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Home My WebLink AboutPermit Electrical 2006-3-29 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3~ing ELECTRICAL PERMIT APPLICATION City Job Number Lc.M 2..DOb . oc:x::> z. ~ t:'~.?-: ''''_~<~-('_",:::~ ,',", ?: ,;-~, ';?"~"':'?:! ~ <:N",,::__,___,_<>_,,:__^_~ ^" ."<:r-'\'c:><:' _:_,~,~, , _ _ ,,"',' _i'.-<:':":'>' _,:(~ l.rbQCA1'IPNcOF..IN$T.ALLATIO ':~y 3b3""~"\.;7rx:.;'~6;; ~Il ~~ LEGAL DESCRIPTION 170~ I ~ C{Z Date 3'2-q"~i(IO ~~ 3. .t)~,;):<:~':"::,>c'-.':-':-',::;:~;,"""\'::-~r' '_;::'J}.(A,- :'-~r::-iC';""':-~"~:(:\:- ,', :~;~>:'~"\::-::kY;__;:~!'-;--:'; :_?.. PUTE FEE'SCHEiJULEBELOW ;f.-.,;:;;:J0~Jt;;\bx\!:tAN\:;t:~.;:.,~'ti;k;'b.;;:;;SE;y,~'i;;;*Wl.::;;-:"<,:;~_JJ:,,,w;,::-h\k;oJ: A. o 5 S- C<:::> Service Included JOB DESCRIPTION 1000 sq. ft. or less Each additional 500 sA, ft. or CL64."\I vfJ 91"tM.<-/~c if'tq::tJCiC- portion t\t,~~,f:, ,,!,~'.\".J \?lVI ,8.\ ,'" '. Permits are n.on~transferable ~nd expire i~w~~~.,.i~Dtt O\8o,;~~~~tM~~~:~\~?!TI~6~ .' not started wlthm 180 days of Issuance o~~orR: ~~c; 'Odop\8~~~uJar\..DWel~1!}g~)~JXJce or Suspended for 180 days. \o\\O\N ,0\~' ce\lte~. ...Fee>~f6U9\\ U':',~',-,' OCyi -00 \ L r\/O& ,/ IJ :\\~, .', ") ',\,~- Electrical Contractor JJJ j-tr J{< W ~(~~\'\~Oo \\\8 ~~:\~\O.9:~~_~~~I:~~~':;' , "\:1;08' \0\ _( ',J~lc-Mnps to 400 Amps IIV C I'll\:; , ' Address _2Xi D m~:l'-;'vv{~uF e 401 Amps to 600 Amps 601 Amps to 1000 Amps City 5J&&'F' O'it{. Phone qz 1-$1;,"10 Over 1 000 AmpsN olts Reconnect Only $106.00 $ 19.00 $50.00 $ 63.00 $ 75.00 $125.00 $163.00 $375,00 $ 50.00 IZ~ Supervisor License Number L.j 7 7?-. S. c. Expiration Date 10 ,- C i - D 7 Installation, Alteration or Relocation Constr. Contr. Number I L.J ~ 74c,- 200 Amps or less $ 50.00 HQ1"Ci: ~l.~~~~mfpV'JORK $ 69,00 1\115 PERM\1 Sr\~O(~~~~p'&S N01 $100.00 r\U1~Q~IIEO UNO ~~905g~olts see "B" above. COMMENCEO~ _,r_I\N'l180 Of>. '1 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Expiration Date D J - I ~ - c> -, Signature of Supervising Electrisjan 4~~ ~ ' . Owners Name LA/..JlJ:" 1~j,7'y~r.:I.-LE Address 5(, ')", IMv[)FtV &: ?-./J I $ 43.00 t.{ $ 3.00 /2- E. City S{)t.;J Phone 52' 1- ~l >~ Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 OWNER mSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Inspection Request: 726-3769 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges (3~ JIOt( I \>50 p 16 Z ~ TOTAL ..,--:*:/t}'\, Owners Signature: ncal Pennit Application I-03.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00024 ISSUED: 03/29/2006 APPLIED: 0110512006 EXPIRES: 09/29/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3639 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1702194205500 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install furnace ,. Owner: Address: Contractor Type Electrical Mechanical MICHELLE TORKELSON 3639 HAYDEN BRIDGE RD uires yOU to SPRINGFIELD OR 97477 iENilON: Oregon law reqoregon Utility AT . _..J h'j thp. - 1I- tolloW rules auutlw;,_~.'~.rJ\les are sellU1 . Notiti(I,~QNItm\.'