HomeMy WebLinkAboutPermit Electrical 2002-12-13
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2002-01374
ISSUED: 12/13/2002
APPLIED: 12/13/2002
EXPIRES: 06/13/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1724 CARRIAGE PL
ASSESSOR'S PARCEL NO.: 1703252110600
Springfield TYPE OF
Single Family Residence
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install 1 circuit for hot tub
Owner: LUCAS TODD M & CHERI S
Address: 1724 CARRIAGE PL SPRINGFIELD OR 97477
SETBACKS
_ ,IOU \V
I CONTRAcr~<?B\lN"F~ORM~T~
~ \'0."'. O'{e~- e\ W"
eQP \'(\0 '{e s ~QV
Contractor. . Q~"O'{ o'O~ ~eS~ 9~{~ic~e
NEAL I~,\~. . t~Jbl'{3ts)'E1~'(\ose '{~'(\ O~~e '{\9'g9'5.3
LUCAS ~QP,Pwt~9JI\E~J~ \'(\'(O~\~S 0\ ~_\o.{)'(\O~~1\
~~\\\\~~~stt6iiiiid~ING~'iNIFO~\iiD~' -
\'{\ O~ --(OU ~'{\\e\. ~o'{\ U"\ "~,?>A-l>.l'
rRl?JO. ~'f\f0 \'(\e 4t~CSrol'i.e~.:3""?-~ Lot Size:
Ca~\ e'{\O\~Heiglkg;l" Sq Ft 1st Floor:
ofIl\'O ~D\ ' '
'{\U'.... Ce'{\Type of Heat: Sq Ft 2nd Floor:
Water Type: _ ~~ Ft Basement:
Range Type: ~ ~QSlfYt Garage/Carport
Energy Path: ~ \r \~ ~ ~Ft Other:
. \ \ 'i:.i-\>\'r\ oc.~~\\ ~C\,.lmpervious Surface Area:
_0 "c. \"\-\ b.\..\.. ~\\,c.."(" ~ ....('\ ~"'~
I DE~~~j,~~\.fl,~tMl..~.
ua ()\\\~
": -. ~i~:~~ ,?'t.,<-\O'i).
\tJ ~~44~:
ved Drive Rqd:
Expiration Date
10/22/2004
Phone
541-485-2472
Contractor Type
Electrical
Owner
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
% of Lot Coverage:
IPUBLIC IMPROVEMENTS.
Street
Sidewalk Type:
Downs pouts/Drains
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation DescriPtion'
Desc ription
Type of Construction
$ Per Sq Ft
Square Footage
Value
Date Calculated
1 of 2
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2002-01374
ISSUED: 12/13/2002
APPLIED: 12/13/2002
EXPIRES: 06/13/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I Fees Paid I
Fee Description
+ 7% State Surcharge
+ 8% Administrative Fee
Add, Alter, Extend Circ
Minimum! Adj ustment Electrical
Amount Paid
Date
Receipt Number
Received By
$3.15
$3.60
$43.00
$2.00
12/13/02
12/13/02
12/13/02
12/13/02
1200200000000000399
1200200000000000399
1200200000000000399
1200200000000000399
djb
djb
djb
djb
Total Amount
$51.75
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. Ail 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.
L Reouired InsDections I
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefuUy 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 wiD 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
2 of 2
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELEL.. ..LCAL PERMTT APPLICATION
3. CONWLETEFEESCHEDULEBELOW
City Job Number
A. New Resid~p.ti;ll-Single or
, ,,{M~lti;"FamiIy per dwelling unit.
. G,,'l~\\\5-e'rvice In!,:luded:
\O\~\\/~;v'2F~\ ItelTIS
r.;;\} "'6
'. ?;? 00\\
'r>.G '. \~ .
,n;o~~ ,,0' '
~-,\i'''~ ~o~~
'. ~"o' .~(\
; I ,\,{\2 : f\C;; - .~;.~
~,o\\\\ ,1'3 ,~'''\~ '
Permits are non-transferable and ex~~~o ....0'
if "vork is not started within 180 days' "",;:;5 .
of issuance or if work is suspended 'for i\.b' .ec rj;P"
180 d -0 ,'\"
ays. ,~,\o' .
~; ,,'0.
1. ~QC~TI<p-'f OF INSTALLAJ:JON
;l 1",)'4, t.,,'/',I",'(, c,.'.. i I,'.,' 7
I "T~' '0' t." '
LEGAL DESCRIPTION
,/ ~<
JOB. DESCRIP.!IO,N
1..// '/ />b
Cost
Sum.
lOOO sq,fi. or less'
Each' additional 500
sq. Jt.d"r portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00
$ 19.00
$ 50.00
Electrical' Contractor(.' 14-"/1'-'
I ( .:
'-j' .-
(~( i /-:~C -f" l .('.
B. Services or Feeders
Installation, Alterations or
Relocation:
2. CONTRACTOR INSTALLATION ONLY
Address
. . t4 I
'. ",,1. ' ,
f,. /( / it.-/;'? &: r:
\ PhoneC)'////
, -
City j_-:.' '.ffi/'
. c/
Supervisor License Number
Expiration Date
200 Clmps or less
201 amps to 400 amps
401 amps to 600 Clmps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
'-,
.)
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date I t/z
Signature of Supervising Electrician
,'7/ /'
,. //,(-C<~_:'-'f
/-
I .
\. ~(
,f' ~~/; !
~-~ ;-;~ ";
D. Branch Circuits
New Alteration or Extension Per Panel
E. Misc:ellaIleous'(Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
1;/
>~_.". L.,...
Owners Name
r;
Address /
},/
-\,.~{ ,,{ 1;"
/,
1
City '>. ~ v
:>>;:; (
Phone
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
200 amps or less
201 amps to 400 amps
Over 40] to 600 amps
Over 600 amps or 1000 volts see
"B" Clbove
$50.00
$69.00
$100.00
One Circuit
Each Additional Circuit or with
or Feeder Permit
$jO.OO
$50.00
,$2j,OO
$.j.j.OO
Minimum Electric Permit Inspection Fee is 545.00 + Surcharges
4. SUBTOTAL OF ABOVE
7% State Surcharge
8 % Administratiye Fee
TOTAL