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Home My WebLink AboutPermit Electrical 2007-8-20 ZON LDZ- INITIALS ~ VV\ DATE '1('... ,.::)\[-01_ SOURCE 'r<\~%'pJ Date ~ - cl1) - CJI 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION 0 City Job Number LovV' '2.0~ 7 - 0 (( 8' ~"_,y.;._-' ;.-:, ,:. _ " ,"':C_-"",;"^1-"~~"~"V'"~ ,";~_ ~'-1l: '~g_':""..' ",:.y-:(~'''''~' \,,':':C "'~'7- ~r' ""':","^' v 1. .. Lod!tfON"QE'INs'rLwMrlo.' " ~. ~.....\..,.~ ~.i.."",,,"'~K._. ""-,,.., ~.~,.-a .~~;o...""...;........~)<:?>""f",')i(:,~"~.",, ,.-:;.f on."",,,*, '" ~\'&4 ~,~_ l...nDI). LEGAL DESCRIPTION: 6 . '7("'t'^ 17D] 2?\.\ ~ Ot.{ ~u ':"" JOB DESCRIPTION: (~~ (;:J/'-"^f- Permits are non-transferable and e~pire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. '/,C(ff{i;1!JWiQf!Ji~t~YMtig~g,~~~~ Elec:;i::~C~::::':W.~ o;"~"=. ~' Address P () ~DX d..d.c~ ) City ~t-J-- (),Q. Phone "",:-\ 43 ~ (b~ I, lj ql'tOd. Supervisor License Number 'L3,Q cl- ..:s Expiration Date I D - r - n J Constr. Contr. Number /G (S (K Expiration Date q - a2' -dW") Sigm.ture of Supervising Electrician !...JL,."\,,,/IAA4AI1 )(~I lt~A ) Owners Name;?", A ~ Address ~ City Phone i4j (qoq OWNER INSTALLATION The installation is being made on property I own w~h is not intended for sale, lease Olie.~\,~~U\fGQ :~~?~\;~I~~ . oregon t If'l~''''~Orl w.. ~^ ,.. '.d ~'ff tff\!9 Y' Q"" h"'/"P, Own~s €I ' ",' ,!,u\es sse >(:;.\:~~ CElfl\~r. "hO\:l~ :n ()!:\'?\ ~'0"'i'\,l;, , . l\~ e ~Att'l\Ja ... ~, "'0") .o01GUY I . on.'''' "~,/~/" ~,.. (JAR 95 ""\~ "''''t~n cop\e~~,., ..,r.'-:;.'::;.\ c'C;v.cJ,., ~~, 'lau m""'y ""IJ N ~e' \1\0 ~." 0 .' T OO~'. 'Ih~ ~r:'i.~f; ~' o'tl\\\\W Nctn;G~;"'f:'-' cam~~ \ nt>e.~on '3t 1" Inspectio6~~4C1f \~.:j tf.~oO-332.-Z ., "'F i\ C~\i'\'~{ \$ r:~;/:" :::: ;\:~<: i. e:^1' '/:"(i .,' "" ;'.;.,h~-;:~'r,.".Xq";:-:./;:;7,':"1'"''''t/''c<: '-'\~~'; . .: ,';.' ,~::rY::"ri"'~ ::C:<y :::')- ~<. ~r>/ ',?::;':.::"'.:>:. 3. i, COMPLETE'FEESCHEDU.r.EBELOW:'.:)I~:;>~ 'J:;" ~\":' .;:.:?,...."-'~~1,,,;~?-..:j,;~~'M_.12 .,:~t.:..;:;_ ~", :.;"",..:, ~ " .~"^",,,~-",,~;;,j.;.:,;::J:i.A~:f..: ,.~:::- '.' ,:;'". - '~....L: "~id~;;",:C::~,:.1L;/NU: ~.~ /0;,,- 't;:N -(",:::- ' ',:....' "::~~~l:';':_;(t",~ ,..'::>;:::' ,';'"~t-;: ~"',:~\":':;:":~~/,\;:;;;J~~0;Z;'/::::_;~' ", :' ,,'}1'.,~"'\t'0'r";:, ,.>, '''!;,7.-':~'::7'_,~.,~;~,~""" '-.-, ',';~ A. ~)~~~:R~~i~~~tiaL~sfngl~~i'Muld~FarriiIY'p~r,a#~lling 'unit. '.' ' "''''' -;ji,~-,.;;.~''''''''''-~~' "..:.,,~,#,,;.~H,,',~ ""',, d." _, ,.>1::".,_' .."",,,,^-,.,.>' V-,*",. '" , '. "",., ",,"""'~""'~Y""'"~''''' ':"''''''~'M'{\:':;-'''''''<'~' ','.....-0.';...c-;!<- .:M: ",,:: ""v'~, 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 $117.00 $ 21. 00 $55.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 55.00 $ 76.00 $110.00 Over 600 Amps or 1000 Volts see "B" above. D. ~,~!~l~~~li~'J';: New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $48.00 4 ~ $ 4.00 .~ ., "''' "1it:V~t~:;:>'7r~~::::~:~PLh~f7-~:?~~?IS<!~0%' ?'/:"}:r~4':.~+:?)7V;.-:~~iW'?"~,t :...'~"':'T ~"""".': ,/. ,- E. . 'eotiS''(SerYiceJfeeder'uQtincluaed):';''Each~Insiallation t'''''r-i-I>i#'T'' '".:.;" '.,''".,-'"" '.. ..A"..: ".., '. .,.< .,,' 11 ;__.Ki~~r~~1 's~t\[rEXpT~E"iFTy~0~U"";"",0"U" , Pumpdtlhtrlgllilb1€D UNDER THffi-"""'o~'i$~5~:,l~ si-u'{klliiW::M};'t!'f1lt 1'1" ' 1...,t-Ll!i$j5~~J~jl glll'U .1?1~ete!S ...R !S A8AI\!D{V~"':Fil O::(j) Limi&a!~tihOO/BA1d~10D. ~h~lbu$r~& Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 4. 