HomeMy WebLinkAboutPermit Electrical 2005-11-23
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LEGAL DESCRIPTION ( A. ;,Ne;/R~;id~~;i~~<S;'~'g'i~f~i~lti~F~ii~~~Vd;~f[l/o uiiit...\j
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JOB DESCRIPTION
~r~~.n:::ansf~2kiS
not started within 180 days of issuance or if work is
Suspended for 180 days.
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,-CONTRACTOR INSTALlATION ONLY,.'
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Electrical Contractor
(!,. Pe.rU<., N S EI~f /(,/c.
Address
po.
1/93
BDX
City r!.-t<t<>. \ lU~ J /
Phone
f79.5- 'T'Ibb
Supervisor License Number :J.. 9 71) - S
Expiration Date
JEJ- dl- a,7
Constr. Contr. Number /5 'j.5'. ~ 7
Expiration Date
t;-;.5-CJrs
Signature (li~; Ele~
f I ()
Owners NamV lY (M V0 [Jl)J.-
Address [31 t Q J/, y> n YlfJn L-f
City~fi ./ Phone
OWNE: I~TALLATlON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Service Included
./,....
1000 sq. ft. or less V: Or S106.00
Each additional 500 sq~n}r'lon law re .
portion thereof "':ent' led by II" _qUires Sd/j-OO
; er. fh - vleg J 10
Each Manufact'~ Htime~Qrl 0 thOse rUles a On Utility
Modular Dwelling'Seevice or rOUgh 0" re SAS'5'O'00'
. '''1 ....tQ1nc. ,..,{:1n...;)
Feeder.. '. Cente OP1t:s Of -Jc-OOl
" 0/ r. fAl"l tb" .
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B. :,Ser\'lces or. Feeders~Jnstallahon;AlteratIRl}s..or/Relo'catlOn:~~'
2':~::;""::;::;"I&~S00-3';~il~~iifi~;::~"~7;]~ dJ
201 Amps to 400 Amps S 75.00
401 Amps to 600 Amps S125.00
60 I Amps to 1000 Amps S163.00
Over 1000 AmpsNolts S375.00
Reconnect Only S 50.00
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THIS P~AMlT SJ:tAII ~YDIDE F '
InstaIlA~M~~!j'liN 'RtInMfotfl I THE WORK
200 A~Urrl~E ) OAD,~RATH/S PERMI,ToI60NOT '
201 A~m ~ j5 1l~I~UUNt@iml
401 Amps to m "PERIOD. SIOO.OO
, .
Over 600 Amps or 1000 Volts see "8" above,
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New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
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E. ~~~:~i~~~~! ~~~:~~~;s"_~(_~~~~~~-!~~H~~;{~~~~~~:~)~~~u~1.~~:~~~,~!i1~~!~l!.~~~\~:;
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
S 50.00
S 50.00
S 25.00
S 45.00
I'vlinimum Electric Permit Inspection Fee is S45.00 + Surcharges
4. i ~6BT'otAi ciF;;(BOM!~:);'i,,~}.H;:'Pt(~ r _ 2 cfL>
~. :'~" c.'~..~...~ ,~,.,.I::,>" . __~rf".~':~:;',.j-:'t;.'. ;':..;.~::~-- ~'.,' ::,\,f. \..00 ..
7% State S~rcharge L.{ - ~ I
10% Administrative Fee <0 - ~
TOTAL ~ 73. '-I-
Shared Drive(T:YBuilding FonnslElecuiCllI Pennil Application l-03.doc
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U 1 i' OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: cOM2005-01635
ISSUED: 11/23/2005
APPLIED: 11/2212005
EXPIRES: OS/23/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 751 LAKSONEN LP
ASSESSOR'S PARCEL NO.: 1702352301000
Springfield TYPE OF WORK: Heating System
Contractor Type
Electrical
Mechanical
Contractor
C PERKINS ELECTRIC
JAMES HEATING
,A TTENTIONTYPE OF USE: Addition
Change out air handler and.~Jfa~ge'on",heaj.~iii~~Jn law requires
,"Olif/cation C;~t':!:[",5I by the OrennnY,~~..to
. ~"" ~b2'00 .. 'V~" rUles -....,
0090. You ma 1-0010 through OA~e set forth
calling the / obtam Copies of th 952-001_
nUmh". 'n_.. enter. (NotA' t/,^ '-. e rules bv
C'_ _ ....v V'tiqOn IltiJj-'~","une
I CONTRACTOR INFORMA;fION".l2_2;~~lfiCation
License Expiration Date
159537 __ 04/1512008
Residential
PROJECT DESCRIPTION:
Owner: -
_ Address:
WOOD VIVIAN F
751 LAKSONEN LOOP
SPRINGFIELD OR 97478
Phone
541-895-4466
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
fjn.,.,-::_
I BUILDING .~I1ft~TION I
"l) J HOR .", ~HAL
# of Sto~I1MJ: /lED UNDE, L fXPIR~ Size:
Heigh~""'~IjIj,l!tA~D OR R TH/S p ~~I\I.r.:,
Type of HeafPO DAY pc-o /S ABAND flIf{l~ 6lIf: .
Water Type: [;'1/00. Of:iIiIYtp},M' lit: .
Range Type: Sq Fi t:'li\-agelCarport
Energy Path: Sq Ft Other,
Sprinkled Building: n/a Occupant Load:
I u.HJ!,LOPMENTINFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback,
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspoutsmralns:
Notes:
..
Paee 1 of2
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2005-01635
ISSUED: 11/23/2005
APPLIED: 11/22/2005
EXPIRES: OS/23/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
FI'I'<P",W
Fee Description
+ 10% Administrative Fee
+ 7% State Snrcharge
Perm ServlFdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$6.30
$4.41
$63.00
11/23/05
11/23/05
11/23/05
2200500000000001615
2200500000000001615
2200500000000001615
Total Amount Paid
$73.71
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 Rl'ollirl'rl Tn.nl'rt~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Electric Service: Approval required prior to ulllity company energizing service.
By signature, I state and agree, that 1 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.
T 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 thai 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 ofl
2~Fifth Street
..,
Springfield, Oregon 97477
5.41-726-3759 Phone
.
Job/Journal Number
COM2005-0 1635
COM2005-01635
COM2005-0 1635
Payments:
Type of Payment
CreditCard
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11/23/2005
RECEIPT #:
ii(.'~,.
.ty of Springfield Official Receipt
Wevelopment Services Department
Public Works Department
2200500000000001615
Date: 11/23/2005
Description
Penn ServlFdr 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
CLYDE PERKINS
Item Total:
Check Number Authorization
Received By Batch Number Nnmber How Received
nJm 32276 In Person
Payment Total:
Page 1 of I
11 :38:28AM
Amount Due
63.00
4.41
6.30
$73.71
Amount Paid
$73.71
$73.71