name VI V""- "",,&tl /Sf1{)AY PERIO . . Address 1/20 FA ,rJ/fFc# S{' / is E. Miscellaneous (Se""iceJfeeiler nol incluileil) "'acli Installation City S-:p,-=-" Phone 72-0 -.so)''( Pump or irrigation $ 50,00 Sign/Outline Lighling $ 50,00 Limiled Energy/Residenlial $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee i~ Surcharges - 4. rsl!1Bmrr~ @Ei~Jw..!.'.v.~ 1. rn@@Aq;I@N.~"".ll~S:PA'HHAq;I@N_ 1/7-0 r:::;..,.v,fw hlL s? IF LEGAL DESCRIPTION 1703.Z73I OObOO JOB DESCRIPTION A\') t:, C. I a..G\A \'" ..\- Permits are non-lransferable and expire if work Is not slarted wllhin 180 days of Issuance or If work is Suspended for 180 days. Constr, Contr, Number J 0,CJ0D 3 Expiration Date 7-/L{~ b0 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Requesl: 726-3769 A. New Resiilenlial- Single or. Multi-Family. Service Included 1000 sq, fl. or less Each additional 500 sq, ft, or portion lhereof Each Manufact'd Home or Modular Dwelling Service or Feeder $19,00 $50.00 $ 63,00 $ 75,00 $125,00 Installa.tion, Alteration or Relocalion .200 Amps or less 20 I Amps 10 400 Amps 401 Amps 10 600 Amps $ 50,00 $ 69,00 $100,00 113 tiS- 7% State Surcharge 10% Administrative Fee -S:/J l/JU <;;Z 6S TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Pennit Application 1-03.doc . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00888 ISSUED: 07/16/2004 APPLIED: 07/16/2004 EXPIRES: 01120/2005 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 1120 FAIRVIEW DR SPACE 18 Springfield TYPE OF WORK: Heating System ASSESSOR'S PARCEL NO.: 1703273100600 TYPE OF USE: PROJECT DESCRIPTION: Install heat pump and air handler Owner: JIM CHRISTIAN Address: 1120 FAIRVIEW DR SP 18 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor ~wequ\re& yoU.t\,~License ~~1lRffil \h8 Oregon UtI I'J 160603 ~~iIU'J1B I ~re s~t f~~~.149452 ~~~,~~~o\WioNI . "OAR maY Qb18II\ cuV ,ePhone #ofUmts: 0D90'-. lMolfl!i,~ . ifi ation Primary Occupancy Group: caft\nQ~ ~egIfuIllIi\i\\t ~cfure Secondary Occupancy Grou~toI 1~(ie~1}' Primary Construction Type ~ Is Water Type: Secondary Construction Type: Range Type: # of Bedrooms: Energy Palh: Sprinkled Building: Contractor Type Electrical Mechanical -~...- , DEVELOPMENT INFORMATION I Frontyard Selback: Side 1 Setback: Side 2 Selback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: New Residenlial Pbone Number: 541-726-5054 Expiration Date 07/14/2006 10/22/2005 Phone 541-659-0476 541-726-7654 n/a Lot Size: Sq Fllst Floor: Sq Fl 2nd Floor: Sq Ft Basemenl: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: r.l\'\~ .4af.1I ~1;,.,Iil'~PROVE~E \1' 1 \S ~O't 1\-\\S p~~N\\\ ~\~~ P~~~~Type: LlO~\lH) u ~B~~OOI1~\I r-.UI fl ~~c~O 01\ \S Downspouts/Drains: COt-/lt-/l 0 O~'i p~~\OO. ~ti'i ,~ Street Improvements: Storm Sewer Available: Special Inslruction: Noles: I Valuation Descriotion I Descriplion $ Per Sq Fl or multiplier Square Footage or Bid Amount Tvpe of Construction Pace 1 of2 Value Date Calculated Status Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-37691nspection Line " Fee Description -Mecbanlcallssuance Fee- + 10% Administrative Fee + 7% Slale Surcbarge Air Handling Vnit Vp to 10,000 Heat Pump Minimum/Adjustment Mecbanical + 10% Administrative Fee + 7% State Surcbarge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid . . Ul i' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00888 ISSUED: 07/16/2004 APPLIED: 07/16/2004 EXPIRES: 01/20/2005 VALUE: Total Value of Project Ff'f'S Pllid I Amount Paid Dale Paid Receipt Number 1200400000000001093 1200400000000001093 1200400000000001093 1200400000000001093 1200400000000001093 1200400000000001093 1200400000000001107 1200400000000001107 1200400000000001107 1200400000000001107 $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $4.50 $3.15 $43.00 $2.00 7/16/04 7/16/04 7/16/04 7/16/04 7/16/04 7/16/04 7/20/04 7/20/04 7/20/04 7/20/04 $115.30 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. ~ired l,mnectirns I Rougb Mecbanical: Prior to Cover Final Mecbanical: Wben all mecbanical work is complete. Rougb Electric: Prior to Cover Final Eleclric: Wben all electrical work is complete. By signalure, 1 slate and agree, tbat I bave carefully examined tbe compleled application and do bereby certify tbat all information bereon is true and correcl, and I furlber certify tbat any and all work performed sball be done in accordance witb tbe Ordinances of tbe City of Springfield and tbe Laws of tbe State of Oregon pertaining to tbe work described berein, and tbal NO OCCVP ANCY will be made of any structure wilbout permission of tbe Community Services Division, Building Safety. I furtber certify tbat only contractors and employees wbo are in compliance wilb ORS 701.005 will be used on lhis projecl. I furtber agree to ensnre thaI all required inspections are requested at lbe proper time, tbat eacb address is readable from tbe street, tbat the permit card is located at tbe front of tbe property, and the approved set of plans will remain on tbe site at all limes during construction. Owner or Contractors Signature Date Paee 2 of2 .' "- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00888 COM2004-00888 COM2004-00888 COM2004-00888 Payments: Type of Paymenl CreditCard F. :., f\,.. '~ ~:. 7/20/2004 . RECEIPT #: ~\ JiiilY of Springfield Official Receipt -"elopment Services Department Public Works Department 1200400000000001107 Date: 07/20/2004 Description + 7% Stale Surcharge + 10% Administralive Fee Add, Aller, Exlend Circ Minimum! Adjustmenl Eleclrical Paid By KEN WILLIAMS Item Total: (:heck Number Authorization Received By Balch Number Number How Received djb 000446 102089 In Person Payment Total: Page I of I lO:27:50AM Amount Due 3,15 4.50 43,00 2,00 $52.65 Amount Paid $52,65 $52.65