€TOj(jJSJi~UAllurON-I01- , OAR 952-UU \-Uv I ~ .. ies of the rUle by Contractor I~090. You may obtam{~ofe: th~Wep'se~e Expiration Date MITCHS ELECTm.~rm~e center. \ 0 Utilityl~i(~atlon 01/18/2007 MARSHALLS I~<;\mber tor the Oreg~; '1~?-2~ 12/23/2009 ""~Tq' 1" I 0 I J$Ufi..1JING INFORMATION' Phone Number: 541-744-0367 Phone 541-521-5690 541-747-7445 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: , # of Bedrooms: VN # 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: Occupant Load: R-3 n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: , Solar Setbacks: N '\fELOP I OR'" 1H\ NDER 1H\S PE NOi AU1HOR~P~~~~~: ABANDONED fOR COMMEW18M!e 6~~qd: ANY 18CPM)i Ne'1t'qd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pal!:e 1 of3 Status Issued CITY OF SPRINGFIELD" Building/Combination Permit PERMIT NO: COM2006-00024 ISSUED: 03/29/2006 APPLIED: 01105/2006 EXPIRES: 09/29/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone , 541-726-3676 Fax 541-726-3769 Inspection Line 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 ~ Fee Description . Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $10.00 1/6/06 1200600000000000021 + 10% Administrative Fee $4.50 1/6/06 1200600000000000021 + 8% State Surcharge $3.60 1/6/06 1200600000000000021 Furnace - up to 100,000 btu $12.00 1/6/06 1200600000000000021 Minimum/Adjustment Mechanical $33.00 1/6/06 1200600000000000021 ~ + 10% Administrative Fee $13.80 3/29/06 1200600000000000364 w - + 8% State Surcharge $11.04 3/29/06 1200600000000000364 Add, Alter, Extend Circ Ea Add $12.00 3/29/06 1200600000000000364 Penalty Fee - BWOP Electrical $138.00 3/29/06 1200600000000000364 Perm Serv/Fdr 200 amps or less $126.00 3/29/06 1200600000000000364 TotalAmount Paid $363.94 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. ~~ouiredJnsnections . Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required pr~or to utility company energizing service. Final Electric: When all electrical work is complete. Paee 2 of 3 Status Issued CITY OF SPRINGFIELD~. Building/Combination Permit" PERMIT NO: COM2006-00024 ISSUED: 03/29/2006 APPLIED: 01105/2006 ~XPIRES: 09/29/2006 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 all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertainhig 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 ~ Pa!:!:e 3 of 3 225 Fifth Street Sprin'gfleld, Oregon 97477 541-726-3759 Phone "'~ty of Springfield Official Receipt ~velopment Services Department Public Works Department RECEIPT #: 1200600000000000364 Date: 03/29/2006 8:12:17AM Job/Journal Number COM2006-00024 COM2006-00024 COM2006-00024 COM2006-00024 COM2006-00024 Description + 8% State Surcharge + 10% Administrative Fee Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add Penalty Fee - BWOP Electrical Payments: ~,ype of Payment Paid By CreditCard MITCRS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 038580 In Person Payment Total: Amount Due 11.04 13.80 126.00 12.00 ;' 138.00 $300.84 Amount Paid $300.84 $300.84 \1 ;( '~ . ! i .\. Xl, - :1', " G '. " , i I ! f .:~.. \,) -.t'.J .... :1', Il :r 3/29/2006 Page 1 of 1