The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-12-21 CITY OF SPRINGFIELD, OREGON :,,' Installation, Alteration or Relocation 200 Amps or less $ 50,00 Constr, Contr, Number 1 621 91 201 Amps to 400 Amps $.69,00 NOlIe 40 I Amps to 600 Amps .' $100.00 11/19/06" IE: ' , Over 600 Amps or 1000 VollS see lOB" above. Address \o.S~ ~ Phone -Z 41.(0&11..-- Pump nr irrigation $ 50,00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25,00 The installation is being made on property 1 own whicb Limited Energy/Commercial r -445,00 is not inAAiil@fcf~@I"', @a~llJlJ;dQtW requires you to Minimum Electric Permit In_r__.:.n Fee ~ Surcharges follow rule!'. adopted by the Oregon Utility', .' ': ,co ';;co.~': -."', ,-:,pC."J,"';:,"~"T.' "" :,':",; Own~~~~J~~~,~~t~~16~~~;u~~e~:~e 9S;~,f~~~~ 4, SlJ,BTOT~c O~~o,l(E."~ ;;' i, \ ," ,:~ .": 4S W ^,,^^ ,,_. ,_." ""''';,~ ..~..... ....~~'ules by 7% State Surcharge ~. \ ~ --~;Iii~;~h~-~e~;~; (N;I~~til~t~I~~hone 10% Administrative Fee l.\. '7:JJ Inspectrn\irR~qIiJft; tn6-Gm~on Utility Notification TOTAL {) (L~ rti. \ Center is 1.800-332-2344), ... IJ~~iQ~~;~~:_. ~ ,44a) JOB DESCRlYfION ~~~n-~~I~n: t~ork is uot started withi~';~::YS of issuance or if work is Snspended for 180 days. l...,~=......",.-,.;.j;-~~f.'J7;F'_";;;.';':J<,.,;;",,,,,,~,0"~":'-"':.,;:;;';;~;;!i~-,,:-r;;-.D,~' _'~ "'CONTRACJXJRtlNSTALEATIONONLY<" 2. [i....\..:-t'i-5:.:..;zl,;::,;.-'u.;:t:..ir.:;j~~,::~<<&:iId.;,:~~>i-:--Vi:~' -,'.::: ":'""...: =:.-- "; ,':'.,..... Electrical Contractor MnB Electric Inc. Addre$ 957 Northridqe Avenue City SpUd Phone 741-7369 726-8601 4874 S Supervisor License Number Expiration Date 10/07 Expiration Date Cit q~t. \~OO 3. A. 1000 sq, ft, or less Each additional 500 sq. ft, nr portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106,00 $ 19,00 $50.00 i}S~~"~@J';t7.-",E""I~'~~;.."O'~',""';'$""""',"i;i:<,;~i~?i~"""'l~' ~'f,f-;,o.n_~./"\'=fr"E'r~':':.a.-"':'fr.?f.~\! B. ;:SeiViees'oiO.Fetiders ",~luStlillation;:A'lter8tioiis:oroReJoc.tiiin::~) ,";:".,'Z.;''''Z,j:~~'~ ::.~:t..(~:;~....';:!;.:;:'.s:..}.t.~'.r..s't~~-,:,~,-.,r.~':::;S:;'-':;i::;'S.t..i.",:'::~i:!.;.'<f..'S.;.;~~?:"~i~ 200 Amps or less 20 I Amp; to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNollS Reconnect Only $ 63:00 $ 75,00 $125.0,0 $163.00 $375.00 $ 50,00 c. 2T~1i,'6';X~'S'~J.;i~Y~ffl:~~~l~1~~~~~1r!:;;~:.~i.t~~:;ii~B~r;~H.t~~ ," .t.',c.,....'.::.. .~...;>_~";....).,=:""'"'~,~;.l.,,:::;,p~~"~.".Q;)_,~~..:...:.._""~.:;,..m'.J::....Q.:~~..,.;t.""':;;.,-;':~{I::.:.t . :"J"'T70:~~~~~,tLtl->C~~~""~ilJ2!.f':';~.'~HJ'.~.;;:~..,..:?:\~~'"o'r?~~~;7'~"?~~"'J.;.;;..~;::.~z,:.~ E.,t\-~1Sce!I..~~~{~~ms.ii!".@~!i'n()t't."c!~d~)t;J;;B..!'~':J.I>~~!I!dio!i. . : _, .',," ,"'^ .',,_....,._..:;,., _''"~..J:-.,'''... ~,...."~...._>-..~CI\... ',,..cv~,,,-,.:\,Oi.-,:.::~:Jt,..^.....,,,;,;,........-,,,,,.~........_'==t.'J."};" Shared Drive(T:)IBuilding FonnsIElcctrical Permit Application 1-03.doc . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax ,541-726-3769 Inspection Line SITE ADDRESS: 658 MALLARD AVE ASSESSOR'S PARCEL NO.: 1703221314400 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01762 ISSUED: 12/21/2005 APPLIED: 12/21/2005 EXPIRES: 06/21/2006 VALUE: Springfield TYPE OF WORK: Heating System PROJECT DESCRIPTION: Install heat pump and air handler Owner: TIM JABLONSKI Address: 658 MALLARD AVE SPRINGFIELD OR 97477 TYPE OF USE: New Residential Phone Number: 541-747-6842 , CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor MNB ELECTRIC INC COMFORT FLOW License 162191 460 Expiration Date 11/19/2006 06127/2007 Phone 541-726-8601 541-726-0100 I BillLDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VN nla Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEJ\o."'''.I>' Street Improvements: Storm Sewer Available: Special Instruction: Notes: NOTICE: EXPIRE IF THE WORK ~~~~~~6 ~~~~~ THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 00 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: ATTf?r,'Y~~,u~I-!?~~~aw requires you to follow rule!'. adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center, (Note: the telephone number for the Oregon Utility Notification Center is 1,800-332,2344), . . CITY OF SPRINGFIELD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01762 ISSUED: 12/21/2005 APPLIED: 12/21/2005 EXPIRES: 06/21/2006 VALUE: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ )?pPO. tiWU Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid $4.50 $3.15 $43.00 $2.00 Date Paid 12/21105 12/21/05 12/21105 12/21105 Receipt Number 2200500000000001725 2200500000000001725 2200500000000001725 2200500000000001725 Total Amount Paid $52.65 I Plan Reviews I ", To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. f 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. : n Pa2e 2 of3 . . CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2005-01762 ISSUED: 12/21/2005 APPLIED: 12/21/2005 EXPIRES: 06/21/2006 VALUE: 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 aU 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!e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-1759 Phone . 9 ~ity of Springfield Official Receipt _evelopment Services Department Public Works Department v Job/Journal Number COM2005-0 1762 , COM2005-01762 COM2005-0 1762 COM2005-0 1762 Payments: Type of Payment CreditCard ,. :( :, .!:. ':~' " , : )" :' -" '2 '. 12/21/2005 ,,' RECEIPT #: 2200500000000001725 Date: 12/21/2005 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Paid By MNB ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received lIh 021035 Phone Payment Total: Page I of I 10:33:15AM Amount Due 43,00 , 2,00; : 3.15 4,50 $52.65 Amount Paid $52,65 $52.65 , 1 "