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Home My WebLink AboutPermit Electrical 2002-11-19 ... .. 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: .726-3759 ELE" _JCAL PERMIT APPLICATION City Joh N~~llerLf)'tv\~ .20\ .:l-~l. 3. COMPLETE FEE SCHEDULE BELOW 1. LOCAT~N OF :w'f~TALIj.4TI.pN , 9 5L 0 c ~u--\ W~ A. ~<<i\J1ti\?rij:l'ential-Single or s submitted :c~\\c 1311d u Multi-Family per dwelling unit. ec' {e s? LEGAL DESCRIPTION ~??{~'lIot {eOu\ Se ,'ce Included: ~, 0 3 ~ ~ \'2..- ~ ~ ~~ --t-". v Items Cost ZO{",." \ ,!-l _ 0 3??{O'oi3 \V\ JOB DESQUlTION 100 .. or less ~ \~ \-\-\-- ~ ~~' Each additional 500 \j dYe . SlgIl3\\J{e sq. ft or portion Permits are non-transferablel><'U\~~Pre thereof if work is not started within 180 days Each Manufd Home or of issuance or if work is suspended for Modular Dwelling 180 days. Service or Feeder Sum $106.00 $ 19.00 $ 50.00 2. CONTRACTOR INSTALLATION ONLY '. DIXON ELECTRIC, INC. Electncal Contractor 33736 IN MAnTIN 9RESWELL, OR 97426 Address 4541) 89~ B. Services or Feeders Installation, Alterations or Relocation: City Phone Supervisor N Otf~t~on Date . T~rPs&fWhTr.&tl\M&JXItJ~ AUTHORIZED UNDER I Hill P COMflJIrffiN0flJaOOJS ft>BA ANY 180 DAY PERIOD. Signature of Supervising Electrician .flA, 't~ ~,;~neo:6~~r; ~~<\ ~ ~ ~ AddrestJ.ci:)~V-(;ll Y}uJ L;:(y ~ Cit)::)~~ Phone OWNER INSTALLATION The installation is being made on o\vn which is not intended lease or rent. D. Branch Circuits New Alteration or Extension Per One Circuit "> Each Additional Circuit or with Serv\ce or Feeder Permit . I 3.00 "\ Owners Signature: E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm $50.00 $50.00 $25.00 $45.00 Minimum Electdc Permit Inspection Fee is S45.00 + Surcharges TOTAL 4~ .($V 3. . ~'"L- "2. - (p~ 5,.) ~q() 4. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee ... Status: Issued CITY OF SPRING~lELD Building/Combination Permit PERMIT NO: COM2002-01282 ISSUED: 11/19/2002 APPLIED: 11/1312002 EXPIRES: 05/19/2003 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 560 CARDINAL WAY ASSESSOR'S PARCEL NO.: 1703221204000 Springfield TYPE OF Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install air handler and heat pump Owner: TOM PARRISH Address: 560 CARDINAL WAY SPRINGFIELD OR 97477 Phone Number: 541-343-6991 Phone Number: 541-343-6991 I CONTRACTOR INFORMATION. Contractor Type Electrical Mechanical Owner Contractor DIXON ELECTRIC CHITTIM ENTERPRISES IINC TOM PARRISH License 66894 47396 Expiration Date 07/18/2003 03/08/2005 Phone 541-895-2440 541-343-6991 BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: hnpervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: IpUBLIC IMPROVEMENTS. Street Sidewalk Type: Downspouts/Drains Storm Sewer Available: Special Instruction: Notes: 1 of 3 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Fee Description + 7% State Surcharge + 8% Administrative Fee Air Handling Unit Up to 10,000 -Mechanical Issuance Fee- Heat Pump Minimum!Adjustment Mechanical Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 8% Administrative Fee Add, Alter, Extend Circ Total Amount CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2002-01282 ISSUED: 11/19/2002 APPLIED: 11/13/2002 EXPIRES: 05/19/2003 VALUE: I Valuation Description I $ Per Sq Ft Square Footage Value Date Calculated Total Value of Project Amount Paid $3.15 $3.60 $8.00 $10.00 $12.00 $25.00 $3.00 $3.22 $3.68 $43.00 $114.65 I Fees Paid I Date 11/13/02 11/13/02 11/13/02 11/13/02 11/13/02 11/13/02 11/19/02 11/19/02 11/19/02 11/19/02 Receipt Number Received By 1200200000000000230 1200200000000000230 1200200000000000230 1200200000000000230 1200200000000000230 1200200000000000230 2200200000000000200 2200200000000000200 2200200000000000200 2200200000000000200 djb djb djb djb djb djb djb djb djb djb 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. I Reouired Insnections I 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Electric: Prior to Cover 4 Final Electric: When all electrical work is complete. 2 of 3 CITY OF SPRINGFIELD Building/Combination Permit Status: Issued PERMIT NO: COM2002-01282 ISSUED: 11/19/2002 APPLIED: 11/13/2002 EXPIRES: 05/19/2003 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 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 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone r .ne Items: Job/Journal Number COM2002-01282 COM2002-0 1282 COM2002-0 1282 COM2002-01282 Payments: Type of Payment Check I Paid By Description Add, Alter, Extend Circ Receipt #: 2200200000000000200 Date: 11/1912002 Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 8% Administrative Fee DIXON ELECTRIC Received By Check Number Confirm No nJm 5014 Page I of 1 11/19/2002 9:59:57 AM City of Springfield Development Services Department Public Works Department Official Receipt Amount Paid 43.00 3.00 3.22 3.68 Line Item Total: $52.90 How Received Amount Paid By Mail Payment Total: 52.90 $52.90 .. cReceipt.rpt