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Home My WebLink AboutPermit Electrical 2005-9-26 '"tt, rOllowmg project as SU~~ . zoning. and does not. . the following .'r.. nd use ing~r.ortq1o~1 . FAX' (54D.....6=""". ~~~'.\..l.. . . I }I~I -"JUOi. ~:1f;,,' ~ ~\ '., . Date ~i;r:~d Slgnatur. - - ~ -. '--r~ 3. ~-coMPhl:i/FEE;scHEij"r:JLEiBELOWr'~~~':', :;;;iF;: )>,\ 1.2.-...... .,.~,.._- .~. ~..'-~. ..' ". ~..~.,... . "--_'ol.~lii -, . " \' ~<:f"~, " ,,, ,", .' '. I" , . .' N ":, . -" i .{ t ,.~, ,~~.. "., t ., '} , " . "\,1 .. ,Ii. ;'''-'1 f,., . -',1 ,~,,,-":'r' <'t I "~'., , I ' . . "l,l .....~ 'r. Jt I -~r' ,. ~t\..~(~,1 " ::..".~ ',' "..>" ~,1':". ..,.,- ~ ....,' \' . . .: '. ,,_"'~ '. t .....;.'.~I'~'~I,<', . Ji "'<":t, ...... -...~.. . -. ,.'~ -~ ....,,,. '">-.- .~ '-""'" ".<"..,. 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PERMIT APPliCATION City Job Number CO""v:>oS- ooJ7J A. ~~~]i_e~r~E~raiifg).~2t~!I~~:;Je~~;{~j1ii;"~] .tol/ow' Service InctUd~ an'~~prOject 8.1:1 .~/,hrt'o;.... 1000 sq. ft. or less --" Each.additional 500 sq. ft. or portion thereof $ 19.00 '. Permits are non-transferable and expire if work is Each ~J~filIlt![jltloQJ~?on law requires you to d . h' 180 d f' 'f k' Modf]"alr'0D"we' nl'l'I'~nOg S-rle!:ii..ocje~rlorby the Oregon Utl'I,'tv ..- not starte WIt In ays 0 Issuance or I wor IS 11 . ,. Suspended for 180 days. Fee\iertification Genter. Those r'.:':: :::: set~~9rRO .. N"'" ",' . .. _, ",~,. ., .. . '" '_'L ...="Af'! &1:'!tn,;Q#~;Q.Q~TPQ~OWW!1.h,9AfW~@1.. ',' , . ~:' .,' ..., 2. t~Q~{q8W~l1Y~TA,fgrr.0Y.9~Lr:A1 B. liSS~IS~~~~~,e~Q1~!!~~!II\!!1',Il~I\!',~!!Pv~ ev~~!o.call.ll.n; ',' r7J () _ ,) , calling the center. (Note: the telephone Electrical Contractor '-.:. 'reIZ.K ,ill<;- F 1...;;Tgre. fi / 200 J}ml\~I9~I<l&.- the Oregon Ut;la~, ~lrM;Lt!'iMlO 201 Amps to {oo'~Pi 1-800-332-2344\ $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsIVolts $375.00 Reconnect Only $ 50.00 rrp--......l\.r-:"""- ~~"":'~,.., __'J'-~"t'r ",_~;;.,~~ 1. ~9S1.H91Y9f-IlJ$TA! ~~4.1IQ~'l:tiL;,,~~ 7'6 ..TsIA....d ~+ LEGAL DESCRIPTION 17033yz.1 0031 b JOB DESCRIPTION kid C-I -IZ.c. '^ f +- ( Address ffi ' .R,,)( Iff? City CRA<;lolf'> I L Phone 99.5' trCJt,~ Supervisor License Number .2. 970- S Expiration Date /tJ -/ - CJt':, Constr. Contr. Number /. c;- 9. <...5 "7 Expiration Date 'I-/s-oR' Signature of Supervising Electrician (!U QAthK I' Address sJ,A-tI1IA.O..... tfA_; Ih-.. Y'b -7S1A-..\ ~-\- Phone 7'17-D38'1 Owners Name City .s~p", OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 $106.00 \ c. ~~pprilry S~r\1c:e$ ii.r:~F~~~~is~':;-(~:,~~.>~' :'~..)~:f.:.:,~;.'::~~ 1 !,!OllaT!CJ:~. . R I . nst~,v h()rr.~:r-uterahon or e ocahon "I." /"E !.,.,. 200 'P,;mP!lf(0 les. SHA $ 50,00 :i:.~1~~~:v,. New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit ;...'...1. ~~ :.;.....'''j '. .".. $ 43,00 L(] $ 3,00 E. f;1\-fitiena!,e~A~(S~~'i~e!f<:t~!i' :n~i \fl~IKded );iEfi:ch l.~;i.u. tillll] Pump or illigation $ 50,00 Sign/Outline Lighting $ 50,00 . Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45,00 Minimum Electric Permit Inspection Fee is@llD+ Surcharges 4. t:S'rJBTOtA1.()F.ABOvl;~~...,:;r,>::"J't",~,,{3 'f \ b.;,;...... ,-.;.;::":......:\, ,~\.":!/; ,.~..,"'.. -;:-".:" ",,~.~~ _r < '~~. ~i' j ,~"'i-.o~"~_' fl> ,".;.J Jlr '1ro SV~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1..o3.