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Home My WebLink AboutPermit Electrical 2003-12-18 .", ,-., :,..... 'CrrY'OF'S p' '~d - " -.. . C-." .:. 'c -.:"':/..::';',:>.:'-, . '. .- .~_ :":.,P., <, Fl~~P,o.~GON, c:",::.';:" - '.. ~ "V ,,-, . " ~. . , , ~. "'.. "" ~ ,_ '. .. _ .,~' . \,~ ,. 9 proJect as submitted has the tollowing does not require specific land use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726.3753 . FAX: (541)7~gc~~. LD (C, ELECTRICAL PERMIT APPLICATION ZOning f\_-'1f\M.,I\IIt'>-:l. Date Date .. \~-\9. .O~ City Job Number \:.a'\t/~ \ Authorlzeo Signature ct><.1... J !:.>iellh.i.m..~.;;;-itEE1:.0-i:iuUiilliillEoo:li."~~.~ .' 3. ~~~~~~~~~:l:~)ii..j~if~~~ I. ~'Wij'I@~~F~~1':~~~'1~ ., 4:.l ~~ '.cJr..' _ - ~ ,',. ~l:. _ . ~ L\o \11 _ . ~ t)~.2 ) LEGAL DESCRIPTIr IV"'\ \ <tD~ ~(a I. () lJuu JOB DESCRIPTION _~. (\l"~ ~ t-/:;-\ ~ ~cl Per~l~ts are non~transferable and-expire i~ork i~. not started within 180 days of issuance or if work is Suspended for 180 days. 2 1f7~@Nfi;mre.iiQIt'"~~sM'iii-'bNt@1WY...Jj . ~r_W~~~J~Ifl.__~~1r:\1..,,_......;::."'ti-.I:r.f,o_~~.o:;._~~~}Ji!fi (.2 Oh, f:/~{'J-r'1 C Address -2( ~C) Qhl (j S+- City _fll:ff1~ Phone 0 ~-5lfCft; Supervisor License Number .. 717 tj Lf > Expiration Date 10 - 0 ( - C \.( rSGb7g ~ ~-lL\,oS- Electrical Contractor Conslr. Contr. Number Expiration Date Signature of Supervising Electrician ~~~ Owners Name I~~ Address 4t'\1]), M City ~~one OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature; Inspection Request: 726.3769 ~ A. ~~4t~fa~ifti~I~Siii-'-g~6f-?i\i~fti)F~~f~ri~tm~Hih~g"li~i~ '" ~~~3~ ~1--~'''''''''~' :r.,..-:J~~.....,.,....}g~~ ~. 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 S50.00 ~:~~..~.tl47'::'~.*i't;it.~A.~. .~~~""'.~~:;~.' 'OIt:...lIV..ttl1;:.;,o~.~~.~..~'~~~:1f B. . ~e~~~~r~~M1~!~ll~~~t~tW~~~J:.i{i~~<,~tlOnif~:, ' 200 Amps or less S 63.00 20 I Amps to 400 Amps S 75.00 401 Amps to 600 Amps 5125.00 601 Amps to 1000 Amps 5163.00 Over 1000 AmpsNolts J~]5:00 Reconnect Only ,,,,nUIT'''' 5 50-,00' la\N . gu.. V'" '.. _ _~"ol\ ._ ()!e ,~do" c. l\!.!.if.~iD.~ii~1~..tb>q~~~~rs~I'~.~'~t:"'1(~,'" --~"'I'~J}~~~~ ~..".,x.......,.......~-. ....~ ' - n..I~~I~)fi::;t.~ -.~~..~; 1-'" Ic""'" \I\U-'- \'It)1" ,- S \ . "0\111 (Il rpq'\9(. ",'0\10 \\'Ie (\\Ie Installation; A1teratio'bor,Relocation, 0\ p\'lOl\e 20bl\\m~~:~;e;'s()U\ - 0~1,~l\ ('~:J~~,ne le\~50;06)Ol\ U'~. . . 'f1'c\'/ I.~'" . I~U"" 201 rAII!P~ .tb~400 ~'PP'~l\\9!' or I IIIII\\) /l,s..~?00 401lfi.\hps;tci,600\~ml's e OteQ C'0-"'''-'''/-;) SIOO,OO ......... ,t\u\~"_:...~J' . . Over 600\A1Yi~~ or.IOOO'Volts see "B" above. D. .. '11'NIf~il €i~@"~llflA~"a.~_" New Alteration or Extension Per Panel One Circuit \ Each Additional Circuit or with I Service or Feeder Permit ~ 4;/})0J ex) --'~, S 43.00 5 3,00 E. -~m~~m~~.~Sfktl-r';.~{fet'.a~.lt.~~t~~~jdrtt~~1illk~.iO~ ...... ...~~'..~ ,;",,,,,,,:,,,,;<;v,,,,,,,,,,",,;t:';._~:"'~-.:-jt - - ~~.......~ Pump or irrigation S 50.00 Sign/Outline Lighting ,,~oll S 50.00 Limited EnergYlRe~9fi\~IW 'H-It. ::-~'~i $ 25.00 "\\)1\~t;;lited\E'et~k}~~rn;8i~~\i ';:o'~ S 45.00 \~, 'Ie. Pt\'lW\l~ !l\~\I\t.~ \t\'';):;''''Ntll'lV;' Minimum "1~efriC'PerJlli"Tn'~etlbri"'Fee is $45.00 + Surcharges \l- \--\ut\'::"'._ "P. \':l "w' ~r~&B~~~~;i v'" t.,,;~w~;r;~~~~::.'ft~"':f.~\ft'~iS!r~-J.. ....