HomeMy WebLinkAboutPermit Electrical 2008-4-15
3.
ZON I , .,
INITIALS ~
t&!:. DATE ~. \~ .O~
.,, SOURCE >>~~
l{J~ f
c I (
COMPLETE FEE SCHEDULE BEWW
,c
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number COMZooB -- 00 )00
2 CONTRACTOR INSTALlATION ONLY B. Services or Feeders - ~nstallation, Alterations or Relocation:
E'lectncal co~tractor ;:::'1):: ;;:&.{./;/~/ i~ J 200 Amps or less ^^'" J' $ 70 00 "'l~ e-
If; 7/ 201 Amps to 400 Amps $ 83 00
Address &::;"0 S:;, U.;..-- f/.; u../ 401 Amps to 600 Amps $13 8 00
- .
~... \ t' l !1 4frV -~~,",.2--- 601 Amps to 1000 Amps $18000
City (}f//:.)../tY'1/10/1 ilL Phone 7V / .... ;;t~i Over 1000 AmpsNolts $413.00
I I Reconnect Only $ 55 00
PC'l/ ATTENT'ON'~" ' ", ' ,
Supervisor License Number 30 1 S fallow rules alff SfaB~Wl"~tJi:1U'eeders
!'JOtltlcation Cenf~te: oy the Oregon Utility
Expiration Date I'c, r ,#'1 {} ~n OAR 952-00 1-dtJ;l)tnFr~td"~JmOAeJffti88tcfD"'location
vu~u. You may o~~r~ gJ R 952-001_ $ 55.00
calling the cen~.l' ~ ~~~'es by $ 76.00
nUmber for the () e. <trrlnl:l~pnone
Cent . ~fflOOiltPJttbtyqQ_ation $110.00
er IS 1-800-332-234.:1\
Over 600 Affi')rs 011'1000 V olts ,~~~ ,"B" above.
D. Branch Circuits " r:'::"
A ~ " <
Pump or irrigation $ 55 00
Slgn/Outlme Lighting $ 55 00
OWNER INSTALLATION LImited Energy/Residential $ 28.00
The installatIOn IS being made on property I own which LimIted Energy/Commercial $ 50.00
is not mtended for sale, lease or rent. NOTf~nimum Electric Permit Inspection Fee is $50.00 + Surcharges
THIS PEflMJ~~W~I~~O~f(" 7tf
AUTHORIZEDtliJNa6a ibWLimMIT IS NOT If Zi!>
COMMENCED<6QASnA~~ FOR yf'D
ANY 180 DA't5~logy Fee I.{ '?D
117.3B
1.
,~
LOCATION OF INSTALLATION:
;Od-, 7 ~llt(~J fJ. '
LEGAL DESCRIPTION
, 7DZ3SZZ
Dt.{oco
JOB DESCRIPTION:
c4~ ~ "Ev-f-eM ~/ ~i -f~ G( c ~ IS
I
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
Constr. Contr Number
.R 7 J--{)~
Expiration Date
J1!4./?- :J<.>/ ()
SIgnature of Supervismg E~~an
~~
t...-r-- -..., ,
Owners Name ~"fI
Address ? ,,- ~
City 5f+'J
7J I/;~) t5'~(
~ frM'V-<r>v 1r..J.
Phone 2c.;~ - :;<;.-117
Owners Signature:
Inspection Request: 726-3769
Date
A. New Residential- Single or Multi-Family per dwelling unit.
VbW~~ "''' ,
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portIOn thereof
Each Manufact'd Home or
Modular Dwellmg Service or
Feeder
$117.00
$ 21.00
$55.00
New Alteration or Extension Per Panel
One CirCUIt
Each Additional Circuit or with
Service or Feeder Permit
$ 48 00
,fi- $ 4.00
J-ft~
E. Mis~~lIaneous (Service/feede~ not included) -Each InstaUation
TOTAL
Shared Dnve(T )lButldmg FormslElectncaJ Penmt ApplicatIOn 1-08 doc
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00500
ISSUED: 04/10/2008
APPLIED: 04/10/2008
EXPIRES: 10/15/2008
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 7027 THURSTON RD
ASSESSOR'S PARCEL NO.: 1702352204000
Springfield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Heat pump and air handler installation.
TYPE OF USE: New
Residential
Owner: DILWORTH GUY F & PATRICIA A
Address: 7027 THURSTON RD
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION.
Contractor Type
Electrical
Mechanical
Contractor
K & K ELECTRIC INC
MARSHALLS INC
License
87202
25790
BUILDING INFORMATION I
# of Units: # of Stories:
Primary Occupancy Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: Energy Path: oU to
ATTENTION: Oregol$~i\\Jt~MB~~'U\llity n/a
,,__ ^rI("\f"\torl hV the 'Orag _
N~'~rtl~~t~~~ Q~~Vmi~PM~ION I
in OARy952-0~Y'-~bt~i~I~;Pies 01 the rules by
0090. ou m llW-etbt,ttmsw1ephone
calling the center. "'~ r. t..I tilication
number for the ore~~Mttlilt':1~~qu;
Center is 1-iQg~J1Moe"lU)'d:
% of Lot Coverage:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Phone Number: 541-747-2587
Expiration Date
04/30/2008
12/23/2009
Phone
541-741-2663
541-747-7445
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
NOTICE:
THIS PERMIT SHAll EXPIRE fF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
Pal!:e 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
+ 12% State Surcharge
+ 5% Technology Fee
Air Handling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Mechanical
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Total Amount Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00500
ISSUED: 04/10/2008
APPLIED: 04/10/2008
EXPIRES: 10/15/2008
VALUE:
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
~
Amount Paid
Date Paid
Receipt Number
$20.00
$5.00
$6.00
$2.50
$9.00
$14.00
$27.00
$9.40
$11.28
$4.70
$24.00
$70.00
4/10/08
4/10/08
4/10/08
4/10/08
4/10/08
4/10/08
4/10/08
4/15/08
4/15/08
4/15/08
4/15/08
4/15/08
2200800000000000434
2200800000000000434
2200800000000000434
2200800000000000434
2200800000000000434
2200800000000000434
2200800000000000434
1200800000000000351
1200800000000000351
1200800000000000351
1200800000000000351
1200800000000000351
$202.88
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.
lJeouirerUnsnections.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Pal.!e 2 of 3
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2008-00500
ISSUED: 04/10/2008
APPLIED: 04/10/2008
EXPIRES: 10/15/2008
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 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
Pal!e 3 of 3
225 Fifth Street
Springfi~ld., Oregon 97477
541-7~6~3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-00500
COM2008-00500
COM2008-00500
COM2008-00500
COM2008-00500
Payments:
Type of Payment
CredltCard
cRecemtl
RECEIPT #:
1200800000000000351
Date: 04/15/2008
DescrIption
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
K&K ELECTRIC
Item Total:
Check Number AuthorIzatIOn
Received By Batch Number Number How ReceIved
dJb 010161 In Person
Payment Total:
Page I of I
9:41:04AM
Amount Due
7000
2400
470
1128
940
$119.38
Amount Paid
$11938
$119.38
4/15/2008