HomeMy WebLinkAboutPermit Electrical 2007-6-11
09/11/06 MON
10:50 FAl 5417263689
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CITY OF SPRINGFIELD
Ii9 004
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ZON L P'2-
lNITlALS N f\I~
DATE t. ..[, ~-n
SOURCE IY\.~
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m FlFTIl STREET. SPRINGFIELD, OR 97477 0, PH:(541)716-3753 0 FAX: (541)716-36"
ELECTRlCAL PERMIT APPUCA TION
City Job Number en I . ,":U7lJ7- CJ7),r-;( Date en - r - 0 '/
l.I:,OcAi?fjfi;p'i1I?ist~Tf4. 71oM;:;',';;. 3.:.c/f4fPL.'f4fpI;iij:;$CTfil!jji;f!,:BiJ+o.~'
NcA:l. '~OILrl.l (Jp,' JJr' ""..,P" ",' ,- .' ,.,
LEGAL DESCRIPTION: J A. ;~eF;~~li~~Y#:~SJNff~~~Mti:it!~~i~~rd.~'~III~~Un1t.
'"10 S'n tJ 0 ~ (0 () () Service Included
JOB DESCRIPTION: 1000 sq.~.;ohl~1rtnl\" 0, S106,00
.L , n Each additional 500 'q, ft. or egOi, law I eqlJlreS you to
LA ') I >.,-t- (f~ portion iJi1!i~W rules adopted by the Orels:1.9,ootililll
, Notification Center. Those rules are set forth
Each Manufact',d~Home,or 0 '
Modu'i'\-'OY)[Jllng S.'~lce oP1 0 through OAR qS~.001-
F d' IlJ;;'). You may obtain ---.. - -. .tS50,00 ,
ee er .--~............. . Ie rUles uy
'.,.... :81:Jtf1qih~.cen!er.,{Nqt.s;',lhEJ,telephnn'"
B. Servl(O$,or"Jlffil.n,",JnstallaUolI; Alleratio""jor Relocolion:
. ',.,.... ,~"', ''-''.' , ~ VI "YUi I lJUlIlY I~Olr Icatlon
200 A I Centel is 1800-332 23t.$'A_L 00
mpsor ess : b'J.
201 Amps to 400 Amps :$15.00
401 Amp' to 600 Amp, ',S 125,00
601 Amp. to 1000 Amps ,SI6).00
Oyer 1000 AmpsIVolts $)75,00
Reconnect Only S 50.00
I
Permits are DOD-transferable and expire Irwork b
not .tarted within 180 days of IssuaDce or If work Is
Su.pended for 180 da~..
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CONTRACTOR INSTALLA, 'TION,.()NLY
2.
Electrical ContracaREGON ELECTRIC SERViCe
P.O. BOX 2237
fuGttic, Uti ~fqUZ
Phone ~~'i..:l, - (b'irl
Address
Cit)'
Supervisor Licen,e Number 'J ~=l9-0 ' '\
. - -
Expiration Date /0 - I - ()j
Constr. Contr. Number J La I S 1<)(
Expinltion Date q - ~9: - D7
Signature of Supervising Electrician
IL MINfA"" )(t~PLL</
Owners Name ~ .0 rfln., f) 0 J
Add~ss ~
Cit)'
Phone
OWNER INSTALLATION
The installation i. being made on property I own which
is not intended for sale, lease or rent.
Owners SlgnalU~:
. ."
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In.p',ctioo Rcqii..t: 726-3769
G~RINO"U:a..O .:'
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c. ;-f~p&Aiit~*y4i~e{~:~f~€f~1;P!!(;:)1P .: .
_PO;
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Iristallatio'n,-AlteratioD or Relocation . . - --.
200 Amps or less S 50,00 '
201 Amps to 400 Amps S 69.00
401 Amp. to 600 Amp, S 100,00
qyer 600 Amps or 1000 Volts 'ee.:.'8.': aboy~, ,
D. ':;~"f-~ ~~:W:~f<~,itij~;"i' ::";~;;:;>~;~~\~:~":?.:-:.:~k":;~kri",;'::~};:Ll \,:'~;;
~e"-A:lteration or Extension Per PaDel
i'n~~ilc'GIt-: J S 4),00 1fc3 '-1::>
,lihtAlfcITtiOh~r~~~i'J~Lw~~PIRE IF TH' . \
Serv,celor.Roodcr Penntt ,$ ~ ll9R/f
,.~ ",un'ILCU UNuER TULS 0 .'
