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Home My WebLink AboutPermit Electrical 2005-10-5 1. \L~CAhON'OF:1.NS.'. TXL~TI~l~ ~~r-"~o"~'H:ir~ ( LEGAL DESCRIPTION I~D2. OS/2 The followmg projecl a~~ted has the following nd does n~7ff'lre eClfic land use I SPA'W',F fJ.~'-- lil ;/Y 'I ZOning 1i>>~. .- . FAX: (541)726-3689 ~I .., , rJlJt Date ~I . to I c;''I't)')' Signatu~l:r~;,'( wi . , I .' _ 3. !fffOMPLb"'ib'"FEESrn."'EjjUI.E;BEi:OW}i,.lt~~,*,jl';'l.~.1 "'~J.W~-""''''~~iiit.'~':~iiil.~.la/"<,l+"~~~ Date , 225 FIFfH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PERMIT APPLICATION City Job Number COM -zOo s- - 611 ~b 070c0 A. l!r~~~rel~~~ill&fl~itj~~y~p.:~1~i=~.'a ri4w;..........~ . .:>l""""",,O"'_"_"""".Q':'''''~'~f;;;';4..~lliW';)'~<'l.~~lJ Service Included 1000 sq. It. or less L Each additional 500 sq. f\..or (, If CJ,A.. \ n N ~ffeEtjlereof $ 19.00 Permits are non-transferable and expire if work is Tf~~lp~~wm:cStllHblnf~IREIF THE WORK .' ~:f~.~.C~O~;;:~~O::R:;'IN.~:~SOT.f;:~~TI.e~o~~:~ow:~.. ~ r~~~::::...~ 2 r. H.~.nL'1'-'.L.'. ~ .LT,' H..Liir.:li lJ\ :~!OJ'~J1)ffll~~;Iristan~tion~.,_~!.t.~r..I!.t._~.,<m. s.~.:~~.lr;.t\Jl~.e.!9..c.,~Jj~n:c.,..~' ~'.' . ~\~"'/1;'~lf~'I.l.:t:i>:-r"~'''';~,-ro'''''--'''?I'Xt4.''-'''''T~~ "-'---: ::;;:':..-=~=~'-~'~~-"" '.' Electrical Contractor C!. ~d..tJ <; F /;.,;;r~ # / JOB DESCRlPTION A-c:lJ $106.00 2 City C!..RfCi",1r.l-1- Phone 995' fJc;d.!, 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Address -0! ' R" x 1/ P..? Supervisor License Number ,.:1 9 70 - S 1\l;'_!~""'0f><""""_'--'''''''~1i\!i!Iiil c. f.T~.~p'Q~~r.y:,S~!:YJ~.~,~o,~~,te~ts. '".:,; ~. '.,' , - ..,i ';. ~~ Expiration Date /t!J -/ -c)r., Installation, Alteration or Relocation (l2..1)', J2/1~ ' u - Owners Name ;t! It {2.( L y....... Address LI S-SO i--k./ ((.. \\- I 'S>~ P'b Phone 71(b - I&') ~ N A-6- V 200 Amps or less $ 50.00 201 AmP$..tQ 400) Ampslaw requir"~ \lnll 10$ 69.00 ,ATTENTIUN' nreyuol . 401 Amps to '600 ;.;mP~y the Orennn Utility$1 00.00 follow rUles aoup."". .-, t f h NoOver.600'A:JI)PS:or.IOOOlVoltSl~ee ~B!' ~1iOv2;t. df~~1'~.:......,,,",,...' . ... ~''''''M>L':f~~''''''j'f''''".l iP.. 'l!r,a,\~~;g!rf.~gt'w;' '" ~ '~. .".- '~;'~"'"..ii"",~~ ~~ Oonn v,..., I m:;:lV 0 tr:Hn co lit: VI II' ,........ New Alteration or Extension,Per\Panel\one ....::llliO"'lf] the cenH~I, \1'IlV.~C;, ~1I"" ......-ro:. A s>~~ C~~.J-!! th'l 0regon Utility NntlfiCi.dOf$ 43.00 'EaclilAddll1onal CircUit or,wlth2344) , r ~~. llP" I::: ,-QI,IV-"';"';'" . $ 3 00 ServIce or Feeder Penrnt . If) '7 Constr. Contr. Number /, <;'9. -::3' /> Expiration Date '" -IS-- elf Signature of Supervising Electrician ~~II=",;"~:"'^~':/'"~m"'.a':f';4'~~"~,;o.,w'&,,,;'-'~~:.~';,,;:: ~i.i.l~.~.:7!.-f}.'T~'4,....~~g E. ~~~1$,!!~nJR~~i(~,~iE!![e.!~~,~~P.tii!9~:~).~~;1g?}~t!J!.~~.d City Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 OWNER INST ALLA nON 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. ~u:r6t~~~~11;~~~Xil 11/ k~~,.,...;;~-:-~'&:~"i'.>:J.:>",,!;:::;<v~..{.:;i~~~~;cr,,'.........~~:6,;.\,~ ..., b 37Z 1{60 S"382. 