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Home My WebLink AboutPermit Electrical 2005-10-5 ". . The followmg project as SUb~itted ~ ?n~I~~~ing . as not requ e p 13 . . · I fn, I D' · il ' .:':'PR'NOF' ~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 9 ~~ ' Date ,-,....,'j' ~ ELECTRICAL PERMIT APPLICATION '" zeo..Slgnature' - __ City Job Number COvn:z.ooF - 0/1 S- Z Date I D I ~ ,rtJ s YVl~Wy, () 6 3. ~MPU'ii'nESC;;ED('IE'fBEEOw.f1i~~t~i';;...~oi'..i.'!o.~tl ~........~....---~.l---.~.~',.'rr.'!"'-"""",~~ I""""'-.'F"~",,'M""'."_""'.'. ..""".....,--~...,.~~'c~.."""'..... .".. ....._.~. ---.~ ,.......~"\. ! }..}!~.-._,,~ .cr'.n,.o,""""-:""":\-It';m;.u;'~~"!-"'9-",~j<l"""!~:I:~';'~"'~""""""'G.!'!I/;" A. ~l'1~IW!.d..".!I.!i.~!~~iJ!gl,~~l!!!~;tami.ly,;p~",d,~"" . . o S S"'OO Servicelneluded " - . , 1000 sq. ft. orless $106.00 Each additional 500 sq. It .or portion thereof 1. ~!.'6GAT1:Q~Off1&STA'EErTI~l&~ !....ot,.J...;$&.JiJ..,._...,_,..lhl~~~ - 2b/ L{ mA-1 A L f? LEGAL DESCRIPTION /703 ZS-I '-I JOB DESCRIPTION A-cL! 7. c..lrL,",,---:h $ 19.00 . Permits are non-transferable and expire jfwork is Each Manufact'd Home or .' not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. . Feeder , . ~'fCo~~.""croR'fiN~:;r;:r'::tTION7i'iit.' ~ B. ~fS~k1~~FreUef1'~~I.1fti'iii"ti'K~ilWttWii?&i-;R~~ti-gm~~ 2. 1il.:,~;\-;,.,':k'_<~'i"'~~~~'''''''I'~~~;X4t~~ mlifffi~l\l'eflCE~i"''''''''~~'...n.~.'N;J:.''~~''''''''~~'~~)\''''''''~-~''-l:.;t:J . Electrical Contractor (!. ~.fZ){,IJ<; cE /1"'/'71</('. jii:" 200 AmWb't ~M/T SHAll EXPIRe J~ i ~3,OO 201 AmWTo~W/AmilsUNDER THt"f I"Cf;M ,i~\MPHK 401 ~p~rtY((~~DR IS AB,~NDDNfOAi~.aaOT 601 Arii~~olib3d:l1.\np'SERIOD: $fWbo Over 1000 Amps/Vo1ts $375.00 Reconnect Only $ 50.00 $50.00 Address f?n -- R" x //93 City c.j~fCJ<::'I,1~' 1-1- Phone 99.<;' 9Cj~!, Supervisor License Number ..:1 9 70 - S Il't..... '''''''',+,-",''''''' '-"""~(-=--~"k~f~~"'~ C. ~T~~k~~~ry~~t~1~~~.~;l?I.;.f$~~ts~~, . ,'; ~l~~ ,~~~'l' ^.- , flfuA -f2A!~ {I \-L.~d c:-f'S Ch." VlI1 rh A- L" Phone 9tf - 5bbb Installation, Alteration or Relocation 200 Amps or less $ 50,00 201 AmP.s--to,4QO Amps ,$ 69,00 rll I c.:.'l. rUI'i, \Jl egon law, .:.-1..."....... ynj.l to 401 -tunps/to.600Amp~)ted by lh- ~_u. $ 00.00 Vi .J \< I UIC,'" QI....:...Jt' .:. ...... .....::;1...." UlllllY OvM:6(jO:Amps'orHOOOVo1ts:see ~B~abo"e.~et forth' , !f'B7i"'~"1:-.q'~(\':l~lf.i<\rlm." ....,~"'"'" ". ~""i;l:("",,~"'~ D. ~::,~!i~~~~ma1~~~.;t;h~t~~~~~r'5~~~"~i~~11lh New Alteration or;Extension P.er P.anel ,} ? ~t:l.III~ I~ lJ It:: ....tlllt:I.. \I'lute: tile leler.Jhone l/ ) One ~!!'~H!!.er for !he ,OregQn Ut:"~;' ~~:~:~'ctrt~-80 Each Addinonal Crrcult or LWlth332 234 .J . 3 vr;;II'''1 I~ '-uuu- . if! $ 3 00 Service or Feeder Permit " Expiration Date /~-/_c)/., Constr. Contr. Number /, <;'"9 iC?? Expiration Date '" - /s- o? Signature of Supervising Electrician Owners Name A I V / '^- 2.G. ( l( -;'?FO E. f:~fisi~ll:i~~6li~1(S~~felf;id~~.it1fffft~l1td~d)!~E;;~J~~llrti~iiT1 ~""""'~""""<-'",~""",."",'r~~~~f'-'(-r.:~.->tl<:Moo~""'''",,",,",",''-.'' ~'~:-"',"~~,j2:li.~ Address City Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45,00 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Inspection Request: 726-3769 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ~roTAf'Oif!l:8VE~2;~"'~.&~? I.{ b ~f~~"~f~~~-::'~~~t~Vf."~~r1.~~~t.~~~~ - SZ1.. </bO 5" 3 &'2.. 