HomeMy WebLinkAboutPermit Electrical 2004-1-28
. ~. -'. " . "~' , : . -, \ _ '-, '. " ':-'~..:..~ L' .' ,i.... ; .' _' ",", " .
,"::'~~' r' :'; ,".CITY ,OF--8\. _.,INGFIELD.~ OREGON""':' >< ;). "
~/,y'.~~.,.' .....~~ '. ,::-~',~~1': ..;:_.~ ;', "";;".-: ;.~;.' ',,~".,; . : "':l~_'.'~:'~:''':i\'::i:l'~''':;''::'{''_\''r~t'i''''?::, ..:'...,.-......
~
('
225 n~ In STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX:r(i4tb)lOUn~~ect as submitted has the following
ELECTRICAL PERMIT APPLICATION zoning, and does not require specific land use
'1. . ro::J. r approval,
City Job Number COmwOtt-(bU9 Date j-nt.'6--lJ"1 Zoning LDv'2..
,;r7:'l!:;it/'.:,~~ ,t; ~""~~'N/~~:,K;:f;;~':~l~:~t'\;~')~ l:)~.'J; '+~r.~;;i:.',:~;;f,~,:~~I'J,!lM'!;!.i~,;}:,;~Wl~'it-~~~,:tXY:J~\ i!fl~,.:~t;~~,-'~:\":'.~ri '.:!:~l(.;'t,t.,:,:;~".~:~~:(,t'f;~~:~"
~!~ ..~. ","~/:!:".(!;t\~;;:~l',tw,~ri:;'I:~\;.;,?(j~'~~:'wl~;'\f;'~~""'~"'N\\j .-;.J,~~jr'.lh.ff~trfJ,~_ti.r:1f:~i",~;
1. ,.,.:r:~"'~~"T;,.~ p',:n.., s~"'r;F;;{A"~~"T,,"":."",'..l,',"""',",~",'\.;;l 3 ~'I;,V;1lIl~r,~~ E'E' " ,,'-" ...,... ....',- ....,..,..,., M'"""\~,,,,:~,,,,,,,,,,\, "'1.ft"" '...fJtJ.I.
r." ..,'0.,.,
~.~t"'~J."'lV"""_I:&JY. 'A~':a"~VJ~I, t ",};. . :....:~V~!~>...~:&::p;.,E:.D~., . .. ~~..a.aJ'AI'.LI.&:.n.:.r"."",1':"l..~(; .'k.\,\\':....\t,;"!. t ,"t'....'>'.,...~
5CO~'\;: 6~.~';~\:,:,,:'1Si,r,.::..~"Tq,'\',....,:."i."'Y'.:'O: ,"-,...",'..,.,':. ,:': "":"':";-:"'''.':'''''';''A'~tt~'8'fi'z~;:rSig~'-~tJ~~''':),"''''1'';,'''",'<': " '..:,'l,:',~:~i,
.., ,,' ,',l,:" a
:'\\, ~l,~'~.,..~'>'.I7:'.t::O .~:;~( l~'~' t(.\,~.a;~';':~~j".'I;";~'~~'~.. \. \. f.-" 'f.1, W""~:"~:~1;"..~\~"~' ~ ;.;'I;:.'..,.'..~I~''t!.:j.:'4~)i''\...:::~ ~i~~J?"')..1.~j..~,';:'!:I'~\I....\i
i1r~'~;:~';\~~ .;."\I',.,),J:{~~~.I.. \.' ..\~,~~ l..:.klil.'.i:';"~. i.,'\
A. :~iNeWt'R~ide~tUiI'::':':S.il'i"'I~'~irMiifti~FaiDif l~."'~f,~:tt~~m'ii'~}i~'l1it~Y ::;~:~
LE'1~ESCRIP ION:o \"\-'21 S;~;: ~;~;;';' -"" .'''> "',,",- "r;~"h",$,- ""'"
JOB DESCRIPTION 1000 sq, ft. or less $106,00
I A \ ) / ~ \ _ Each additional 500 sq. ft, or
\L\{=O:\-fi\lAYv\(\:::\ 'v-J/ ho.V\~ \-€ -y portion thereof ._)"' \'D~ 'l19.00
I . ~ ' \ \N requII ,,- I .'
