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Home My WebLink AboutPermit Electrical 2008-3-25 225 FIFTH STREET 0 SPRINGFIELD, OR 97477 0 PH:(541)726-3753 0 FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number CO.-vfZJ:;>O b -- C>( 2- 9 S- 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts U \1''1 Reconnect ~~Ig:w requireS YOUti\ity A'rH:.Nl\ON', ~~~~~d bY the ore~~nset totto to\\oW 1(J}e~m~v.nr~e;&j~~b~'R1f1s$1~1- NotliICatloli O~ -OO~ 0 t\'Houg t the fU\es bY in OAR 95fi1~llV~O\.m9~~~~'t~\l!fJtoQ~on 0090. ,'{O~~~ ~~&r ~~t~ti\iW Notiiica\\On ca\\'ng;)4nf~e..Ple9ruih A>t:l!J.s2,344). oumbe", ,uIl\s ~ .~\:iu~ ~f}\~ps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D. Branch Circuits 1. LOCATION OF INSTALLATION: G- S-.J- ZqBD LEGAL DESCRIPTION 17033{,fl JArrlA(l-~ I L\v'"CcA-;-'t- P~rmits a~ non-transferable and expire if work IS not started wJthm 180 days of issuance or if work is Suspended for 180 days. o b '00 2. ; CON~RACTOR,!NST~LA1'IONONLY' Electncal Contractor Address CIty Phone Supervisor LIcense Number . t~p,.. ExpIratIOn Date r Con,', Contr Numbe, OJ ExpIratIOn Date SIgnature of Supervlsmg ElectncJan Owne" Name, A vJ r ~ ~ L; Address 2- '1 g 0 G- tJ r CIty ~rJ~"i he (j Phone ?'1( 7'17lf 7t-f jf ( OWNER INSTALLATION The mstallatlOn IS bemg made on property I own whIch IS not mtended for sale, lease or re:/t Own~rs SIgnature ~ v/ /: '-/ L-~ L-/ I . Inspechon Request: 726-3769 Date 3. : COMPLETEFEESCHEDULEBELOW :- . A. New Residential- Single or ~ulti-Family per dwelling unit. 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 $11 7 00 $ 21 00 $55 00 B. . Services or Feeders - Installation, Alterations or Relocation: $ 70 00 $ 83 00 $138 00 $180 00 $413 00 $ 55 00 $ 55 00 $ 76 00 $110 00 New Alteration or ExtensIon Per panel/I / Q. One CIrcUIt $ 48 00 "f c;:;7 Each AddItIOnal CircUIt or With ' Service ~.f.eeder pennitf i\ \E W'b,,\40 N01\\Jt'. Hf1.\.L EX?\RE \ \1 \S N01 E. -M\StWtiiJ'J}tl ~~~~ff~~~~I\~~ -Each Installation I\UiHOR\2E.0 OR \S M~I\NOON Puef3\~~~l€i&t) 00 $ 55 00 Slg(~t~~'/JlPgER\ . $ 55 00 LImIted Energy/ReSIdentIal $ 28 00 Limited Energy/CommercIal $ 50 00 Minimum Electric Permit Inspection Fee IS~O + Surcharges 4. SUBl'OTALOPABOVE S-O 12% State Surcharge 10% Admmlstratlve Fee 5% Technology Fee b S- 1,-0 bJf!!- TOTAL Shared Dnve(T )IBUlldmg Forms/Electncal PermIt ApplicatIon 1-08 doc Status Issued 225 Fifth Street. Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD C Building/Combination Permit PERMIT NO: COM2006-01295 ISSUED: 10/10/2006 APPLIED: 10/10/2006 EXPIRES: 09/25/2008 VALUE: Springfield TYPE OF WORK: Heating System SITE ADDRESS: 2480 G ST ASSESSOR'S PARCEL NO.: 1703361106900 TYPE OF USE: New PROJECT DESCRIPTION: Install gas furnace and associated piping and duct Owner: FOSHA Y ANDY Address: 2480 G ST SPRINGFIELD OR 97477 Contractor Type Electrical Mechanical Contractor OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Residential I CONTRACTOR INFORMATION I License Expiration Date Phone R-3 BUILDING INFORMATION I # of Stories: I \f'J requires veh't~re: He!ght,..or. S~~\'~tur@90n ba t\1e oregors~tF~r: ftt Floor: Typ~ of,He~!:,; c.l.doPte~\1Jse rules are !Iliia d Floor: Water TYP.~:1 center. t\1roUg\1 OAR ~~(J t Rllt<;ement: \\\C\tl'\' J.d I U 5VT Rangel...yI!~=2-00\ -00\ ~ copies oi t\1es~ h~arage/Carport Enreidy) lpitlu may obta\n~Note: the te\~\bKt\~her: sp9H.1..'ifl*,~lljtdiD2ntoer'et\on QYJ:i\iW N~~ccupant Load: oa . ~~. the r ~ {, _ '3r)?_?346fJ' ... I DEVELOPN1t~fO~O'RNrA1f)O~ I VN REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEME~~ MOl . Sid I~E \f THE WORK THIS PERM\1 ~\1~t~ ili~~~f.fitvlIT IS NOT AUTHORIZED BO~R 1:~BANOaONED fOR COMMENCED ANY 180 DAY PERIOD. Pa2e 1 of3 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 + 5% Technology Fee + 8% State Surcharge Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01295 ISSUED: 10/10/2006 APPLIED: 10/10/2006 EXPIRES: 09/25/2008 VALUE: I Valuation Descriotion ~ $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $10.00 $4.50 $2.25 $3.60 $6.00 $12.00 $4.00 $23.00 $5.00 $6.00 $2.50 $43.00 $7.00 10/10/06 10/10/06 10/10/06 ] 0/10/06 10/10/06 10/10/06 10/10/06 10/10/06 3/25/08 3/25/08 3/25/08 3/25/08 3/25/08 1200600000000001512 1200600000000001512 1200600000000001512 1200600000000001512 1200600000000001512 1200600000000001512 1200600000000001512 1200600000000001512 1200800000000000274 1200800000000000274 1200800000000000274 1200800000000000274 1200800000000000274 $128.85 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~e(]uiredJnsnections , Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 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. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-01295 ISSUED: 10/10/2006 APPLIED: 10/10/2006 EXPIRES: 09/25/2008 VALUE: 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 of any 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 locate~ front Of. e property, and the approved set of plans will remain on the site at all t;mes during coo,trucnon. ,. / . ~ I~. 7 -- Z,S- <- {/ )( O:;';;'r or contractrgnature Date Pal!:e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2006-01295 COM2006-01295 COM2006,01295 COM2006,01295 COM2006-01295 Payments: Type of Payment Check cRecemtl RECEIPT #: 1200800000000000274 Date: 03/2512008 Description Add, Alter, Extend Clrc MInimum/AdJustment ElectrIcal + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstrative Fee Paid By ANDREW FOSHA Y Item Total: Check Number AuthorizatIOn Received By Batch Number Number How Received dJb 966 In Person Payment Total: Page 1 of 1 3:09:27PM Amount Due 4300 700 250 600 500 $63.50 Amount Paid $63 50 $63.50 3/25/2008