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Home My WebLink AboutPermit Electrical 2006-5-26 225 FIFTlI STREET. SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FAX' (541)726-3689 s~~ ELECTRICAL PERMIT APfLJCATION City Job Number e.A 0 . \ rN !/ Date fI.5 . 2.10 .() Lo CITY OF u,JR,INGFIELD, OREGON Supervisor License Number Lf f17 4- -S c. Temporary Services or Feeders Expiration Date J (J /0 7 ATTENTION: Oregol~~~il}lilY~Bl~~~tiofbor Relocation / . tallow ~ules adopted20Ji)*'mp])p~~e~~1 Utility $ 50,00 Con,?tr. Contr. Number ~O -.5" ~11fl~~ Center, Tt20:tfArop.s:!.oQ4Q9~'PP0rth $ 69,00 c:c. ~ ) {po.-/Cf I n u~ 952-001-001 0 WQl)~y\p's~Q\c?~Q)&.l!lesJ1- $100,00 Expiration Date / / j't@/JVCfrwmall obtain e~nni6~.O-oc.f +1-00 .""'''OO')Mi It "B" b /. . J. I"'" 'ver ., 1\1llpS 0r~1\0' 'yO s see a ove. .!GElding (he center (~'. ".-,": 'h'h"o-.I , Signature of Supervi ing Electrician b " "' . D: '-BrancO' d'rt!ultSJne num el lor the Oregon UU!t'/ ;\!~)tiiic8tion (;'''-I'''''r is 'I' 8' ,New-AIteljation or Extension Per Panel \ ~v ,." I - VV-00.c-'::::v'+4). . One Circuit $ 43,00 Each Additional Circuit or with Service or Feeder Permit I r Owno" N~ ~{tR..'<- Sondo. ~il--> Addres~'()W S. 'h S-0<---\> L E. Miscellaneous (Service/feeder not included) -Each Installation City (1 d.-.- Phone 13 \0 .l33 r; Pump or irrigation $ 50.00 ",\\ Sign/Outline Lighting $ 50.00 OWNER INST ALLA nON Limited Energy/Residential $ 25,00 The installation is being made on property 1 own which Limited Energy/Commercial $ 45.00 is not intended for sal~\lI,AfliI-~ 19l",r~nt. Minimum Electric Permit Inspection Fee i~~~UrChargeS bJ\lJUiL&:. ~ Owners Signature: THIS ~ERMIT SHALL EXPIRE IF f.H~mTAL OF ABOVE ~S) (tJ AUTHuRIZED UNDER THIS PERMIT IS NOT ~ 0 COf\.':~,r:~~~S~~ 8:11~ AOANDONED FU'KS'tate Surcharge , ' W ANY i 80 D/-W PERIOD. 10% Administrative Fee .7:1) ~2:>. \0 1. LOCATION OF INSTALLATION 3. ~Q.{) ~~. S5'\-r\ 'V~ LEcr~C;:DZ\\ () \? cD J~;CR't~~0~ (1lIlli 4P 1 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor M" c a~<....~ r:( C , 95 7 noN-~('\clq ~ , City Sr1d Address Phon~ .?i(dJ( Inspection Request: 726-3769 ~ q~1):\gDD COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-Family per dwelling unit. 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 $ I 06.00 $ 19,00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60] Amps to 1000 Amps Over 1000 AmpsNoIts Reconnect Only $ 63.00 $ 75.00 $125,00 $163,00 $375.00 $ 50.00 4StcU. $ 3,00 TOTAL Shared Drive(T:)/Building FonnslElectrical Permit Application 1-06,doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00642 ISSUED: OS/26/2006 APPLIED: OS/26/2006 EXPIRES: 11/26/2006 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 820 S 55TH PL ASSESSOR'S PARCEL NO.: 1802041101200 Springfield TYPE OF WORK: Electrical Work Only PROJECT DESCRIPTION: Add one electrical circuit for heat pump TYPE OF USE: Addition Residential Owner: MARK SANDAFER Address: 820 SOUTH 55TH PLACE SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Electrical License 162191 Contractor MNB ELECTRIC INC BUILDING INFORMATION I # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondal'J Occ";e.ancy Group: Type of Heat: Primary~bbJtNJJlib"ti:'tYijtgOn law requires you tcWater Type: Second~~I.~{:fn~t~fiC:tiOnOf,~pe: by the Oregon Utilit~ange Type: # of B~'f-oomS'~tlon Center. Those rules are set fo~nergy Path: in OAR 952-001-0010 through OAR 952-0GlP.rinkled Building: nfa f'\l'\r"\n. '/_ , '.__ . I',' . .. - - -..... .......... 111\..A"J VlVl\...Ull \...oVJJJC;v VI Lllt-= (lilt-'...... J HI calling the center, (Note: the telrJ~rE,V.-EJ.,OPMENT INFORMATION I number for the Oregon Utility Notification Frontyard Setb~f{)nter is 1-800-332-2344). Overlay Dist: Side 1 Setback: # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: I PUBLIC IMPROVEMENTS I Phone Number: 541-736-1337 Expiration Date 11/19/2006 Phone 541-726-8601 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: ~~~i~~~MIT SHALL EXPIRE IF~oHEnWOuRsKDrains: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 1 Rn nDV p!=Rlnn I Valuation Desctiption I Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Page 1 of 2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00642 ISSUED: OS/26/2006 APPLIED: OS/26/2006 EXPIRES: 11/26/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid' Fee Description + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $4.50 $3.60 $43.00 $2.00 5/26/06 5/26/06 5/26/06 5/26/06 1200600000000000719 1200600000000000719 1200600000000000719 1200600000000000719 Total Amount Paid $53.10 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. Reouired Insoections I 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 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 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 Page 2 of2 22S F.ifth Street Springfield, Oregon 97477 541-726-3759 Phone C.aof Springfield Official Receipt ~lopment Services Department Public Works Department Job/Journal Number COM2006-00642 COM2006-00642 COM2006-00642 COM2006-00642 Payments: Type of Payment CreditCard cReceint 1 RECEIPT #: 1200600000000000719 Date: OS/26/2006 Description Add, Alter, Extend Circ Minimum! Adjustment Electrical + 8% State Surcharge + 10% Administrative Fee Paid By MNB ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 524586 Phone Payment Total: Page I of 1 12:02:31PM Amount Due 43.00 2.00 3.60 4.50 $53.10 Amount Paid $53.10 $53.10 5/26/2006