Permits are non-transferable and expire if work is Eac~ Ma!lI,l~,\Gt(9~e?6jOn a oregon Utl\lW
not started within 180 days of issuance or if work is ModU~~~li%~~~rbY the \es are SP$\~to
Suspended for 180 days. Fe~~~W f.U S cen1sr. ,hose ru h OAt\ 35Z-UV
· {ti(iiniti.til!(jjj)msTJiii{id;JJii.iJMfl.&tif,f,j: B. ,,:1:.~.~,..,.nO.e.',..'..,r-vIC.~..)..,,~.J..P.:'.li~.,.'~"..,..f..,"','..,~...o,~,'..,'\',_.'.,','..l.,.m~"'"".'..,.,_".:...""'..'.,',.',~\'
. :~,:,':.~,'~,.,J.n i,~.:.tA'.'...t".,~,r,I...:..I~.r,A,..p.'~,;.".,",~,,'tII".";.g,';8;,:;,z.,~.'.~.~..,li,'"Pe'1',I.':;et:;m,,ioi',',"'e~~.(\.~n,~,',i~".~I,'.".'if.,',(;.v.,'~,'.',~,','.t;ec:.,i..
';,~,~~,\,.~.:,'.~\",:,~t,;,'I,;,o,\.'~','~',b,",;,~.,~.i::,~,;,~,:".~~~,'"',,,~,;.,
2.,:,,~,:\:,~:,"~\'\~":";i'_;/':'~;:"\-~~,\:,);:;<,;~:i~(\..:t.,~(\.:;:;t~,\ ~:';'~j~)J:'rt'tJ~',,~..~:,';;.;:~'~F~~,.~..S:;;t~:..9..;t~~;;~\t;,\"(~~):::~\' t"v~~>~~ ..: f . ~,,,,,vtat~"~~
U ,;'" r~T 'p.ll\:1.Tl~~', " V ,- ~/' ~
\ ~ n<)~_O 'toU tar {Note. tltication
Electrical Contractor ~'E. \ '(2 C'T( . ~ C 20(T ~~\Wi4r~'sIe cen or~gon Uti\ity NO~ 63.00
201 AmD!Wfl~O~~. 1_p-nn_332-2344$'75.00
'1l~00l ,.G\ ....to~\c::
401 Amps to 6vvlJGilps . $125,00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsIVolts $375,00
Reconnect Only $ 50.00
Address l..{1o<65 ISQbej \~ <i;~,
City E\~ IJ '2..h-f>
v
Phone 1P <j( l '-$\ l 0
" Supervisor License Number 3<6') ~ - ~
Expiration Date i () - i _.O'i
Constr, Contr, Number \ G~i q d q
Expiration Date 3-1'-4. GLf
:.:~ .~,..,~:'~< ~. ;,"~~;,:-"!.::.t,---,',:.,' '~:rL :\ ';"':, l'~:; r ~1 ,;' i,l'.....;~,', !~';;.!.l\f ~~,$;:Y .~~ ';r'J~ ~~. ','.' ;I~~'.\'t.;:" ? ''.\ "r~~ eX. t "';"';o)'~ I;,
. i'\ .~..::~ ~~'~ '~~'...~:~ ~::'~',l;" f; :;/};:
C .~l~ T' ~....._.v.~"~'1,ry"",>::,'!i;..?, S':-:o'~.."'''':. .1I:t"""'!:;I~ ':~:t'''::'F. eta,-;'''lr...,(!,;;.z'~~. ':O'V\.. t\'k ~'l {i,,\l''''''J .\,:<~'l'~'h';i,,;\j,.. "J! ~l'"
!!-;){' 1.l.,....,,~;..-,~.r{W'JI,,'~
'.' :.:c:: :empora~~;' ervlces~otJ'. ers~v;~~~::~ ~t~'t~ ~};, ~~~~l;.~'~\1j'\R"i:\~~"r,t\iJ.'.. '....":J;lti,t;~\til;..;;.\.;":tf
.-, ~-""\' " ./,. ". .~( 'i ":~': :J;,.. 4'.\l.,~., "....., ."r" ,'~f"'"",:;"""" ,,,, \ '.'- .,'."......,.,t.;,.,'.:l ,."::'.'\~:'>,,,.-.; '" f ,...".,1,~'11~... <j",:"\'p'(,.,.,,,~J~~:,.~1j,,f'f\;'~
4.~.\v:,'".'~'..
