The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-3-21 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 h following bmitted has t e ELECTRIC# !ERMIT APPLICATIO/y ) T~e fol~ng proiec~~~:~Uire specilic land use CityJObNUmberUJCC?t:b~ -ro\~kJ ~ 21:~~a\ddoesn . ~ 1. r~~~~~~ljj~~~!!Ji1f~i~~~!*&N::^~:;::;^ '^] 3. [~W&?.J1g#~' 1 ''":~H1t~1i~"::":~l t~-./y":,p~-{ ,-- H_~; (\ale '" '.''':'''f'''fc (rzach$jg~at~~!L" ,7;; , J .. ' ---..,-- ------ A. ;Ne~Tfl~~JW~~tiiIT~:::Si~~I,e:'~~~~u~~':Fam-i,!y ,perdwelli~g ~~it. i ~~ t)~A~.\~ &\-' Sp.c\~; C)lU-US LEGAL DESCRIPTION ~4D0/ CSb . JiO:::n 3~ JOB DESCRIPTION O~ ~Ywr+- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. -.:~'~_~Z~"".':'---::--.~."":""'.~~~>'<';'.,....,.". '."_'_' ., I: :::;);;;-':)":Vt;;;;~;;, ;:i~:,;,::/::;,~"::;,,;;,,:.(;,,,,: , CtlINFRttCE{R@ 2. I ':"';- " ; ';"...., , .. .,~.~,~~~..;m..'._'.;_~'."" _" "";"<<";'~'" ',. ','.;-" ~~_. "-::n:r:;TI::';;:j~i:'.~J&rf~M*E~{:':"i;,::: .. i/i..;Jf)NI!:Y i ,::,:,..,<..~.."/-", / Electrical Contractor Address t' \: :. ~,\ ~ lVt~.\JiU~O:llciVl: .'C:\.{li,1 ":'\". .~:". ',l- " I" \..1 "lIlt-" 'HJQ\)tSI'HHlthl:J(l(j \;,' \' Ciry,l IU"" : , ~'~ ....\", I . ':" "'PIiOlie "'::;) ,1.., ;"'J \.j~:'l~n,;.......dC'~ a vL: ,t,-..:. : n~;S~ ;' .l~)~. ::ii \;; ~~): ~: ;~, r) I\.~ ",,'''''l)':' _\""~ (' 'I' wr Ipi" ;-...../, '-, 'n~?..n,'~ . . \.. r . .1, ,r. "'''';' l . ......;. . .1. ,;_ ~()Pq "';QfI 'rtit-" ,,",h'\-;~ "":7':~";~ r,;; f~:-:~::: ~;;)G :' SiipetvisQf Lipe'rtse N~mbe: " .. ., . _ c8.11:~~ \.hr) cc~!.~rr~ \' ~" )l.~-;:. V~, 'j :.,-:;",:..,. :",;i~ .,;j I.' . ''"'II 1;'''~ 'rr\- ~'"'' ~(v...,,,, 0 w,;~., \1,)"'!':"~~;C!~ Expiratiori'Date'" ,....,;j... , '~,L'!, ,',~" ." .J .. ~- '\ '~/nrH:> ~'-. ; -~ i' I: j-..: T'~-~: ':.!->,. e of Supervising Electrician Owners Name f~lD~\~~ Address ~3 ~!^\~ ~- City ~~~.\t\L Phone '1L\L\ ;<1P-jD OWNER INST ALLA TION The installation is being made on property I own which is no i d r sale, lease or rent. \ \ Inspection Request: 726-3769 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. 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 OW(Jrl'C~Q1psNolts $375.00 RerPllge~l'1\~ $ 50.00 C.~ii0~~.- I~~YIa\W}.,OAij~~lOO. Reloca9ion 0 FOR 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1 000 Volts see "B" above. D. New Alteration or Extension Per Panel , One Circuit / Each Additional Circuit or with . Service or Feeder Permit .tfi U? ~ $ 43.00 7 ...../- $ 3.00 E. ~!~~~~~~x~~~i~~~~~ii~ti~:~,~~~~iij~~:w:'::::"":,'m~~~~..;;~~t~!~~;iori~i Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. 43 C5b d. . C5V 3 ./5' Lj'S-D --- _ ... r-- .::;, d... . <?J ....) Shared Drive(T: )/Building Forms/Electrical Permit Application 1-03,doc 7% State Surcharge 10% Administrative Fee TOTAL . , ."N~~~. >~_~_~_" . ., 3/21/2001 r -. - 1:41:41PM~~ . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 2200200000000000624 Date: 03/21/2003 .. Line Items: Job/Journal Number Descri\>tion Amount Paid COM2003-00 190 COM2003-00 190 COM2003-00190 COM2003-00 190 Add, Alter, Extend Circ 43.00 2.00 Minimum/Adjustment Electrical + 7% State Surcharge 3.15 + 10% Administrative Fee 4.50 Line Item Total: $52.65 Payments: TWe oCPayment Paid By Received By Check Number Confirm No How Received Amount Paid Payment Total: I 52.65 $52.65 . Check ERIC M. GWALTNEY nJm 2095 In Person Page I of I cReceiplrpl Wi~q},i'mi9ti -- -::-""~,.._'------..