7% State Surcharge 10% Administrative Fee Owners Signature: TOTAL Shared Drive(T:}lBuilding FonnslElectrical Pennit Application 1-Q3.doc ,,' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . U 1 f OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005-01152 ISSUED: 10/05/2005 APPLIED: 08/25/2005 EXPIRES: 10/05/2006 VALUE: SITE ADDRESS: 2614 MAlA LP , ASSESSOR'S PARCEL NO.: 1703251405500 Springfield TYPE OF WORK: Heating System TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Change nut furnace, add heat pump Owner: ALVIN HENDERSON Address: 2614 MAlA LOOP SPRINGFIELD OR 97477 Phone Number: 541-988-5666 NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK MU I nunlLCU ul~ucn I "Ii' r-tnlVIII 1:1 NU 1 1 CONTRACTOR INJ!aRMffiHlNJIIS ABANDONED FOR , i~!n ,-,i ANY cU AY PERIOD, License Expiration Date 159537 04/15/2008 47396 03/0812007 Contractor Type Electrical Mechanical Contractor C PERKINS ELECTRIC CHlTIIM ENTERPRISES I INC , Phone 541-895-4466 541-461-2101 # of Units: .' Primary Occupancy Group: , Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: , Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I BUILDING INFORMATION I # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: VN Wnter Type: laW re~gi~sert.ent: Range Typ~:ENTION: Oregodnb the ~qoI;t;GarlilMCarport Energy I1~\~JW rules adopt\e.;se ru,,%q likOther:Jrth SprinkIed,BuiIding: Center. wa tOccup.ant;L\lsd: I\lVll"......_~~_^ ....,,-4 nf'11n tnroug I v" . - . .. _ h" .~. .-.. .......- . . lesUllll....."".--. 1 DEVELOPMENTcINRORMNfI0Nll1 CO;e' the telephone calling the cem"!. ,No Utility Notil~Q~IRED PARKING , the Oregon Overlay Dist::nberc:or _., IS ',_800-332-2344). Total: # Street Trees Rqd:,e: ,l~' Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: Paee 1 of3 . . CITY OF ~rtOl'~GFIELD: Building/Combination Permit PERMIT NO: cOM2005-01152 ISSUED: 10/05/2005 APPLIED: 08/25/2005 EXPIRES: 10/05/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion , Description Tvpe of Copstruction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fpp<. PiilIJ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $4.60 $3.22 $43.00 $3.00 10/5/05 10/5/05 10/5/05 10/5/05 2200500000000001376 2200500000000001376 2200500000000001376 2200500000000001376 Total Amount Paid $53.82 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. 'RPn~ Rough Mechanical: Prior to Cover Final Mechanical: When nil mechanical work is complete. Rough Electric: Prior to Cover Final Electric: Whep all electrical work is complete. Paee 2 00 " . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005-01152 ISSUED: 10/0512005 APPLIED: 08/2512005 EXPIRES: 10/05/2006 VALUE: Status Issued 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!e30f3 , 225. Fifth Street " Springfield, Oregon 97477 541-726-3759 Phone . ....~.'!'!I~m.o ., '~'_'_'.' IIIL' f _ f .' --~"~.' ! .. ._"'- 'W''' .'~ ~y of Springfield Official Receipt WVelopment Services Department Public Works Department RECEIPT #: 2200500000000001376 Date: 10/05/2005 8:59:56AM Job/Journal Number COM2005-01152 COM2005-0 1152 COM2005-01152 COM2005-01152 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Payments: Type of Payment CreditCard Paid By C. PERKINS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 227786 In Person Payment Total: Amount Due 3,22 4.60 43.00 3,00 $53.82 Amouut Paid $53,82 $53.82 :' 'j ',i 10/5/2005 Page I of I