..~ '. .. '''_''_' ,1-' .,,".".'.1. ..~,_....'."r,.,..!,....... "_ .,,'~..'1..,\1.. 1'." '.0...... rr""\)I.',....,.-~T....,,...,..".,..'
Address
.
Installation, Alteration or Relocation
200 Amps or less $ 50,00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100,00
D qf,,~~,~?f~~'.~i'~'if"I~Sg"'ffi~?~"~flli;.,~:oiM;~~t~:~~~';'~~; ~~~tt~\\:~ ~~~$~'i~t1i~f:rl~~:{-~l~~;'tP;'1.."\.~'i
""-'~S~~'~"i . ~ .: .'~ ~ .~!X.ga\1h'";,:"",,,;"~~~I'f,"'ti-'~",*.IS~.J .,..,~. "~[:'''t~'~.{ 'j'~';" ..~:'I\' '11,*"
. ..~'.' \.' .'.,.".;..'.' '_'~"""Jio....r.;.r'~I""'\'~ "M""\ "'\ '." ",~..,\"",.~)..~..,-'I~I- '1'IJ.t_ .
..".-,'" ',.' "..1." .' """ "',"'" "'li"?f ""IHWt''' "~;",, '. ','" '''', '.', , t"'it,;'''''', ,""J "1' ,.""", .
"..' , .. ", '.'" ."', .,'..'.'.~,l ..',..' .....".tr-\...,. "'\v"-' ""n .'1,..,' ! - :"........... 'f' . _..t.,... '.
New~~ifU~tl'JhroQ ~PI\!Hon~ef~aJ~EO FOR, '? 0
, OneCOilMMENCEO OR I~ A p., i $ 43.00 Y"""'")9'
EachpMPi~ianardiY.c8t~~~ ~~h 1'1\ ,j 00
Service or Feeder Permit. I' $ 3,00 .:>,
":';:~.':'~~:l~ ~<'-'~ ;'~~~::':"..:.\'.}'Y,,_~,.....r.\:'.j..... ~ ,}',\:,';:;~'~"'~l':{''/.<'j:"" -:-"':)":J.: 'r'.1'y;".U~,.,t0f.t;"tlY;\>,l, '':l-~;,,~ "~O'",''J,\ ,\-.1.: "l,....,/"
"...-1.1.."."-:-....,1>....' "~j,''; ''''1
E. ;:~Mi~C'e1j~ii~tit!'s~~tWr~~~~ffi'6;t!ilicl~d&t'i':~!E~~~:ti~tailiiti6~1~
...-'!;:?':.;, ~i :::." :~~::} r,':':"',:;':~~:;~' . . ;"~., ~ 1'; ~',~':'.l~r-.~":.:- ",/?i:"':I'-:'Y'\''II:.I,::; .~~, -! '....:f.\~;:-.:'.!~i~<:. ~,'\ \~4:1",,,;.lr"~: :~'~:~' ;\I-.~!.'.~,~,:
'';''-l.,,-...:...-~\\\i('
City
Jhone
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50,00
$ 50,00
$ 25.00
$ 45,00
The installation is being made on property I own which ,
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Owners Signature:
.~ ,:': '~'..'..: '-;~' ,.,; :".;' tY .);: ~ ::'_',~'~; _ -~\'''':~ ~ :::..-, <;~: ~ :'ci'.{ ';f:~~re\" (~j;"J~i '~;.'n',i1 ;,'- ,t ';~\;',~ l~, { .,' ; ",-:-;,';}'kJ "
"."'8" r.rn~;rAl;o":Ji.'?":'';O'" -.ffi'.lil)'~;"";>"'\;\""\;1;",.\!.,l~"';-!"3'," '-t (0 0
4 :''3;' &,)D~:U~'~ ~ ;.' : r.r}W ;.....n~{i'.~..:~'~''\+,'(\'V''..,.\.,)~.::',::'~.,.\~;-;;':':,\~:,1
. ;}:,\.~~, i-,.:~".'J,~-:';:~'~,':;; '-' ';::7'>::':\":}: ':>;'::;:': ;'i~;,.'1 .; t.;t;f:~>;?{Jj~+'~~~;::~\~X~H\{(t~\ ~'~~~~:;:;l;~~~f~:'A::r,;'1 .
