HomeMy WebLinkAboutPermit Electrical 2003-8-14
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<t. : .~" CITY OF 81 INGFIELD "OREGON..' /' -, "
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 6- '5?~
ELECTRlCALPERMIT APPLICATION <>/1 { . ssubmittedhasthel~i~:"ing
City Job Number ((h1<WO.7...o0 70 G Date ()/ (y ~ iheIO\lOW:.,gJ~~~e~~~ require specihc Ian
I. ., zOOlng, a l""'" / .
,. )p.rova\. I-..Ie:::
I. LOCATlONOFINSTALLA110N 3. COMPLETE FEE Sc#EDULArB>f}WlI' i-{,'It;~ -=-
~7-1 (I') . ~~ It.)~ Dale - = _-
LEGAL DESCRIPTION U A. New Residential- Singkull<<lM~tli'PRa\'If~ per dwelling unit.
I to z 6-:; Z'{ 0 iLfc)O Service Ineluded
JOB DESCRIPTION D~ 1000 sq, ft, or less
().11 c..;J II ^ J-. () 1. (i:~.. +. Each additional 500 sq. ft. or
riI d. -) I 6Yl ~ Y~.......~.r.' ponlOn thereof
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. Feeder
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2. /;,o.f.v.TI{;1(:r.o.~ J1f.~T.1Pr'\WWq~~r.,
Electrical Contractor JB Electric, Inc,
Address
4685 Isabelle Street
City
Eugene 97402 Phone 687-5770
37587-C 10/1/03
Supervisor License Number
3872-5
10/1/04
104929
3/14/04
Expiration Date
Constr, Contr. Number
Expiration Date
Signature \~triCian
/v
Owners Name <)'\~ ~
Address L.120/() ~ U j'(Jz..ty'
City ~ Phone~I-Y(Jif
OWNER INSTALLATION
The installation is being made on propeny I own which
is not intended for sale. lease or rent.
Owners Signature:
Inspection Request: 726-3769
$106.00
$ 19,00
$50.00
',' . . . .
B. ~er-"ic~s ~~ ~ee~.~r~~-:Insta~iation, ~!terations o~ ~e'l.ocntioll:
. . .~, .-, ~ -
200 Amps or less $ 63,00
20 I Amps to 400 Amps $ 75,00
401 Amps to 600 Amps $125.00
601 Amps to 1000 Amps ':1('\\\0 $163,00
Over 1000 AmpsNoltse~\}\(aS (\ \ \\i\i\'l., $375,00
Reconnect Only" \a'l'l \ O(a~O ~<>\ W' '. $ 50.00
'0(a~v Ij \~a s a(a - :2--\}U
-<-< "'\'i~f~~~9r~~~~11i:'is1~;,(af~'d~;:' \\eS\.,~:, ., .
1'-' ,t:-"\l\a<,;<; "~e\:\' \O\}~~\\'II:l\~"(\a
~\O'l'l ( . Ca(\ ",\ () \\'1 iaS 0 \p,,",i.'O. (\
\0 ,. c,Iiisthllatioii;<'AlteratlOn'?or Re,,~fationc'3\\O
~\,\ - r;.,?.-u- ':0\:""" \a'. ,.' ~O\\"
~Oop..'200'"Amp.Slor1esSa\' ,~O ,\\\\\\':1 ..~ $ 50,00
'(\ "o\) , e'" (1(\ v n~~"
\ (l9C:Z01I\nms:t6 400-Amps ",~'2.-" $ 69,00
()v "'I'!l" .to V' n"()'';>
c4Qo1 Ampl1,'lo 600Ainp~' $100.00
.(\\:oa\ ' ",,,\e\ \s -.
rever 606J)'imps or 1000 Volts see "B" above,
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D. ~ranch~~rcUlL~: ...,' ,~~:'_',:. . t.~ ~'.. ,~
""
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New Alteration or Extension Per Panel I I <:' 00
One Circuit \ $ 43.00 ......,. .,I.
Each Additional Circuit or with _11ol~~'t. <, 01)
Service or Feeder Permit ~ f.:\,\3.00 _'
. . ,_ . ~\f. ~,c~ ,
"'.~ '-', .\l._ ,OJ.,.