50~ 8% State Surcharge LJ \So.."C) 10% Administrative Fee cS ........., 5% Technology Fee at. 0-() TOTAL Co I S-o Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc i'."" .,',.,.,....(;.;.,., . 'i :~:.,', ':.::.;, <.','''; .' .:'.: :.; Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2007-01180 ISSUED: 08/10/2007 APPLIED: 08/10/2007 EXPIRES: 02/23/2008 VALUE: $ 0.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3184 Wayside Lp ASSESSOR'S PARCEL NO.: 1703224104200 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Heat Pump Owner: ALEMAN ELIZABETH R Address: 3184 WAYSIDE LOOP SPRINGFIELD OR 97477 Phone Number: 541-747-1909 I CONTRACTOR INFORMA nON I Contractor Type Electrical Mechanical Contractor OREGON ELECTRIC SERVICE HOME COMFORT HEATING & AIR License 161518 84164 Expiration Date 09/28/2008 06/2512011 Phone 541-343-1681 541-345-2838 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # 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: R-3 n/a .*,. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMA nON I O CE REQUIRED PARKING . N TI : Overlay Dlst: IT SHA l ex.'] ~WORK # Street Trees Rqd: THIS PERM l.. . Paved Drive Rqd: AUTHORIZED UNDER T~~ . S NOT % of Lot Coverage: COMMENCED OR IS ABAND NED fOR ANY 180 DAY PERIOo. I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: AI · CI'moN: Oregon law requfres you tG follow Rllea adopted by the Oregon Utility =~on Center. Those rules are set forth "" 952-D01-Q010through OAR 952-001- 0090. You maVobtaln copies of the rules by 08I1ing the center. (Note: the telephone IIUmbet for the Oregon Utility Notification Center 18 1-80000332-2344). Sidewalk Type: Downspouts/Drains: Notes: Pa2e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Total Value of Project ~ Fee Description -Mechanical Issuance Fee":" + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Air Handling 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 Amount Paid Date Paid $20.00 $5.00 $2.50 $4.00 $9.00 $14.00 $27.00 $5.00 $2.50 $4.00 $48.00 $2.00 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/10/07 8/23/07 8/23/07 8/23/07 8/23/07 8/23/07 Total Amount Paid $143.00 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2007-01180 ISSUED: 08/10/2007 APPLIED: 08/10/2007 EXPIRES: 02/23/2008 VALUE: $ 0.00 Value Date Calculated Receipt Number 2200700000000001278 2200700000000001278 2200700000000001278 2200700000000001278 2200700000000001278 2200700000000001278 2200700000000001278 2200700000000001336 220070000000000]336 2200700000000001336 2200700000000001336 2200700000000001336 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. lJeouireCUnsoections I 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. Pa2e 2 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2007-01180 ISSUED: 08110/2007 APPLIED: 08/10/2007 EXPIRES: 02/23/2008 VALUE: $ 0.00 225 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 ofany 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 Pa2e 3 of3 225 Fifth.str~et Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01180 COM2007-01180 COM2007-01180 COM2007-01180 COM2007-01180 Payments: Type of Payment Check cReceintl RECEIPT #: 2200700000000001336 Date: 08/23/2007 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received OREGON ELECTRIC SERVICE djb 21127 In Person Payment Total: Page I of I 8:38:48AM Amount Due 48.00 2.00 2.50 4.00 5.00 $61.50 Amount Paid $61.50 $61.50 8/23/2007