7% State Surcharge
10% Administrative Fee
~.~~
4.(00
/:) 3. <6~
Inspection Request: 726-3769
TOTAL
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00119
ISSUED: 01/28/2004
APPLIED: 01/28/2004
EXPIRES: 07/28/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5660 DAISY ST 14
ASSESSOR'S PARCEL NO.: ' 1702334401427
PROJECT DESCRIPTION: Heatpump with handler.
Springfield TYPE OF WORK: Heating System
. requireS yoU to
ATTENTIO~;Vi?\!j~~~9 olt~n Utility,
tollow fUle8 adopteTh:se rules are set for'
,._.;flr-"tion center. '\ _ ,.,,"" ('\AR 952-00
.-' 001 -uu I v l .. -...", , S \
SELIN CHRISTOPHER J n OAR 952- , ", \ b' ih copies of the ru e
5660 DAISY ST #14 SPRINGFIELD OR 974780090. You may 0 t t~ (Note: the te'e.p.ho~e
_...lIlnn the cen e . I.. u:t:t., Nntlflcatlon
, - - h ure\dVIl Co.. .
. ,"t;ar t'lr t . e 32 2344)
I CONTRACTOR' lNFO~.I.9~ 1-8on-3 - .
Residential
Owner:
Address:
Contractor Type
Electrical
Contractor
JB ELECTRIC
License
104929
I BUILDING INFORMATION I
Expiration Date
03/14/2004
Phone
541-687-5770
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
, SETBACKS
I DEVELOPMENT INFORMATION I
CE REQUIRED PARKING
. NOTl: ORK
Overlay Dlst: IS PERMIT SHALL EXPIRtdfaiTHE W
# Street Trees Rq~W HORIZED UNDER THIS fQil.4J~ifp\fectmT
Paved Drive Rqd~~~MENCED OR IS ABANI98f\W!ct~OR
% of Lot Coverag~NY 180 DAY PERIOD. '
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:'
Solar Setbacks:
I PU~LIC IMPROVEMENTS I
Street lmprovements:
Storm Sewer Available:
Special Instruction:
.
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
, Value
Date Calculated
Total Value of Project
Paee 1 of 2
_'!J~l~9JI~~..',.. _
, "
I
,
r
!
]'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
.
I Fees Paid I
Amount Paid
$4.60
$3.22
$43.00
$3.00
$53.82
I Plan Reviews "
Date Paid
1/28/04
1/28/04
1/28/04
1/28/04
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00119
ISSUED: 01/28/2004
APPLIED: 01/28/2004
EXPIRES: 07/28/2004
VALUE:
Receipt Number
1200400000000000127
1200400000000000127
1200400000000000127
1200400000000000127
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.
I Reauired Inspections.
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
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
Pae:e 2 of 2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
C0M2004-00 119
COM2004-00 119
COM2004-00119
COM2004-00119
Payments:
Type of Payment
Check
Receipt #: 1200400000000000127
Description
Add, Alter, Extend Cire
Add, Alter, Extend Cire Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JB ELECTRIC
Check Number
Batch Number Authorization Number
Received By
ddk
013691
City of Springfield Official Receipt
Development Services Departm~nt
Public Works Departmell;t
~..:
Date: 01128/2004 2:42:12PM"
Amount Paid
Item Total:
43.00
3.00
3.22
4.60
$53.82
How Received
In Person
Payment Total:
Amount Paid
$53.82
$53.82
.
.
.