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . LIl r' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00373 ISSUED: 09/26/2005 APPLIED: 03/31/2005 EXPIRES: 03/26/2006 VALUE: SITE ADDRESS: 996 ISLAND ST ASSESSOR'S PARCEL NO.: 1703342100316 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: InstaU heat pump and air handler Owner: Address: ATTEN'T10'J' 0 Phone Numher: 541-747-0381 I, .1'. regon law requi lo"';N nllf'- adopted by the Oreres you to Nui ,.cd1on r."nl,,_ Th___ , gon Utility 1'1 L/u ~~<:j?nn1 () - -......... Ulc; ~t:a IOnn I CONTRACTOR INFORMA TION_I01 0 through OAR 952-001_ taln copies 01 the r I call1nfl ttle center, '"Intr.' t .._ ,u es by llumbeLlcense EXPlrallonlDatene Phone l5.?~?Jr~2;~io~~ 1i~i~~~~~;cation541-895-4466 47396 3'03/08lt007 541-461-2101 SHANNON HAMILTON 996 ISLAND ST SPRINGFIELD OR 97477 Contractor Type Electrical Mechanical Contractor C PERKINS ELECTRIC INC CHITIIM ENTERPRISES I INC , , # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Sethack: Side 2 Setback: Rearyard Setback: Solar Setbacks: '. Street Improvements: Storm Sewer Available: Special Instruction: Notes: BUILDING INFORMATION I # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: VN Water Type: . Sq Ft Basement: Range Type: . Sq Ft Garage/Carport Energy Path: n'" _ Sq Ft Other: Sprinkled Building: nla Occupant Load: j}aT!~~; EXPIRE IF THE WORK I DEVELOPMENT INt\~B~~Ul3'fliAll . AUTHORIZED UNDER THIS PEgIJUSUlO1i>ARKlNG Overlay Dist: COMMENCED OR IS ABANDO~Q.;.OR # Street Trees Awt-180 DAY PERIOD. Handicapped: Paved l\W~e Rqd: Compact: % ofLo~overage: I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspoutsmrains: Pa2e 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 + 7% State Surcharge Air Handling Unit Up to 10;000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid I I' . I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project ]?pp< PUlLI Amount Paid $10.00 $4.50 $3.15 $8,00 $12.00 $25,00 $4,50 $3,15 $43,00 $2.00 $115.30 I Plan Reviews I Date Paid 4/4/05 4/4/05 4/4/05 4/4/05 4/4/05 4/4/05 9/26/05 9/26/05 9/26/05 9/26/05 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00373 ISSUED: 09/26/2005 APPLIED: 03/31/2005 EXPIRES: 03/26/2006 VALUE: Value Date Calculated Receipt Number. 1200500000000000418 1200500000000000418 1200500000000000418 1200500000000000418 1200500000000000418 1200500000000000418 3200500000000000575 3200500000000000575 3200500000000000575 3200500000000000575 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 aU mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When aU electrical work is complete. Pa!!e 2 of3 . . CITY OF ~rK11'1u1'l~L1J Building/Combination Permit PERMIT NO: COM2005-00373 ISSUED: 09/26/2005 APPLIED: 03/31/2005 EXPIRES: 03/26/2006 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 he done In accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed 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 ail required inspections are requested at the proper time, that each address is readahle 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, . :S\.~'f'J.- ~ S0\}:li~c9.. Owne~ Contractors Signature ~\Llnl O~ "'\ I""-"- Date Pal!e 3 of3 225 Fifth, Street Sptingfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00373 COM2005-00373 COM2005-00373 COM2005-00373 Payments: Type of Payment CreditCard ':c " 'Yi " :c " )" . " 9/26/2005 . RECEIPT #: aPRJ~Nal'la.o 1lIit' ," ...,--.'.; .'. ...., ',1." ' ~ -,,~, i --,,~ City of Springfield Official Receipt .velopment Services Department Public Works Department 3200500000000000575 Date: 09/26/2005 Deseription + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Paid By C PERKINS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received njm 226796 Phone Payment Total: Page 1 of 1 1:29:51PM Amount Due 3.15 4.50 43.00 2.00 $52.65 Amount Paid $52.65 $52.65