HomeMy WebLinkAboutPermit Electrical 2005-3-10 (2)
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m..l....l1STREET. SP~GFIELD,()~97477' PH:(541)726-3753 'FAX:(54il1iW~ . ~ ~~-.,
. ELECTRICAL PERMIT APPliCATION' '. . _' f~ "~{ ~.,O' ~.c, ... ~ .J
CityJobNumber CDI'\II7.o0S-':"'OOZI../) Date. ~i~ ~ OO""~""/ ',.' ",'
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A. ~W>.Kesldentilil~SlI!gl~or; . ultL a
Service Included
1000 sq. ft. or less
Each additioual 500 sq. ft..or
portion thereof '.
....
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LEGAL DESCRIPi10N
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JOB DESCRIPTION
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: Permits are non-trBlUferable and expire If work is Each Manufact'd Home or
... not started within 180 days of issuance or ifwork.is Modular Dwelling Service or S5000 .
Suspended for 180 days. . ATTE~..~jJ: Onlgan..,...r'~ .
2. 'l(eiJNJ1iIDl:cro7i'{JNST;;,~rrt.&tTIOm.'OMJt~~ 10110.8'1 ~~.~{lt!iR1'\~6i'if~~1
. r.';,'''''''>.......".".,.".'''''--''',,_..,..,,--.~~~!l Notifice:'.' . . .' . .,. . .' iiF~""-~ ."*'\11
Electrica1Contractor,.Jl'I5ePb 'f)an~. \ ' f.C !!tntRI2~~:~=CJ1tt\erul8SW $63.06' .
0090,. ~~(NBm:U\8ttl1&ptlOllt $75.00 .
Address 7525 l;JlllfJY\cft. Dr .'. ':-~3 f~d~MIi1\tyNutiilv.dI~ $125.00
. . ,I r 600_.:J~2344). $163.00
City F=:\MQX\..t . Phone:.!:f1..Lr-~7~ Over 1000 AmpsIVolts S375.00
\ Reconnect Only $ 50.00
Expiration Date ; D I 01 10 '7
., I
Constr. Contr. Number 2-0 - % ~ U /SIP?!; I
Expiration Date I {) I O~ / 'if /07
, /
rp'g:;'l~
Owners Name )ce-Af ,rl-DWlkS
J I ""- I E. Ij.(Mfs"t-ffiiffi'€ct1rf,tS~ma~=a.rd~rd"i:i'ffi1ffifl1ijjltll'tn"l
Address 7"3 JJ/~ c:!.. P':",--.-.:.-...~~,.,.:o:;:;--=-"""r..:..~~tr..-,;,o<J.'--'~"~' .>>rI....._~.~-:.....,.-,,:;a
City 'S t:>/"" I'::.. Phone 7'17- OJ ')b Pwnp or irrigation S50.00
Sign/Outline Lighting S 50.00
Limited EnergylResidentia1 $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
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490
57 :r~
Supervisor License Number tf 7 3L1- -S
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent
Owners Signature:
Inspection Request: 726-3769
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Installation, Alteration or Relocation
200 Amp,s or less S 50.00
lOPlJiPiti:, 400 Amps S 69.00
4b111&Pp'i~\~oowmpsL EXPIRE l~nH: '~$JP!IIOO
~J~RI ~oY~!QOOrvJI\iIWfBr~8l\O.,Jt; NOT
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D.. oJ n ~-'< . . ~~~~\W&'<{~"~~~
u .
. NewAIlerationor Extension Per Panel I
One Circuit .
Each Additioual Circuit or with
Service or Feeder Permit
S 43.00
IT::'
b
Z S 3.00
7% State Surcharge
10"10 Administrative Fee
TOTAL
_ ".....,,~~__ 'C'___Ie1_...:.....1 D_;t ......1;.....,;,," 1.01 tilV!
.
