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Home My WebLink AboutPermit Electrical 2006-6-23 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number -.t\ 0 I \.QVl\. 1. I LOCATiONOFIN8TALLATION -:-:1 I, .... ,,' ' '.',' '- - -",--, .," (\~ ~\ \'ce.Nt \.o..~~ LEGAL DESCRIPTION \ ~ Om.o t 4-tr\ \DCJ) JOB~~IOt~ (MdL Date SI&~~~O~ Jl l.2'6~'- ~~~" ~\1).~ . f (~... i. CCll1nf(Q)!r.. ~DQ ~lTN((]fFn [El/D)9 <<))~((](Q)W 3. I COMPLETE FEESCHEDUu: BELOW j A. 1:~ewRe~id~~tial_=-single'or Mlilti-D?amily ~er dwelling unit. Service Included 1000 sq. ft. or less Each additionalSOO sq. ft. or portion thereof $106.00 $ ] 9.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 2. ii.CONJ'RAi:n:OR~INS!ALMTjON ONLY I B.I Seryices or E.eede~"': Installati<!n, AI~erations or Relocation: 'j Electrical Contractor fhl\ 8 z=..lC'c~ I'lL --L hC 200 Amps or less $ 63.00 20] Amps to 400 Amps $ 75.00 401 Amps to 600 Amps . $]25.00 .. 601 Amps to 1000 Amps $]63.00 Phone 'j-:::u.".. <:ii-rJ OverlOOO Amps/Volts $375.00 - ~ 11 0'TitE Reconnect Only $ 50.00 ~S PERMIT SHAILLEXP-18E-IF-:r:H~WQHK _~__________ Supervisor License Number Ljq:?<...f fHORIZED UtiJDE~~~~P3E~!r~flC1f!.ers' .~ .__ /~. COMMENCED OR IS ABA.NDONED I=f1Q \ /e / 0 7 ANY 1 An nAY PE~It5"~latlOn, AUeratlo'Ji'dr Relocation / ~A~m~ Constr. Contr. Number rYo' 5' ~ 7~ 20] Amps to 400 Amps CGf-O /~r:il /;' / _ 401 Amps to 600 Amps · Expiration Date / I '/&J/tJk, Over 600 Amps or 1000 Volts see "B" above. / / Signature of Supervising Electrician D. ~rancljCircuits . - /\J./ )J New Alteration or Extension Per Panel It. L1... (X) . y y ~J One Circuit \ $ 43.00 "TD -r-' 't . . Each Additional Circuit or with . / {\~A. \\' ...1.. _bO A 1'1MM.~Ficeo.r. Feeder Permit , $ 3.00 Owners Name ~ -\ ~~ ....vI''''\.UL~ Address (\~.t:\ ~ \ 'f\p it tcJ.ll () ') E. I;J~1isc~J1ane()~s.(Ser,vice/feederIl9t jn~luded).-Each Installation ! City ~.c;n ~ ~ tQ Ph:ne J~l ~ ",Pump or irrigation ~\ ., Sign/OutlifieLighting OWNER INST,ALLA TION Limited EnergylResidential $ 25.00 The installation is being ~'MVAQ.~~I own wnich . l;imited Energy/Commercial ~5.00 is not intended for sale, fe\Jse Of'Mrtt' I 'I. regon aw req~r9~I~J~c. tric Permit Inspection Fee i~ Surcharges . fol.l?w ~ules adopted by the Oreg?n:Uiitr~, .' .' -C:-;---I () Owners Signature: ~otlflcatlon Center. Those rules41r~S~rmlTAHOF ABOV1?':.' , I ~p In OAR 952-001-0010 through OAR-952=001- . Il. ,_^ 0090. You may obtain copies of the ~~~urcharge 0 .lULI calling the center. (Note: the telepll~ministrative Fee ~ ..SO . . number for the Oregon Utility Notiflcrltion ~ InspectIOn Request. 726-3769 Center is 1-800-332-2344). TOTAL ~ Shared Drive(T:)/Building Forms/Electrical Permit APPlicati~~. \ 0 957 City ~&-l& {'p r---\:h \' ld.1 ~ ". Address I _n_..1 Expiration Date $ 50.00 . $ 69.00 $100.00 $ 50.00 $ 50.00 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 984 FILBERT LN ASSESSOR'S PARCEL NO.: 1802061407600 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00669 ISSUED: 06/22/2006 APPLIED: 06/01/2006 EXPIRES: 12/22/2006 VALUE: Springfield TYPE OF WORK: Heating System TYPE OF USE: New PROJECT DESCRIPTION: Install gas pipe, gas furnace and heat pump Owner: CHRIS CUMMINS Address: 984 FILBERT LN SPRINGFIELD OR 97478 Contractor Type Electrical Mechanical Contractor MNB ELECTRIC INC COMFORT FLOW # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN Residential Phone Number: 541-746-3980 I CONTRACTOR INFORMATION I License 162191 460 Expiration Date 11/19/2006 06/27/2007 Phone 541- 726-8601 541-726-0100 BUILDING INFORMATION I # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard 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: .-~ NOTICE: No,eA:IS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: ATTENTIO~ Ore~on la~ re8.ulres you to follow rules a~OVp~WcPB~/1tl~aO'~~gon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Paee 1 of 3 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 + 8% State Surcharge Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid CITY OF SPRINGFIELD- Building/Combination Permit PERMIT NO: COM2006-00669 ISSUED: 06/22/2006 APPLIED: 06/0112006 EXPIRES: 12/2212006 VALUE: I Valuation Description I $ 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 $4.50 $3.60 $6.00 $12.00 $4.00 $12.00 $11.00 $4.50 $3.60 $43.00 $2.00 6/6/06 6/6/06 6/6/06 6/6/06 6/6/06 6/6/06 6/6/06 6/6/06 6/22/06 6/22/06 6/22/06 6/22/06 1200600000000000799 1200600000000000799 1200600000000000799 1200600000000000799 1200600000000000799 1200600000000000799 1200600000000000799 1200600000000000799 2200600000000000870 2200600000000000~70 2200600000000000870 2200600000000000870 $116.20 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. ~eauiredJnSDections , Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 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: COM2006-00669 ISSUED: 06/22/2006 APPLIED: 06/01/2006 EXPIRES: 12/22/2006 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 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 Date Paee 3 of 3 225 Fifth Street Springfiel~, Oregon 97477 541=726-3759 Phone Job/Journal Number COM2006-00669 COM2006-00669 COM2006-00669 COM2006-00669 Payments: Type of Payment CreditCard cReceintl f'!......, of Springfield Official Receipt .... elopment Services Department Public Works Department RECEIPT #: 2200600000000000870 9:52:40AM Date: 06/22/2006 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 8% State Surcharge + 10% Administrative Fee Amount Due 43.00 2.00 3.60 4.50 $53.10 Paid By MNB ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 067077 Phone Payment Total: $53.10 $53.10 Amount Paid Page 1 of 1 6/22/2006