E. ;,Misc~lIa'~eo~'; (SerV~;!'It;~~tI)'~lnil\-d) .-Each Installation
":'" '\>-\..'i.;V~\<5 "... ~'t.\)'('V'~' , .
P~~~\&liti~~\)'t.~ '\ 'X>'r-~\)<:J $ 50.00
~"n(9Ut~~~I~tll.\ \<5 ~. $ 50.00
LlIR~~~~1ti~.\1~ $ 25.00
Lil~~~~~mmercial $ 45,00
Minimum til~tric Permit Inspection Fee is $45.00 + Surcharges
~ . ~ . ~.- ,'- ., ,.,-, '.
4. ; SUBTOTAl/OF ABOVE"'" -,,"":',
'[.-'~ :.;-h.;,.,....i~).F. '.>...:. ....\.; 0.1,,"'"' ~f-.:\\t'; ..:
L( Co .6lJ
3.2.L.-
\..of .<00
S' --:s . '8')",
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)JBuilding Fonns/Elcctrical Pennit Application I-03.doc
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,. CITY OF ~rK.lI"uI'IELD
Building/Combination Permit
PERMIT NO: COM2003-00706
ISSUED: 08/06/2003
APPLIED: 08/06/2003
EXPIRES: 02/14/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SlTEADDRESS: 4216 COLE WAY
ASSESSOR'S PARCEL NO.: 1802052408400
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install heat pump
Owner: SHARLOW JOHN S
Address: 4216 COLE WAY SPRINGFIELD OR 97478
# of Buildiugs:
Primary Occupaucy Group:
Secondary Occupancy Group:
Primary Constructiou Type
Secondary Coustruction Type:
# of Bedrooms:
. ,0.
I CONTRACTOR INFORMW-nON .
. -.rl 10"'- ~on v' \0(\
Contractor . 09pn 1-0: \~0 010 ~\'U€~te)'
JB ELECTRIC 2\0\..-.01 'e6 '0':1 0\,,).\0S ....~!l49290S \
^. 609' OS Or 'bl\
MARSHA,"I,!\ 'IN '"'' -0: . _, -<i~ . _~,\o.~ ,,;1,~79 _"e
, ~,.... ............ I':'" '-,~- ._'I"~. '(\
\0\\0 ~\lhIBUlLDlNG lL'r'u"'MA'f.ION'~cll-\IO
o\\\\c g'5t.-v o'O'~ ~o'''''',,~ ",v'
~ O....~ I<:#;}--If St.'.< ~ \)\\\\:-:1 n. ^ f>.'),
',n r 'IOu _ 0"." o~le~hon _'>: -z.""
R_{j9Cl, ,,,r\ \'Helght of'StructUl'e~
u '~I"''' . I. IV .rt ....uv
ca.' e\ '([yP~A~fl!:,elit:
VN null''O ~(er Type: .
Rauge Type:
Euergy Path:
Expiration Date
03/14/2004
12/23/2003
Phone
541-687-5770
541-747-7445
Contractor Type
Electrical
Mechanical
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 DEVELOPMENTINFORMATION I
REQUIRED PARKING
Overlay Dist: il!!!NQ?-~
# Street ~rees Rqd: . ~'1-'il\?-~ \r \'P~&t~~d:
Paved Dme ~'\1\\C~. ~\ ':I\\t>.\.\. ,\\\\':1 'il~\{t; ~1p(Sft
% of Lot Cov~ 'il~?-~~\) \)~\)~~ t>.'Ot>.~\)Q~
t>.\)'\~~~~C~\) ~~o.\Cl\).
I PUBLIC IMPROVE~i~lj \)f\.' . -
/,
Sidewalk Type:
DownspoutslDraius:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvemeuts:
Storm Sewer Available:
Speciallustruction:
Notes:
Paee 1 00
-
.
. CITY VI' I:SrtuNGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00706
ISSUED: 08/06/2003
APPLIED: 08/06/2003
EXPIRES: 02/14/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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
Date
Pa~e3 of3
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