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Home My WebLink AboutPermit Electrical 2005-11-16 , fI · · It .. 8 9PR'NQ",aLD ~J , 'cl a . su~ itted has the,follofring . ~. ,. ,-.fIO ODes not I! ' :sp~lfi~f~nd,use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX~~~4Jm6-3689 (/ :"" '~/:tL:'Y> ELECTRICAL PERMIT APPliCATION Zoning' L.{)f..... / City Job Number (-"10<< WO S- - 0 , 2.04 rDate _JJ - , b - c>:O:- II ...~) 1. i~O~~ONOL:::::AnQ~~'~17 3. f.CQMPLEf;EFf:&$C#l'1JUti'ii'tI:O~ .. 9 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. L~r,~nchCircuits,. _ JI<'~~""'_" ,', 1 TNHO'STlpCEER:M,l:j.ew Alteration or Extension Per Panel . _ 'O~Ml,J;tEXPIRE IF THE WORK I $ HOO "u ,HORIZEIila\,\N,OlifiliJMtS:mlMlJOO NOT : ownersNameJ:xLOe...es :f?,1~~MEN~~=~A<NIJONE&~OR ,,/ $ 3.00. , , j . Addr~ fi) l0.ltyZ.\. 6Y ~ ~~ E. t Mlscellaneous (Service/feeder'"ot h..c1~ded) __Each IlIst'!!I:it!OIi'! Ci~~~ Pholl";J~(o-73q7 OWNER 1TALLATION The installation is being made on property I own which is not intended for sale, lease or rent. LEGAL DESCRIPTION \ 103 'Sf 1(")0 44crU JOB DESCRIPTION Ad &. 'Z c..\ . '-104 \ h . Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CONTRACTOR INSTALLATiON dNLt,~ Electrical Contractor Cmn I Address IrnC City ~~7 Phone SlI-'1tH--tf.3 f7 Supervisor License Number J.l7..y~5 Expiration Date /6/, / ,,/ Expiration Date JifP;J /.;( //.'3 /L).5 Constr. Contr. Number Signature of Supervising Electrician '!tttt~ ./f ~ Owners Signature: Inspection Request: 726-3769 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof $106.00 A. E,N~'V 'Resi<!enii~I-Siligle~r.~ltioFamih perdivoiling uni ' Service Included $ 19,00 Each Manufact'd Home or Modular Dwelling Service or Feeder ''fI'-''I, '?'J: I 't.>'N':V'~~"iJl.)rl._tlvy,H5~Y~n:',). )'.......<~;. ,..- ". " B.;,:, .~~~~'~~~~.o,~,-:~ce~~--ri!y~~~!l~t~?~Q~'~qJmUs '~t ,~~I~c_atloll: 't N. ,.<:,,~tinr. (:pnter Those rules are set forth 200'Amps odess ' h ~ . ~ ~~n $ 6].00 Ir "lIq 4"2.(ln1-n010 lhroug v',,, w_'u\Jl- 201 Amps to 400 Amps ....__ _HI.$l,tOO on,,') VOl! m~" 001"," copies ,.. .H_ ,-"", i~ 401 Allmpsltho 600 A1mps(NOle' Ih,-'-'--h~I$12 ,00. "'1 ,"u e cen el. . v ._._~,.. ,tj 601 Amps to 1000 Ampson Ut'tl'II\' ~lnt;f;"~tt\93.00 8umo8r lur lilt:::: VI t,;~ . . vcr 100P;6mB:o/Y:,oll~800-332-2~"-"-) $375.00 . Reconnect OI1ly $ 50.00 $50.00 c. r~Te~p~[ary S~r~~~c'es;or "Feeders ~ . I Installation, Alteration or Relocation $ 50.00 $ 69,00 $100.00 ',. 'j <',., " 43 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45,00 Minimnm Electric Permit Inspection Fee is $45.00 + Surcharges 4. LS.C!lrt(),!:AL qF AB.b~" l(fo 'J'Zz. 4bO 53 'l(L 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FormsfElccttical Permit Application ~'()3,doc Status Issued 225 Fifth Street, Springfield, OR , 541-726-3753 Phone , 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01204 ISSUED: 11/17/2005 APPLIED: 09/02/2005 EXPIRES: 0511712006 VALUE: SITE ADDRESS: 2150 LAURA ST SPACE 97 ASSESSOR'S PARCEL NO.: 1703271004400 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential : PROJECT DESCRIPTION: Install heat pump and air handler Owner: DELORES BLACK Address: 2150 LAURA ST SPACE 97 SPRINGFIELD OR 97477 Phone Number: 541-736-7397 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility ~t....