E~;U\li~lret~:~f~1;i(~~I~~i~~{lt~R~9Ji~.tali~do'n
ANy i 80 DAYPER:- . ""''''uli!'.flJ /"~JH ,. .,
Pump or irrigation 100, S 50,00
Sign/Outline Lighting S 50.00
Limited Energy/Re.idential S 25.00
Limited Energy/Commercial S 45,00
Minimum Electric Permitlnsp,:"t1on Fee 13545,00 + Surchal'l:es
" ?..' " .' ;'". ': ",,"..: . .. <~" . -', ',. , :' .' ", "~..: ' " , .. , .:,f
. 4.~;qS;f;p.X/Jif,:O/{?Y!PY1f. ,;:i;., '::1, 4 S, '-<:>
8% State Surcharge I A \-'0
10% Adminlstratiye Fee : "4,sc:>
5% Technology Fee c:S..~
TOTA'L ... , I I s.s.. as
Shered Drive(T:}'Building FormslElcclrical Per nil Applicatjon 8.Q6,doc
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00788
ISSUED: 06/01/2007
APPLIED: 05/31/2007
EXPIRES: 12/01/2007
VALUE:
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2093 DONNELLY DR
ASSESSOR'S PARCEL NO.: 1703271303600
Springfield
TYPE OF WORK: Heating System
TYPE OF USE: Alterntion
PROJECT DESCRIPTION: Install heat pump
ATTENTION: Olegoo law requires you to
.. .. ......_ ~_~ , ,..Id..
tollOW rUle~ aUUl-H"U U J ...- - - u . '
Owner: KIVELA JERRY A & CHRISTlNA","otification Center. Those rules are se: forlh
Address: 2093 DONNELLY DR . AR 952-001.0010 through OAR S52.001-
SPRINGFIELD OR 97477 10 0 bt' op'es of the rules by
"'1(\0(\ Ynll m::\V 0 aln C I
__";~n Jho ...ontF'r, (Note: tile lelf;:J.l'IUI '"
I CONTRACfOR.INF.ORMA TIONJ tlotlfication
Centel is 1-.800-3322;;44).
License Expiration Date
161518 09/28/2008
84164 06/25/2007
Contractor Type
Electrical
Mechanical
Contractor
OREGON ELECTRIC SERVICE
HOME COMFORT HEATING & AIR
I BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION J
Residential
Phone
541-343-1681
541-345-2838
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
. Overlay Dist: Total:
# Street Trees Rqd: Handicnpped:
Paved Drive Rqd: Compact:
% ofj~l\qW!~age:
THIS PERMIT SHALL EXPIRE IF THE ~~~~
~PUBLlC IMP-ROVEMENis,.fJcH I HI::> t'tnlYlll ,.:I ,,'"
liUIVIIVIl:I~v~U un IS A~ANDONED FOR
~Sidewalk Type:
ANY 180 DAY PERIOD. .
DownspoutslDra.ns:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Paf!e I of 3
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Description
Tvpe of Construction
Fee Description
-Mechauical Issuance Fee-
+ 10% Admiuistrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Air Haudling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Mechanical
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Total Amount Paid
.
. CITY OF ~rluNGFIELD '
Building/Combination Permit
PERMIT NO: COM2007-00788
ISSUED: 06/0112007
APPLIED: 05/31/2007
EXPIRES: 12/0112007
VALUE:
I' Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
J?pp< Pqitl I
Amount Paid
Date Paid
Receipt Number
2200700000000000876
2200700000000000876
2200700000000000876
2200700000000000876
2200700000000000876
2200700000000000876
2200700000000000876
3200700000000000384
3200700000000000384
3200700000000000384
3200700000000000384
3200700000000000384
$10.00
$4,50
$2.25
$3.60
$8.00
$12,00
$25.00
$4.50
$2.25
$3.60
$43.00
$2.00
6/1107
6/1107
6/1/07
6/1/07
6/1107
6/1107
6/1107
6/11107
6111/07
6111/07
6/11/07
6/11107
$120.70
I Plan Reviews ,
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Rp~,! In<nprti~
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.
Page 2 00
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00788
ISSUED: 06/01/2007
APPLIED: 05/31/2007
EXPiRES: 12/01/2007
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 1 have carefully examined the completed application and do herehy 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 ofthe 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 Snfety.
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 Ihe sile at all
times during construction.
Owner or Contractors Signature
Date
Paee 3 of 3
.
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
e
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Sit of Springfield Official Receipt
.Iopment Services Department
Public Works Department
, Job/Journal Number
COM2007-00788
COM2007-00788
COM2007-00788
COM2007-00788
COM2007-00788
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
3200700000000000384
Date: 06/1112007
Description
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
Item Total:
l..:heck Number Authorization
Received By Batch Number Number How Received
OREGON ELECTRIC SERVICE ddk
20828
By Mail
Payment ~otal:
Page I of I
8:03:39AM
Amount Due
43.00
2.00
2.25
3.60
4.50
$55.35
Amount Paid
$55.35
$55.35
6/1 1/2007