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: . 1173 DIAMOND ST
ASSESSOR'S PARCEL NO.: 1703342400214
. CITY OF SPRlr\l\.Jl'lELD
Building/Combination Permit
PERMIT NO: COM2005-00245
ISSUED: 03/1112005
APPLIED: 03/0112005
EXPIRES: 09/1112005
VALUE:
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install heat pump and air handler
Contractor License Expiration Date
JOSEPH BUNCH ELECTRIC INC 156761 08/21/2007
MARSHALLS INC /. . ;[~mON: Or2~'lllOlaw reaulresl~IMf9ll05
BUILDING 'iNFO'RM'iifOif.PY the Oregon Utiiity
. - -~se rules are set forth
# ~Psl~~f ?52-001-D010 through OAil.Q!SMl01-
lJl ,"'u ~~II rmw obt . . of
Helgh1 ~r !it'ruCT1J1'e aIR copies ltsqmlEntlSloor:
Typel(,if mIltlhe center. (Note: the teSlpl102ud Floor:
wa&J.iifYp'e1 for the Oregon Utility NcS.QillitImement:
Range Typegenter is 1-800-332-2344IiR Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
Owner: KEN THOMAS
Address: 1173 DIAMOND ST
SPRINGFIELD OR 97477
Contractor Type
Electrical
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Phone Number: 541-747-0156
I CONTRACTOR INFORMATION I
Phone
541-344-8745
541-747-7445
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
NOli!';!:: E WORK
TIII<' occ~m "HAil EXPIRE IF TH
I PUBLIC IMPROVEMENillS.,UNDER THIS f'tKIV\II I;) mJ'
'c'o' M'IV\' -tNvtU OR'S ABANDONED FOR
. Sidewalk Type:
ANY 180 DAY PERIUU.
DownspoutslDrains:
Pal!e 1 of3
.
. Lu f OF SrKlJ'Il..Ni!,LU
Building/Combination Permit
PERMIT NO: COM2005-00245
ISSUED: 03/1112005
APPLIED: 03/01/2005
EXPIRES: 09/11/2005
VALUE:
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Oescrintion I
, Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
L.Fpp< p"W
Fee Description Amount Paid Date Paid Receipt Number
-Mechanical Issuance Fee- $10.00 3/2105 1200500000000000282
+ 10% Administrative Fee $4.50 3/2/05 1200500000000000282
+ 7% State Surcharge $3.15 3/2105 1200500000000000282
Air Handling Unit Up to 10,000 $8.00 3/2105 1200500000000000282
Heat Pump $12.00 3/2/05 1200500000000000282
Minimum/Adjustment Mechanical $25.00 3/2105 1200500000000000282
+ 10% Administrative Fee $4,90 3/11/05 1200500000000000315
+ 7% State Surcharge $3.43 3/11/05 1200500000000000315
Add, Alter, Extend Circ $43,00 3/11105 1200500000000000315
Add, Alter, Extend Circ Ea Add $6,00 3/11105 1200500000000000315
Total Amount Paid $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.
I RpRwrprl Insnections ,
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 of3
.
. CITY OF SPRINvI'U"LU '
Building/Combination Permit
PERMIT NO: COM2005-00245
ISSUED: 03/11/2005
APPLIED: 03/0112005
EXPIRES: 09/11/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
By signature, 1 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 he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described hercin, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services DivIsIon, Building Safcty.
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 Fifth Street
Springfiel~, Oregon 97477
541.:-726-3759 Phone
Job/Journal Number
COM2005-00245
COM2005-00245
COM2005-00245
COM2005-00245
Payments:
Type of Payment
CreditCard
"
-'
3/11/2005
.
RECEIPT #:
~~'
~..
City of Springfield Official Receipt
.elopment Services Department
Public Works Department
1200500000000000315
Date: 03/11/2005
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JOSEPH BUNCH ELECTRJC
Item Total:
(,;heck Number AuthorIzation
Received By Batcb Number Number How Received
djb 964855 In Person
Payment Total:
Page I of!
IO:37:59AM
Amount Due
43.00
6.00
3.43
4.90
$57.33
Amount Paid
$57.33
$57.33