-'. ,'- ", -''''. ~ . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERl\fiT NO: COM2003-00190 ISSUED: 03/19/2003 APPLIED: 03/19/2003 EXPIRES: 09/19/2003 VALUE: . SITE ADDRESS: 4343 DAISY ST ASSESSOR'S PARCEL NO.: 1702323406100 Springfield TYPE OF Heating System TYPE OF USE: PROJECT DESCRIPTION: Install gas furnace ans associated piping and ductwork New Residential Owner: GWALTNEY LAUNA RAE & ERIC MATIHEW Address: 4343 DAISY ST SPRINGFIELD OR 97478 I CONTRACfOR INFORMATION I ' .'.' ~ _ . ' 0~V'llu\!lJ ~"",VLH:\",,,,_: -",'. . c~nfJ~eE~m~aHALtc6YmQEtlfr THE WORK f\i~~:.:~~:~I:If.~i~F,~:~e~~t.e!(~&p~~~!i~:1?~tt:!~';Phone Menhani-m'RIZED UNDEK:~t~di(Mc i~>l (Hd-1 }~007l ?" -'J"-',(\ '..,'_(~,~{~~/2,9P5 ~;!'-'~_{I~JI-461-4821 o RUT N".MI\.n. ..1o<11\Z:1I\ awA RAE & ERIC MATTH ,~~ ~ I , \,... ,l. ., WP'f",,"n~tI,Ir.l=n OR b~t{O'I'\'t'Ut.h~,t't\.~"'~ ,,,",,' ~,~.. ....~.....h...:,. N....' , ,.',.',,, -'1,~,,; ANY 180 DAY PERIOD. I ~.. -- "-" '-" - ". ~. - ; BUILDING INFoul\J[!.tmTON .,......""'"'e {~ ~t'" ,." "01_~'n"'!"" ~lI.l'ftrJ.l1 ,\ ~ ,..;'~,....._~.. \! "'1:,...;.:;, ~.,,; '.Vl.....;;:"-' "(""I., 'l-l'''~''''' f.... .., f~~ 0.":"-......,...7"' ; ,....':-;-\, .:')'";;":'~3.t~OT' Z'_,. "~,,", . \ . . .., ". \4.<,. ..I.. ", L ", .. ....\. # of Stories: " """'." ;, '; _rNLotTSize: /' (\ ~, ,.' \.' ~. _, . -, . J f ..! '. -. . I Height of Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport: Energy Path: Sq Ft Other: Impervious Surface Area: # of Buildings: Primary Occupancy Group: Secondary Occupancy P"rimary Construction Type Secondary Construction # of Bedrooms: VN SETBACKS I DEVELOPMENT INFORMATION. Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: IPUBLIC IMPROVEMENTS I Street Sidewalk Type: Downspouts/Drains Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft Square Foota2e Value Date Calculated 1 of 3 . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00190 ISSUED: 03/19/2003 APPLIED: 03/19/2003 EXPIRES: 09/19/2003 VALUE: Total Value of Project I Fees Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date $10.00 $4.50 $3.15 $6.00 $12.00 $4.00 $23.00 $4.50 $3.15 $43.00 $2.00 3/19/03 3/19/03 3/19/03 3/19/03 3/19/03 3/19/03 3/19/03 3/21/03 3/21/03 3/21/03 3/21/03 Receipt Number 1200200000000000854 1200200000000000854 1200200000000000854 1200200000000000854 1200200000000000854 1200200000000000854 1200200000000000854 2200200000000000624 2200200000000000624 2200200000000000624 2200200000000000624 Total Amount $115.30 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. 1 Underfloor Mechanical. Prior to insulation or decking and including required testing. 2 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. 3 Rough Mechanical: Prior to Cover 4 Final Mechanical: When all mechanical work is complete. 2 of 3 . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00190 ISSUED: 03/19/2003 APPLIED: 03/19/2003 EXPIRES: 09/19/2003 VALUE: 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, hat the permit card is located at the front of the property, and the approved set of plans will remain on the site at all i during constr ction. (JjJj1" l), , V fL1('_ Owner or Contractors Signature ~ ~-~/h ~/) ().~ Date 3 of 3