HomeMy WebLinkAboutPermit Electrical 2001-6-22
W,O
~e > u"e
e6 'roe" ,..."..
su'O"'\~ "",c\<;.c
.r}.'bSQ.'I)\t0~
~o\0 ~ ~e:
,,\\9 s"o ~\
225 FIFTH STREET ~\O"" 6 60e I .1/ 0
n..'" """~~' ..." V"
SPRINGFIELD, O......ON.,.., ,II' ?-
INSPBCTION REQUEST: ~6~0"\"\\'
OFFICE: 726-3759 ...
. ~'I)\0
1. ~A~~jF I?-7l1r~/"e
, I
JJ:GAL.. DESCRIPTION I
1)( 0";" 0)...., :;r
.
'-
.
.
.
TRANS#:01-0005916
DA TE : JUN 22 2001
. AMT RECD:2 $ 40.70
CTlUCAL PERMIT APPLICATION CHANGE:
.. / . .I.:ASI;tIEfY001
City J~b NUIIlber e 0 (f)6:::5'7' 0 .'
A.' New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
2. CONTRACTOR INSTALLATION ONLY .D.' Services or Feeders
{".-Ef-'rIC'\::~'r',r.cl1 '~'. !f'p,."i;C-y)C.\0' /' 1I'lS~~!.}.aS:.~on. AHera t ions
Ele~Mjv':i~~,FC9.~S~~,~ t,Op-1C.. ;s,.~ e'.tJljlic., ~. (qvo.ltvr f or ~Relo~~t ion I
Ad4~c;~'Sati;ReI'a<. ')~e~~: Z.e>~93~~ . 2~QH~~;~~ol~llH~J- EXPIRE IF THE '$'(5'0:.00
!n O,~.., ~,;,~-Oi.)l'vv 'v ""v_:~" ~n" vv_ v~r- 20V ampsIZt61'400Eamps<: PJ:~!AIT $ 60.00
Ci fy)9rit';~I1'e.;~ain cOpnone~~'Ya-2:0~ 4Q.t>I~~P"l1,ctl7!) ~Q.q~am..pii^'r - 1'$,hIO.oo
cal r.; t 18 cenler. (Note: thel~lepnone 601 allps to rooo f'ampsN"!:U FCS130.00
supe.~~I}.\:.(!ncJ..~:C;:~l.!s~JINumbe~ N::3:IV,9.ii9>S . .Over' l()()OAamp:sY,~gf ts $300.00
. Ce'1lvri3 H\;'~'li~2f:344). Reconnect Only $ 40.00
Expiratlon Date 1'0;1/01
c. Temporary Services or Feeders
Constr Contr. Nuntper 7/)S-x'i Installation, Alteration or Relocation
Expiration Date ';:Z-/3d C)t) 200 amps' 'OT less S 40.00
I /. 201 amps to 400 amps $ 55.00 -
S~gnature of Supervising Eleetrician Over 401 to 600 amps $ 80.00 -
t (. p Over 600 amps or 1000 vOJ. ts see "B" above
u..v...... "'~~
, --r-. 6 Y I D. Branch Circui ts
. wners Name f J.dJ ,'(" J'I'\ a. R....t? "
. , / v New, Alteration or Extension Per Panel
Address 7:L 73 L-.I C'("r 6f't?"'<--1
City S J '" /) . phone 74'7~2tf9 /
OVNER INSTALLATION
o o't1JV.
fJ.. .JOB n::rf.ION / d '7)
, tJ 1) f' U '/14-'/! 1/ ~
. I U
Permits are non-transferable and expire
if york is not started within 180 days
of issuance or if work is suspended for
180 days.
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
'-
ii;TE~--ZJ'Z7-==~;;:::"-b-T------------
RECEIPT I: ' . , . .
IlECEIVED BY:.I/ , .II X,.l..L,/ .au v
Miseellaneous (Service/feeder
-Each installation
Pump or irrigation
SignfOutline Lighting
Limited Energy/Res
Limited .Energy/Comm
COMPLETE FEE SCHEDULE BELOV
Items
1000 sQ.ft. or less
Each additional 500
SQ. ft or portion
thereof
Each Hanuf'd Home. or
Modular'Ovelling
Service or Feeder
One Ci rcuit
Each Additional
Circuit or with Service
or Feeder Permi t
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharie
3X Administrative Fee
TOTAL
Cost
Sum
S 85.00
S 15.00
. $ 40.00
-L
$ 35.00
-
f
S
2.00
not included)
$ 40.00
$ 40.00 -
S 20.00 -
$ 36.00 =
37cU
",:.5""1
/ - /I
L.,t.O . 1 U
.....
.
I Job# 01-00634-01 I
.
Page 1 of2
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00634-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 7273 Elderberry St Spr
Assessors Map#: 18020221
Lot: Block: Addition:
Tax Lot #: 00800
Subdivision:
Owner:
Address:
Janella Gallagher
7273 Elderberry St
Phone Number: 541-747-2891
City/State/Zip: Springfield, OR 97478
New Value: $0
Scope Of Work: Mechanical
Heat pump
Mechanical Contr
Contractor
Ks Electric & Consultants Inc
Po Box 24933, Eugene, OR 97402-0444
Comfort Flow Heating
1951 Don Street, Springfield, OR 97477
Registration #
70889
Expiration Date
12/30/04
Phone
541-686-6236
Contractor Type
Electrical Contr
460
6/1/03
541-726-0100
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day.
Required Inspections
Electrical
Rough Electrical
Final Electrical
- Prior to cover.
. -When all electrical work is complete.
Mechanical
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete.
"
.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
I Job# 01-00634-01 I
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
Paid On Receipt#
Electrical
06/22/2001 5916
06/22/2001 5916
06/22/2001 5916
Mechanical
06/21/2001
06/21/2001
06/21/2001
06/21/2001
06/21/2001
5901
5901
5901
5901
5901
.
Height (feet):
Proposed Units:
Page 2 of2
Value/Quantity
Fee Amount
2
$37.00
$2.59
$1.11
$40.70
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$67.20
By si9nature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
~~ S/dt'
eo/Z2, 10/
Date .
.
",
.
.
I Job# 01-00634-01 I
Page 2 of2
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
IArea (Sq. Feet}
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt# Value/Quantity
Electrical "I
06/22/2001 5916 2
06/22/2001 5916
06/22/2001 5916
Fee Amount
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
$37.00
$2.59
$1.11
$40.70
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Mechanical
06/21/2001 5901
06/21/2001 5901
06/21/2001 5901
06/21/2001 5901
06/21/2001 5901
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$67.20
By si9nature. 1 state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
Signature
Date