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Home My WebLink AboutPermit Electrical 2009-5-21 Electrical Permit Application ~'~Wi'l~.:'OEkARTMENm,' )l1JSEiONlliy~!fI. - ;Ft.1 :!:".1,.',i',,,,,''''"~'''!''r''';;'~''''''''''''" ""',..,.,......:I~~,~,._,~_.~_,.,.".~. <l'~_ ~~,.,."'T"."..".., ,.~..,",..,',..'""....J,"o;.''"'''-,^'-..~~'"-.,,''''7'....~,''=,;J;2W40'''". .... I Pennitno. r:!9- 0~ I I Date: S ~2/ .-09 I This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. I ,.~ . 2:> Name: ~~,\,,~ ",-""",~ \::~,,~ I Address: 12.::'-. \ '- \~""'1 ~,"'-~ I City:~,~,~ I State:C'>" I ZIP: CI '7471 I Phon,>sL/n?h-o~3 I Fax: - I E-mail: C!~rr..\.\."',^_~~>L>..\"'~ ~ Qxs:'M~t'I..~. V\~ , This installailon is being ma<l\, on residential or farm property owned by'rrre-6r a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature:~""~1>~. 1~:!i:f~C:@'j'l'MCil1(:jR1iINSJ'll~L!l1'~lil~Nmil!fJ&%i!~~W~ Business name: I I Address: I I City: State: I ZIP: I I Fax: I I First branch circuit (2) "I I Each additional branch circuit $ 6.00 I I Miscellaneous fees: service or feeder not included I I Each pump or irrigation circle (2) $ 63.00 I I Each sign or outline lighting (2) $ 63.00 I I Signal circuit or a limited-energy panel, $ 63.00 alteration, or extension (2) Each additional inspection: (1) .1+--~"""'1f0"C:<<I!\Il(:r0~E~NIIIIENifif;J\'RRR(:j~A&-,,-.il'ii~1 \i..~'f~ '. ^......',~~___L"", _",.J__"_,,_,,,Ltt_,______:;tEfi~;Vk~'i Zoning approval verified? 0 Yes 0 No I ~~CA;fjEG.0~'l':~~F;;.{c::}5N$}i!R.'!'-C5J!1!:)'N~~t~1 I ;g:Residentia] I D Government I D Commercial I ~U.GI3'l!$Ijf;!:ilINIi,I1l.RMAij;I~NrANBl!~~lJ.)~mIGNF~~il I Job sit'e address: J t3t (~""'''-=-, 'P*""",~ I I City~,,,,,,c::.,~~"l.. I State:(')Q.... [ZIP: Q']Lt'l't I Subdivisi~n: ") Lot no.: Phone: E-mail: CCB license no.: I BCD iicense no.: I Signing supervisor's license no.: I Print name of signing supervisor: ] Signature of signi~g supervisor: ~~ '6rtJ ~~ . ~0-~ 440-2584-J (9/08/COM) ~SRi!iit""'---"E 1#S'C' ..co, _'i?i!$;~ 1_'iP:~'lf48!#'~mt_" _"'JCO _IilEDl:l~""~~~ZZllc"~mx, 1:!"V1fu\Sf~~~~~!l~l.R'i;l!\~"1I'~I~eostillllij;iffiil'Ci ~l'Iu9'.~~r.ol\m~pectlonSfP.~!ii!t."-mi(;)"'~QP:.. *""'Oil" . &""~~!~ 'A8iI{j\<\SrY<A4''''''~~mfE~t'!:y~~~:;.~;,~ c~~.'1# ~~JJjjif" ~.~ I I I I I I I I I I I I I I I I I I ) a. Fee for branch circuits with purchase of a service or feeder fe2i:> I I I $ 6.00 I $ IZA-I I I I I I ~esidential, per unit, service included: 1,000 sq. ft. or less (4) Each additional 500 sq. thereof $134.00 ft. or portion $ 25.00 Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) $ 32.00 $ 63.00 Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 95.00 $158.00 $205.00 20 I to 400 amps (2) 40] to 600 amps (2) 60i to 1,000 amps (2) Over] ,000 amps or volts (2) Reconnect only (2) $469.00 $ 63.00 Temporary services or feeders: installation, alteration, relocation $ $ $ $ $ $ $ $ $ $ 200 amps or less (2) $ 63.00 I $ 201 to 400 amps (2) $ 87.00 I $ 40 I to 600 amps (2) $126.00 I $ ) Over 600 amps or 1,000 volts, see services or feeders section above I Branch circuits: new, alteration, extension per panel Each branch circuit $ 55.00 b. Fee for branch circuits without purchase of a service or feede0ee: $58.00 I (A) Enter subt?tal of above fees (Minimum Permit Fee $58.00) I (B) Enter ]2% surcharge (.]2 x [AD' I (C) Technology Fee (5% of [AD I TOTAL fees and surcharges (A through C): $ $ $ $ $ $ $ /ost cYV $ I L" Or () $ S...2"'- $ /..7iJ5 Status Issued CITY OF ~rKll'lGFIELD Building/Combination Permit PERMIT NO: cOM2009-00474 ISSUED: 04/09/2009 APPLIED: 04/09/2009 EXPIRES: 