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Home My WebLink AboutPermit Electrical 2005-3-22 SPRI'NGFtEt...P '225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541~~~".9 . ~ . ~ ~~~ ELECTRICAL PERMIT APPLICATION") . /. o~" . O'oQ.s> "t' City Job Number COM"'ZOO S- - 00 Z, <JDate Z ~/ () j-- ...q(.lt~ ~,~0"0. "Ot:: 6'(.16 . P 0". ___~ ~~ 9.. ">Jl 1. r~LOCAiiOl\{OET&S'l'AiLAijQN r:?"':xc'''i''. ........... "<F'F?'<;~rZ=."'< ".';"':"} """"ih&,& ............. .... ... . . ., 3, ilS;J]MK~~.~~!mE;,~C..<IUA,.n..: ,~., qW" Z 7 I 7 vM ,4-, ~ l- I~t",..~ Installation, Alteration or Relocation 200 Amps or less $ 50.00 \ 2011\W~~t~~[~Amps txr\9,~ \~ 1'$\!9~61R\ ;~1~~~:~;~~ 1:.~~ ~.~l~~t D, ::.Ilra .i\..ii~' New Alf~~~tid~l* xtension Per Panel U 3 One Circuit I $ 43.00 '7 Each Additional Circuit or with r 3 'i72.\A.~+ Service or Feeder Permit $ 3.00 '-;'.L - ,,-- -,; -7IY";,:',F - -"-:--:: - '~}':-::',,:'.-' ',-' :::','-,:-_i;:,- _ \":;.::~;:S-P7D-,--",:-':_". ,:" ::-::'7...T_=-:....._ _~l E, ~ l\!~~~~I~aneous(S~l"Vic~!fe~der not inclu(}ed}-:-Each hlstallation 1 LEGAL DESCRIPTION r 7o:rzs-, 4 ()67CJO JOB DESCRIPTION A~~ Z- c..~ (L.0A , -h:;, 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. Address eV:CQ -t o/~ ~ 40t;?7 Wcr$r / /~ Electrical Contractor City p~e~e Phone -6~6-1f!l1 LCL~~ > . -- /O,Lat/ ;)Cb L /~)esq Expiration Date {WI ~f? Ot:?rJ C; ( - Signa,",,~:,:~ ~ c-- Owners Name "J.S:e-/i; /;V 1t:!W167Z-.s Address '27 (7 //14 ,4-( A- L- f S~F~ Supervisor License Number Expiration Date Constr. Contr. Number City Phone 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 A. Service Included 1000 sq. ft. or less 06~0 Each additional 500 sq. ft. or . ut u ~ P~F~~(4'UN: Oregon taw req res yo ,. 19.00 ~_~theOII;l~UJIUl'l ~ . m. ~ose rules are set forth ~ 952..00 -0070W"ou9h OAR 952-0~00 . ' e rules by B'2~~~~~~Jl~ti?n' fl 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 c. 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 is $45.00 + Surcharges t/b 7% State Surcharge '.5"Z-Z 10% Administrative Fee L1 60 4b . '. TOTAL . y- -. I.D4 y: 538l.. Shared Drive(T:)IBUil~g FormslElectrical Permit Application I-03.doc 4. Status Issued CITY OF SPRINGFI~LJ) Building/Combination Permit PERMIT NO: cOM2005-00279 ISSUED: 03/10/2005 APPLIED: 03/10/2005 EXPIRES: 09/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2717 MAlA LP ASSESSOR'S PARCEL NO.: 1703251406700 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump . Owner: BETTY WIEMERS REVOCABLE LIVING TRUS Address: 2717 MAlA LOOP SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION. !<,. .,~' Contractor Type Electrical Mechanical Contractor License Expiration Date Phone AMERICAN EAGLE 153834 12/30/2008 PACIFIC AIR COMFORT INC 39237 "'l' \lnU'Q~25/2006 {eQIJIl v- , uti\i~ BUILDING INFORMA;IION, Q{egon ri:h . .: J\'~' ',- ,.\ b\' ~\e set '0" .' \'~ ~ .... r . anteL' J \eS a{e ~. # of S!or~es:; 00 t" \'(Iose {U p..R 9f>2t e' Heigh~,Rr$tFii~nWfu\ 0 t'(l{O~g'(l ~ tne~tl ~ Floor: \Typ~~{ ~S!!tOO\ -Obtain COpIeS \e\~~~nd Floor: Water '(Y~:roa':l 0 ~~ote'; :~e t--\o\,\\~~sement: Rai1~Q ~~\\I\ile cen~~egon ~\I\\W 344~.q Ft Garage/Carport Ene~!~t~~e{ \'(I~: ~ '\ ~&Oo.aa2-Z '~q Ft Other: SpriftRle\f~~~ \a n/a Occupant Load: 541-672-9510 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN I DEVELOPMENT INFORMATION. Front yard 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: I PUBLIC IMPROVEMENTS. Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Ii 1\-\\= \NOR~ ~01\Ct:, \-\~\..C>~~~~dis/~~1~:~01 1\-\\S Pt~~~6 t~DtR \\-\~~6t~tD fOR ~Ij\\-\OR OR \S ~\3t"\ CO\'J\\'J\t~Ct~ ptR\OD. ~~'( '\ 80 D Notes: Pae:e 1 of 3 ~~~Ji!l.'~~,~I~.~PS~.".__~",,~. ft . ". ....." I )" 1. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Total Value of Project ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2005-00279 ISSUED: 03/10/2005 APPLIED: 03/10/2005 EXPIRES: 09/22/2005. VALUE: Value Date Calculated Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $10.00 3/10/05 1200500000000000312 + 10% Administrative Fee $4.50 3/10/05 1200500000000000312 + 7% State Surcharge $3.15 3/10/05 1200500000000000312 Heat Pump $12.00 3/10/05 1200500000000000312 Minimum/ Adj ustme.nt Mechanical $33.00 3/10/05 1200500000000000312 + 10% Administrative Fee $9.20 4/1105 1200500000000000411 + 7% State Surcharge $3.22 4/1105 1200500000000000411 Add, Alter, Extend Circ $43.00 4/1105 1200500000000000411 Add, Alter, Extend Circ Ea Add $3,00 4/1105 1200500000000000411 Penalty Fee - BWOP Electrical $46.00 4/1105 1200500000000000411 Total Amount Paid $167.07 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. ~eouiredJnsoections . Rough Mechanical: Prior to Cover Final Mechanical: 'Yhen all mechanical work is complete. Pae:e 2 of 3 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: cOM2005-00279 ISSUED: 03/10/2005 APPLIED: 03/10/2005 EXPIRES: 09/22/2005 VALUE: 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 Pae:e 3 of 3 Date 225 Fifth Street Springfield, Oregon 97477 541-726-:3759 Phone f'ity of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 1200500000000000411 Date: 04/0112005 2:10:05PM Job/Journal Number COM2005-00279 COM2005-00279 COM2005-00279 COM2005-00279 COM2005-00279 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Penalty Fee - BWOP Electrical + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 43.00 3.00 46.00 3.22 9.20 $104.42 Amount Paid Check PACIFIC AIR COMFORT INC djb 10005 In Person Payment Total: $104.42 $104.42 4/1/2005 Page 1 of 1