HomeMy WebLinkAboutPermit Electrical 2007-8-6
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Numbe~ um 7 - 0 I 0 l.{ I
1. LOCATION OF INSTALLATION:
40,(.1 S . 8 ~
1
LEGAL DESCRIPTION:
\ID~ ~\ L\-40C\l{(TIJ
~ JOB DESCRIPTION: ...
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
CONTRACTOR INSTALLATION ONLY
2. .. . .
lOt;!
Electrical Contractor (~r elt!./;~ (<J(' L.1t"'~?6.c
-.
Address/?{} ..f{/)X / / 8
City (l)).~,.JJd-l Phone %75 - L/ t; /, t;..
Supervisor License Number ~ 7 7 () ~ 5'
Expiration Date / () ,- LlI - 0 7
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Constr. Contr. Number .7 /' ,:::, '- )
Expiration Date 5/ - /:s- - d;;r
Signature of Supervising Electrician
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OwnersNameP~t },......~.m ('~ ~~
Address q,al0 5 . 0 - ST
City &r 1..0 J- Of!.) Phone 7 2-b - ~ I
OWNER IN\1. ALL~ TION
The installwion :~-~~e1U(M9f ~P.Rf~ I own which
is ~~tl~b1Uig~~~f;ftf{f'Jg~iC5 '~i' JOpaqwnu
'!'(')\U;lele- e~n :eloN) 'J8:,UaO al..jl 6u!lreo
OwRhs ~lgpatJ(eS"'la'O" urs'OO Aew nOA .0800
11.0, selnl oU,l J.o 0. .... . t.
~OC ~-2: 1.;'10 'IRnojulDl.nn-LOO-~96 1::1"0 UI
l.p,.lO!. ~.6S ere salnl 8s041 'laWea ~O!+'SOn!~ON
A)!,iv; uo6eJO 8111 Aq pe~.dop'B $lIl<!I\1.11 MO:IO~
o'~'~oA sal!nbaJ M91 UOOSlO :NOIJ.N3llV
Inspection Request: 726-3769
Date
3. C01UPLETE FEE SCHEDULE BELOIV
A. New Residentia1- Single or Multi-Family per dwelling unit.
Service Included
1000 sq, ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B. Services or Feeders:"'Installation, Alterations or Relocation:
200 Amps or less $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps $125.00
601 Ampstq)990 Amps $163.00
Over 1000 AmpS/Volts $375.00
ReconAt~~6~~~~~ S~~~~ i~~~~[ {f-T~gOJ}&!{K
c. Te~;AtM~cefJtm fg.eAtfA PEHMlT is NOT
ANY 180 DAY PER NDONEO~FOR
Installation, Alteration or iaPdcation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
. .
D. Brauch Circuits
New Alteration or Extension Per Panel
One Circuit /
Each Additional Circuit or with ..3 ...L.L
Service or Feeder Permit ~
f
$ 50.00
$ 69.00
$100.00
,$~.OO
/1. ~
'-I ({.
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$ 3.00
E. Miscellaneolls (Service/feeder not inCluded) -Each Installation
4. SlIBTOTAL OF'ABOVE
8% State Surcharge
10% Administrative Fee
5% Technology Fee
TOTAL
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
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Shared Drive(T:)/Building Fonns/Electrical Pennit Application 8-06.doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-01041
COM2007-01041
COM2007-01041
COM2007-01041
COM2007-01041
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
2200700000000001239
Date: 08/06/2007
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
/
Paid By
C. PERKINS ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm 073357 In Person
Payment Total:
Page ] of]
9:49:52AM
Amount Due
48.00
12.00
3.00
4.80
6.00
$73.80
Amount Paid
$73.80
$73.80
8/6/2007
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01041
ISSUED: 07/23/2007
APPLIED: 07/13/2007
EXPIRES: 02/03/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4076 S E ST
ASSESSOR'S PARCEL NO.: 1702314409400
Springfield
TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install furnace, gas line and AC unit
Owner: CURTIS EDWIN P & STEPHANIE L
Address: 4076 S E ST
SPRINGFIELD OR 97478
Phone Number: 541-726-2431
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Mechanical
Contractor
C PERKINS ELECTRIC INC
MARSHALLS INC
License.
159537
25790
Expiration Date
04/15/2008
12/2312009
Phone
541-895-4466
541-747-7445
I...!!UlLDING INFORMATION'
VA
# 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:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
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:
Street Improvements:
I PUBLIC IMPROVEMENTS 1.(I"''''~''2:88-009'~ S! Jalue~
"-_. ., 1I!+n uo6aJO a4l Jopeqwnu
8~,:. I": i" I Si1f~~l'NTyueiuao alH 6u!lleo
Aq S8;ilJ 8L;1 ;ooWhiHgJ1~Ati!-U nOA .0600
-~OO-0S6 8\'0 -4'OnOJ4l O~OO-~OO-G96 HVO ul
4lJOJ l8S SlB SalnJ aso41 .JalUao UO!lBO!l!loN
^l!l!m uo6aJO a4l liq paldopB SelnJ MOIIOj
01 noli saJjnbaJ MBj l.I06eJO :NOIJ.N311V
Storm Sewer Available:
specNOl'U~((:tion :
THIS PERMIT SHALL EXPIRE IF THE WORK
NoteAUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Pal!:e 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
+ 5% Technology Fee
+ 8% State Surcharge
Boiler/Comp Up To 100,000 btu
Furnace - up to 100,000 btu
Gas Outlets 1-4
Minimum/Adjustment Mechanical
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01041
ISSUED: 07/23/2007
APPLIED: 07/13/2007
EXPIRES: 02/03/2008
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
$20.00
$4.60
$2.30
$3.68
$14.00
$14.00
$5.00
$13.00
$6.00
$3.00
$4.80
$48.00
$12.00
7/23/07
7/23/07
7123/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
8/6/07
8/6/07
8/6/07
8/6/07
8/6/07
1200700000000000951
1200700000000000951
1200700000000000951
1200700000000000951
1200700000000000951
1200700000000000951
1200700000000000951
1200700000000000951
2200700000000001239
2200700000000001239
2200700000000001239
2200700000000001239
2200700000000001239
$150.38
I Plan Reviews I
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.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Pal!:e 2 of 3
CITY OF SPRINGFIELD -
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-01041
ISSUED: 07/23/2007
APPLIED: 07/1312007
EXPIRES: 02/03/2008
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
Pal!:e 3 of 3