11/21/2009 VALUE:' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1231 JANUS ST ASSESSOR'S PARCEL NO.: 1703342200209 Springfield TYPE OF WORK: Heating System TYPE OF USE: 'New ' Residential PROJECT DESCRIPTION: Install heat pump and air handler Owner: Address: PAYNE DANIEL J & SHEILA C 1231 JANUS ST ' SPRINGFIELD ,OR 97477 Phone Number: 541-736-0883 ,I CONT~CTOR INFORMATION I Contractor Type Electrical Mechanical Contractor OWNER COMFORT FLOW HEATING CO. License Expiration Date Phone 460 06/27/2009 541-726-0100 ~UILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # 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: Occnpant Load: n/a r 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: REQUIRED PARKING Total: Handicapped: Compact: 1 PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special~lnstliuction : '~.... ((vt. . TH -. Notes: ~S PERMIT S .' AU OiORIZ HALL EXPIR ' COIviMENC~g ~NDER THIS p~~JHE WORK ANY 180 DAY R IS ABANDON IT IS NOT PERIOD ED FOR Sidewalk .Type:' ATTENTION: Orec"'n law reauires you to -DownsRou ts/D rams :t'l' 101l0w rules adoptea oy t, It, v, ~8U" u llty 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). , Pace 1 of3 Status Issued CITY OF SPRINGFIELD Building/Combination. Permit PERMIT NO: cOM2009-00474 ISSUED: 04/0912009 APPLIED: 04/09/2009 EXPIRES: 11/21/2009 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I V~luation Oescriotion ~ Descriotion Tvoe of Construction $ Per Sq FI or multiplier Square Footage or Bid Amount Value Date Ca/cnlaled Total Value of Project J;'pp<, P~icI I Fee Descriotion + 12% State Snrcharge . + 5% Technology Fee 1st Appliance Air Handling Unit Up to 10,000 Heat Pump + 12% State Surcharge + 5% Technoiogy Fee Add, Alter, Extend Circ Ea Add Perm ServiFdr 200 amps or less Amounl Paid Date Paid Receipt Number $13.56 $5.65 $79.00 ' $17.00 $17.00 $12.60 $5.25 $24.00 $81.00 4/9/09 4/9/09 . 4/9/09 4/9/09 4/9/09 5/21109 5/21109 5/21/09 5/21109 2200900000000000356 2200900000000000356 2200900000000000356 2200900000000000356 2200900000000000356 2200900000000000549 2200900000000000549 2200900000000000549 2200900000000000549 Total Amount Paid $255.06 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. I Rpl1l1irprlln~,nprtionli', I , r , 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. Electric Service: Approval required prior to utility company energizing service. Page 2 of 3 _~~~,~~~~~~:~~' I"' .~, . :1 Status Issued 225 Fifth Street,'Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541~726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2009-00474 ISSUED: 04/09/2009 APPLIED: 04/09/2009 EXPIRES: 11/21/2009 VALUE: By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is trne 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 fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensnre 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. . 1'-,-_ ~ ~ ../ r---~ ,,~- ,\ ~'-'" Owner or ~rs Signature Page 3 of3 ~~ 2..\ \ ~c::,c::,~ Date ) . 225 F\fth St~eet Springfield, Oregon 97477 541-726-3759 Phone City of Springfield' Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009"00474 COM2009-00474 COM2009-00474 COM2009-00474 Payments: Type of Payment CreditCard cRecciotl RECEIPT #:. 2200900000000000549 Date: OS/21/2009 Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5% Technology Fee. + 12% State Surcharge Paid By SHIELAPAYNE Item Total; Check Number Authorization Received By Batch Number Number' How Received NJM 098670 In Person Payment Total: Page I of I 2:17:3IPM Amount Due 81.00 24.00 5.25 12.60 $122.85 Amount Paid $122.85 $122.85 5/2112009