The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-9-9 .' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COM ~~-o l~:z.~ Date A. ()C)foCX::> Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof 1. qc;~ f./ff It LEGAL DESCRIPTION l7 O~ ~S 22- JOB DESCRIPTION tle.ctn~ {N- f-b.J- ~ p 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. Electrical Contractor MLJ{,() IItl/.Lly ~ . Address ;J;s:{ tl L4b.1 f(/KJ , ~ City ;;?A1.L Phone ~;"tJ.3f1 Expiration Date 1-f7v&5 IIJ,- J-tJ/ / '/9 Jl3t / I~-/:;Y~ Supervisor License Number Constr. Contr. Number Expiration Date Signature of Supervising Electrician C--;/IA ,,~~ ~ r ~ -.., ~ c:::::;7" ownersName~ ~bee-, Address qs~ M,tll st 0 City Sp~~etd Phone 74-\ -10(0 ( OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. , .. . '- ~ :';.", \~ /,:J/.,;':UUI,I;:I 200 AIJ1ps}irC less." "t'.J I U 0 "l!UJ"f\irn . 20 l' Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 4WI-~~~ION: Oreqon 13Vi '$;'69'.00 C . 401 Amps to ~I6WP.SJle~ adopted by UK$IOO:OO O 600 A..!\.!!<;\';~I'lt'ti'Ai:nn ..G:PotP.~'Blh15ose ~u.J;;.:, .."" :. ver llIi'HYOr '{'\;I\!/\yVunS'see' a ove, '_'-" .' D. . lJu III 1 New Alteration8cIl~~eMW't81'l.J.:eJf!lr.\~~ote: the ';:';'3!~, ;C,[~" One Circuit rumber for the Ore~on Ut$i~3!GO)tl1lc~1(X:> EachAdditiona ClrcuitEe~Nl:!r is 1-~O-332-2344). 1_ r"r\ Service or Feeder Permit ~ $ 3.00 '" 0","""-,, E. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. 4'fo 00 3./:& 4.'0 S(.~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application I-D3.doc 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: COM2005-01228 ISSUED: 09/08/2005 APPLIED: 09/08/2005 EXPIRES: 03/09/2006 VALUE: Springfield TYPE OF WORK: Heating System SITE ADDRESS: 953 MILL ST . ASSESSOR'S PARCEL NO.: 1703352200600 Residential PROJECT DESCRIPTION: Replace heat pump TYPE OF USE: Repair Phone Number: 541-741-1061 Owner: JACK BARBEE Address: 953 MILL ST SPRINGFIELD OR 97477 I . , ,.' I '. ~..'. 11"<. \, ~__I,_ ~L=.'.,' -.. 1'---: ~ , . I r~lu :JC,' _' O. : Ii i l " i~~ II ,- 'j LIi: 0L;' i ~ I I;) , ,- I CONTRACTORINFORMArION '"i \3 ;\3,i\:\;OO;'kD H);:"1 ANY -\ (jet 01-\"'( PERIOD. . . Contractor LIcense EXpIratIOn Date MAG ELECTRIC INC 149834 12/13/2005 ASSOCIATED HEATING & AIR CONDITIO 106275 08/31/2006 Contractor Type Electrical Mechanical # of Units: - Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Phone 541-461-0387 541-683-2590 BUILDING INFORMATION I # of Stories: Lot Size: R-3 Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: VN Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: :.T:!:~ IT'C"'" nYO~"n l~w rpnl lirA!; "au to I DEVELOPMENT INFO,RMAr1Jl@N:i~opted by the Oregon Utility Notification Center. Those ruleRE~ARKING O I D. t 'In OAR 952-001-0010 thrOUghiR 952-001- ver ay IS: . ota): b # Street Trees Rq8P. You may obtain copleslna{~les dY Paved Drive Rqd:::alling the center. (Note: thE(; m.EfPa~~~S % of Lot Coveraget'mber for the Oregon Utility NoIDicatlon Center is 1-800-332-2344). I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: Paee 1 of3 .-7~J~ .........'.c.... i;.. 1It;:..'C . I '-fj; . -~..-",....-......,...--... ,.,.. ..... Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01228 ISSUED: 09/08/2005 APPLIED: 09/08/2005 EXPIRES: 03/09/2006 VALUE: I Valuation Description' $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $10.00 9/8/05 1200500000000001323 $4.50 9/8/05 1200500000000001323 $3.15 9/8/05 1200500000000001323 $12.00 9/8/05 1200500000000001323 $33.00 9/8/05 1200500000000001323 $4.90 9/9/05 3200500000000000543 $3.43 9/9/05 3200500000000000543 $43.00 9/9/05 3200500000000000543 $6.00 9/9/05 3200500000000000543 $119.98 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. 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. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2005-01228 ISSUED: 09/08/2005 APPLIED: 09/08/2005 EXPIRES: 03/09/2006 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 pertaining to the work described herein, and that NO OCCUP AN CY 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 Pal!:e 3 of3 225 FUth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department . . Public Works Department RECEIPT #: 3200500000000000543 Date: 09/09/2005 12:07:01PM Paid By CROW V ALLEY ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 009202 In Person Payment Total: Amount Due 43.00 6.00 3.43 4.90 $57.33 Job/Journal Number COM2005-0 1228 COM2005-01228 COM2005-0 1228 COM2005-01228 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment CreditCard Amount Paid '. $57.33 $57.33 ;'1. 'I " ", t\ 'I :, 9/9/2005 Page 'I of 1