+:t:.......+:....... ,....._~.......~ T............_ ...1...._ ___ ........ '_~"'- I CONTRACTOR INio~RMATioN~r through OAR 952-001- . , .., _. ._.,.1 copies of the rules by Contractor calling trEit~aW' (N<Ex:JintrJIn'lrjJt'l~ Phone MAG ELECTRIC INC number fl~9834)regonUtllti/~37i'&o5'tlon 541-461-0387 ASSOCIATED HEATING & AIR CONDITIlY1.'O'6'i7S 1-800-33208bl1~06 541-683-2590 I BUILDING INFORMA nON, Contractor Type Electrical Mechanical # of Units: . Primary Occupancy Group: . Secondary Occupancy Group: .. Primary Construction Type . Secondary Construction Type: # of Bedrooms: Frontyard Sethack: Side 1 Setback: . Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: , Storm Sewer Available: . Special Instruction: Notes: # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1 st Floor: Type of Heat: Sq Ft 2nd Floor: VN Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Buildinl!; nla Occupant Load: , 'AI~nff. , DEVELOPMENT INFO~'ElON ~ AUTHORll \. SHALL EXPJRREQUIRED PARKING Overlay Dist: COMMENC~g UNDER THIS I"HE WORK # Street Trees RClt\!y 180 DA OR IS ABAND 11aflPft\;)r Paved Drive Rqd: "y PERIOD. ~ ,{ % of Lot Coverage: i 1 I PUBLIC IMPROVEl\-,,,,, ,I> I Sidewalk Type: DownspoutslDrains: Pal!elof3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Tvpe of Construction - Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Vnit Vp to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Clrc Ea Add Total Amount Paid . . CITY VI' ~rK11'\j~l'l~LU Building/Combination Permit PERMIT NO: COM2005-01204 ISSUED: 11/17/2005 APPLIED: 09/02/2005 EXPIRES: 05/17/2006 VALUE: I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project F pp< PlIilLI Amount Paid Date Paid Receipt Number 1200500000000001295 1200500000000001295 1200500000000001295 1200500000000001295 1200500000000001295 1200500000000001295 2200500000000001591 2200500000000001591 2200500000000001591 2200500000000001591 $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $4.60 $3.22 $43.00 $3.00 912/05 9/2/05 912/05 9/2105 9/2105 9/2/05 ll/17/05 ll/l7/05 11/17/05 ll/17/05 $116.47 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 Rptllllirlf30lrt In(',n'PI~ti'\IIIJ , Rough Mechanical: , Prior to Cover Final Mechanical: When aU mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Pa!!e 2 00 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01204 ISSUED: 11/17/2005 APPLIED: 09/02/2005 EXPIRES: 05/17/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection 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 Paee 3 of3 225 Fifth Street 'Springfield, Oregon 97477 541-726-3759 Phone . JJb/JournBl Number COM2005-0 1204 COM2005-0 1204 COM2005-0 1204 COM2005-0 1204 " Payments: Type of Payment . CreditCard , . r; I ~ , 1: :,: J . . :, \ :, 11/1712005 RECEIPT #: ~i ttlii.ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200500000000001591 Date: 11/17/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Cire Eo Add + 7% State Surcharge + 10% Administrative Fee Paid By LISA GRAY Item Totai: Check Number Authorization Received By Batch Number Number How Received njm 017354 Phone Payment Total: Page 1 of I 9:30:06AM Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82