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Home My WebLink AboutPermit Mechanical 2005-11-04Buildin g/Co mbin atio n Permit t Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7263676Fax 541 :7 2637 69 I nspe ction Line PERMIT NO: COM2005-01558ISSUED: 1110412005APPLIED: 1110212005E)0IRES: 05/0412006 VALUE: SITE ADDRESS: 222 6thst ASSESSORS PARCEL NO.: 17033s3100700 PROJECT DESCRIPTION: Replace hvac unit Springfield TYPE OF TYPEOF USE: Heating System Repair Commercial Phone 541-895-4466 Owner: Address: Contractor TyDe Electrical SPRINGFMLD DENTAL ARTS II\IV 2226THST SPRINGFIELD OR 97477 Contractor C PERISNS PhoneNumber: 541-726-1961 License 159537 Expiration Date 04n512008 # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyrrd Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacls: Street Storm Sewer Available: Special Instruction: Notes: # ofStories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: \SP ERM N I.I S 1H B\,LIDu,ND AU CO MM ENC ED OR Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: RBQUIRED PARKING Total: Handicapped: Compact: nla 1H0 AY PEB\00 BOD $ Per Sq Ft or multiplier Square Footage or BftI Amount DEVELOPMENTII\ Descriptbn Type of Construction ANY 1 lof2 Value Date Calculated T\ON o 1HE ho:;e (u\e io0 30.You ca\\\n9 -.,mbe NO.I Valuation Ucseription l CITY OF SPRINGFIELD Building/Co mbination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:126-3753 Phone 541-726-3676Fax 541:7 26-37 69 Inspection Line PERMIT NO: COM2005-01558ISSUED: 1110412005APPLIED: 1110212005E)PIRES: 0510412006 VALUE: Fee Description + l0%o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Amount Paid Total Value of Project Date Paid ty4t05 tU4t05 tU4t05 tu410s Receipt Number 1200500000000001679 1200s00000000001679 r200500000000001679 1200500000000001679 $4.60 s3.22 $43.00 $3.00 $53.82 Fees Pai Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certi$ 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 certiff 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 stree! 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 2of2 Date l(eq uire(Lllrsnections_l 225 FIFTH STREET . SPRINGFIELD, OR 97477 o E LE CTKI CAL P ERM IT APPLI CATI ON City Job Number (ov.t ?e6r -c>tss6 PH:(541)726-3753 I FAX: (541)726-3689 1 LOCATION ZZZ OF INSTALIA/+\D TION S LEGAL DESCRIPTION7033s3 I oo 700 JOB DESCRIPTION ,+,JJ Z crra^1h Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. z. 90,I{L'RACTORTNSTALLA'.TToN 0NLY Electrical Contractor C. ?,r1," Address Po Bo*//?s Owners Name Address ZZZ (l- S City s?F\p,n n" 7Z{- I 96/ OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: COIVI'LET'E FEE SCHIIDULE BELOW Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder Date I I z s106.00 s 19.00 $s0.00 $ 63.00 s 75.00 s 125.00 s r 63.00 $375.00 $ 50.00 or Relocation $ 50.00 $ 69.00 o B. Services or Feeders - [nstallation, -{lterations or Relocation: Supervisor License Number Jlzo- S C. Tenrporan- Services or Feeders Expiration Date /o d/- a7 Installation, Alteration 200 Arnps or less 201 AmPs to 400 AmPs 401 Amps to 600 AmPs Over 600 AmPs or I000 D. Branch Circuits Constr. Contr. Number s ?5 7 7 Expiration Date Si gnature of SuPervising Electrician ctv eRcsac.l/ Yn""" f?t ^ //Ld b/t-.hrr'.,^* \\5 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 AmPs/Volts Reconnect OnlY 7Yo State Surcharge 10% Administrative Fee TOTAL $100-00 Volts see "B" above. 43.00 t, f W0RK-- rE flhT ? --n@- s38z h Installation s0.00 SigniOutline Lighting $ 50.00 Limited Energy/Residential S 25'00 Limited Energy/Commercial S 45'00 Minimum Electric Permit Inspection Fee is $45'00 * Surcharges 4. STJBTOTALOITABOW :jz" Inspection Request: 726'37 69 Shared Drive(T:)/Building Fonns/Electrical Penrrit Application l-03'doc ,b' sd rl ?- /.< -og A. Nerv Residential - Single or l\lulti-Family per drvelling unit, Ort les n or Extension Per Panel I. New Alteration One $ E. 2?5 Fifth Street Springfi eld, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT#: r200500000000001679 Date: 1110412005 9:17:35AM Job/Jrurnal Number coM2005-01558 ccM2005-01558 coM2005-01558 coM2005-015s8 Description + 7oh State Surcharge + l0% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Due 3.22 4.60 43.00 3.00 Item Total:$s3.82 Payments: T-pe of Payment Paid By Received By ChectrNumEa Batch Number ffi Number How Received Amount Paid C;editCard C PERKINS ELECTzuC djb 320786 In Person Payment Total: $53.82 -sffi I I )r I rt/412005 lofl rya