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Home My WebLink AboutPermit Electrical 2006-5-4 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number CoiAAZOOb -DC S-~( Date S - y.. -00 !-. '.' ~.~ '., ~"( '~"'J,",~ .i6~~i.'i;:~'::~~..'fa:"*,1~...""'t"1~~'~}."':('o~";,,, 1. : 'WCATIOMOE,'INSTifEI521 ' ;;,.t.......:..:~~....~"3",.,.~h~J..,.>..~j~Au.~p..l~_~........'....~,I';:\_ ','" ~&;bS -y),~ ~ LEGAL DESCRIPTION \ 70.] 2 S-I L.( C> 70CSC> JOB DESCRIPTION a,JUl ~ ~~ 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. 3. ""!J'''':''~i,'''''''')';;jo:''''''~~''''''''''.~''l!,h1i""'~~~~JlJ1{1k<-;,-,,_}..~,,,,''''. . R,~:l}l!:~~"jnfJIjB1 . "<;,-"-"I~....;.. ':' - ,,-,t - -l7r.'.-i:t~q.;:-.~~,~,-.. at;:o.: A, Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or .~-~. Modular'Dwelling)~rvice or ,Feeder . " J"" J~~ .: 'C .Iwnu $106.00 $ 19.00 $50.00 ,.'r.o D. ,'.... r. Electrical CO~OON ~L Cf'Tp:r. ,'r-r!I'.M · ;~-, 200 Amps'or'less'c:?'--1 8't/O u! &.l" lIV'-'I.I.Vil/1.. ,'jnl '201 Amp's to:40-0 Wirijfs:J!J!lON Address P.O. BOX 2237 ' ".:' '"..~; aL 401 Amp~(o.6002Amps\01l01 ----EfjfjEf4t ltIt9i2ll12 Vt' ',-,1\ ;;:,c.i!,',u811V\.,., U'j1.,8J[) ''''1"''" 1\l::J '1\..1 I 601 Amps to 1000 .Pllilps- v City Phone ~ 4.allc~) Over 1000 AmpsNolts Reconnect Only Supervisor License Number J ~ qc~..:..s Expiration Date 10 - I - 0 'J Expiration Date ICa tS I~ '1 -~L/ . O~ Constr. Contr. Number Signature of Supervising Electrician "^ '7 \ ~o~ (')jl ,Q,cuv $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. InstaUation, Alteration or Relocation 200 Amps or less $ 50.00 01\C2~~ Amps to 400 ~8~ ' \f 1HE WORK $ 69.00 N ~Ol\AmI ps t0~QQ~psREEDt^\1 \C, N01 $100.00 1HIS P\:K \11 \ U ' \-II P nW\ - AU1H ve 6Q.0~~~ 100 \(os thbove. CO~~\' .....f\ (\ Q /o,V P . AN'{ f,.ew ~lteraticm or Extension Per Panel '/ One Circuit $ 43.00 Each Additional Circuit or with ~ervice or Feeder Permit I.(J $ 3.00 Owners Name ~~ J LA.A...6....t...h. J.~ ' Address ~ Zb6S-~~IA-Lf E. s ~P.1 Phone :>.g] - ~q9 City OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee~i~ Surcharges 4, 4 ~ <9--C ~~O 4 CSb ~~ '0 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnslElectrical Permit Application 1-06.doc Status: Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00561 ISSUED: 05/1212006 APPLIED: 05/12/2006 EXPIRES: 11/12/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2665 MAlA LP ASSESSOR'S PARCEL NO.: 1703251407000 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump Owner: Address: GARY JURGENSEN 2665 MAlA LP SPRINGFIELD OR 97477 Phone Number: 541-747-3099 Contractor Type Electrical _ S\ )8W8C) nll . f" _?Sc;:'.-OC': ~. )Ot )8QW . (o"" j( ~ _ . ,,,\',,8)0 8l\\ i' hI 111113::> .. "".' I '<,"1 ~,'\ ')8'l,1I8'JV"l'._n\ ."\100 \..." "'~Icl C.QNTRACT.QJ~(I~FgRM~TlQ~L' v-~~, 2'..\~\tQ '6~'."- l\\O~OO-VJ\.r\.J~~B::>\\\\ON Contractor.., S"'_\:(' \:\\;0 l\ono) .)8W8C) lIL1c~i~~~\ OREGON EUEc:tl!lfr~ERivteExO~~~ndopB S8}~l~~ ~";J W~~\~\;\ltJliUIf'oJNiiINFin-{MATlg~ -. 0\ noJ\ '='c,.~. . # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 09/28/2006 Phone 541-343-1681 VN Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 nla Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I a\( \i:. ' at: \f 1\-\E \NO'REQUIRED PARKING v,,\nl~"~' "ll E~J)\l\(.. 1 \S \,\01 Ovt'r'lll ~~\'!I\i S\-\t\ \-\\S ?ER\'!I\ Total: #, St\-~ \41~U\'\OER 1Bf\NDO\'\ED fOR Handicapped: PavtdlDrl tt:D OR \S f\ Compact: % ocoM r~~~' ?ER\OD. f\\'\'{ '\ 80 u , I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of 2 CITY OF SPRINGFIELD C Status: Issued Building/Combination Permit PERMIT NO: COM2006-00561 ISSUED: 05/12/2006 APPLIED: 05/12/2006 EXPIRES: 11/12/2006 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 I 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 5/12/06 5/12/06 5/12/06 5/12/06 2200600000000000595 2200600000000000595 2200600000000000595 2200600000000000595 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 ofany 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 Paee 2 of2 2f~' Eifth Street Springfield, Oregon 97477 541-726-3759 Phone l' of Springfield Official Receipt .aJevelopment Services Department Public Works Department Job/Journal Number COM2006-00561 COM2006-00561 COM2006-00561 COM2006-00561 Payments: Type of Payment Check cReceintl RECEIPT #: 2200600000000000595 Date: 05/12/2006 Description + 8% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received OREGON ELECTRIC SERVICE DJB 19661 In Person Payment Total: Page 1 of 1 8:51:58AM Amount Due 3.60 4.50 43.00 2.00 $53.10 Amount Paid $53.10 $53.10 5/12/2006