7% State Surcharge 10% Administrative Fee Owners Signature; TOTAL Shared Drive(T:VBuilding Forms/Electric:!! Pennit Application 1-D3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01156 ISSUED: 10/05/2005 APPLIED: 08/25/2005 EXPIRES: 04/05/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line PROJECT DESCRIPTION: Install AC unit NO~field TYPE OF WOw<t~lI/J~stem THIS PERMll SHAll EXPIRt nl AUTHORIZED U\IlMl~ l!)lllflSlERM~d\Bt~if COMMENCE.D OR IS ABANDONED FOR 1^.. ",)1 Dt:D\nn . 1"\1'111 oJ... ~r._ . Residential SITE ADDRESS: 4550 HOLLY ST ASSESSOR'S PARCEL NO.: 1802051207000 Owner: MARILYN NAGY Address: 4550 HOLLY ST SPRINGFIELD OR 97478 Phone Number: 541-746-1859 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor C PERKINS ELECTRIC CHIITIM ENTERPRISES I INC License 159537 47396 Expiration Date 04/15/2008 03/08/2007 Phone 541-895-4466 541-461-2101 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 nla Frontyard Setback: Side I Setback: Side 2 Setback: . Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I ATTENTION: Oregon law requires you REQUIRED PARKING Overiiiy'Dist:Jles adopted by the Oregon Utilfbtal: # Streetfrrees>Rqd:nter. Those rules are set fH1'ddicapped: PavedlDriveRijd:01.0010 through OAR 952'f(;1i\i1pact: % o!i{lotICoveragei' obtain copies of the rules by calling the center. (Note: the telephone . . . , ..... _ _ _ _ I ...: I:.... "1....+ ~,J; ,.. ...+. ..... '"" Street Improvements: Storm Sewer A vailabie: Special Instruction: J" ......... ,......, ....... ...,.. -:::J- - - , I PUBLIC IMPROVEME!':ITS,II-BOO.332.2344). Sidewalk Type: DownspoutslDrains: Notes: Page 1 of3 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-01l56 ISSUED: 10/05/2005 APPLIED: 08/25/2005 EXPIRES: 04/05/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated , Total Value of Project ~ )?pp< tllilIJ 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 2200500000000001377 2200500000000001377 2200500000000001377 2200500000000001377 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. 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. Paee 2 00 iI . . CITY VI' ~rK11~u1'lJ!.L1J Building/Combination Permit PERMIT NO: COM2005-01156 ISSUED: 10/05/2005 APPLIED: 08/25/2005 EXPIRES: 04/05/2006 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 furtber certify that any and all work performed shall be done in accordance with the Ordinauces of the City of Spriugfieid and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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 00 225 'Fifth Street Springfield, Oregon 97477 .- 541-726-3759 Phone Job/Journal Number COM2005-01156 COM2005-01156 COM2005-01156 COM2005-01156 Payments: Type of Payment CreditCard :f J'I ./ ,.. 10/5/2005 . RECEIPT #: 6 ~ty of Springfield Official Receipt .elopment Services Department Public Works Department 2200500000000001377 Date: 10/05/2005 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add Paid By C. PERKINS ELECTRIC Item Total: Check Numher Authorization Received By Batch Number Number How Received ddk 227786 In Person Payment Total: Page I of I 9:04:47AM Amount Due 3.22 4.60 43.00 3.00 $53.82 Amount Paid $53.82 $53.82