~- p-N~ IV 7% State Surcharge 10% Administrative Fee 4\0 ?V <~ fL L- L\.~ ~S~ .8'L TOTAL Shared Drive(T:)IBuilding FonnsIElectrical Permit Application 1.Q3.doc Status Issued . . CITY OF SPRINGl'lJ!,LU Building/Combination Permit PERMIT NO: COM2003-01I23 ISSUED: 12/18/2003 APPLIED: 11106/2003 EXPIRES: 06/18/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4012 JASPER RD ASSESSOR'S PARCEL NO.: 1802061407700 Springfield TYPE OF WORK: Heating System TYPE OF USE: PROJECT DESCRIPTION: Install heat pump, air handler and ductwork New Residential Owner: ROBERT LEBKOWSKY Address: 4012 JASPER RD SPRINGFIELD OR 97478 Contractor Type Electrical Mechanical Phone Number: 541-741-2303 I CONTRACTOR INFORMATION I Contractor ROBS ELECTRIC INC COMFORT FLOW License 156678 460 Expiration Date 08/14/2005 06/27/2005 Phone 541-686-5444 541-726-0100 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: R~aryard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: " R-3 # 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: VN I DEVELOPMENTINFORMATION , , ,eQ,\.II{es ~U\i;,il'l e o{l \a\'~Ofy~.aycD~tk(>1 \O{\ _\O~'.O\ 19" \)'1 '# Street ,Trees Rqd:) __-c\,\ \ , n ~ '(\\\__1-" .... ~....~~ ~ p;.\ \- . IrC 3L1o,.. -"I\o,Paved:Drlve-Rqll:,s 1 '\0\11 ,0.;,:.;;;.1 'e{\\.~(' ' \~ 'f1\)o,\\ '-"'~ '!:'\~ (l.',\1o:. \U, 1\0(\ G ~_OO,\Q \ "o/?;p.!,Lot <;o0e~~ge:'?; 'IDi,\\ca oS:>_.OO ')1'<'" C'J ~~. ,',,9 1..1 ~"calio{l r \b..~ ~ ."".\1' Q. J~h) -... _L' t'...\~\\\l DO\:lO. :~~ \\V ,,,e-I P.UBUlC'IMPi{OVEMENTS I callI, \al I"~, \.\ ,.".. .."",)BI ,_, ,c. Sidewalk Type: {Iv'" r-' REQUIRED PARKING Total: Handicapped: Compact: DownspoutslDrains: :~~~r~6 ~~~~~ ~~~R~~~~~lEI~~~~ COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pal!elof3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspedion Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01123 ISSUED: 12/18/2003 APPLIED: 11/06/2003 EXPIRES: 06/18/2004 VALUE: I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project )?pp< P~itll Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $4.60 $3.22 $43.00 $3.00 11/6/03 11/6/03 11/6/03 11/6/03 11/6/03 11/6/03 12/18/03 12/18/03 12/18/03 12/18/03 1200200000000002429 1200200000000002429 1200200000000002429 1200200000000002429 1200200000000002429 1200200000000002429 1200200000000002627 1200200000000002627 1200200000000002627 1200200000000002627 $116.47 I Plan Reviews , 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 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Electric: Prior to Cover 4 Final Electric: When aU electrical work is complete. Paee 2 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01123 ISSUED: 12/18/2003 APPLIED: 11/06/2003 EXPIRES: 06/18/2004 VALUE: Status Issued 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 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 Pal!e 3 00 2i5 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01123 COM2003-01123 COM2003-01123 COM2003-01123 Payments: Type of Payment CreditCard " ~'..~"_"""'.:.'.M~' .... .., Wit,' '. , j ;,' 1 ....._,."... i ".- .' ., ^ ! ! ,.~, .,". . . -.<. _.- . .... .< Receipt #: 1200200000000002627 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number Paid By ROBS ELECTRIC 000253 018714 City of Springfield Official Receipt Development Services Department. Public Works Department . Date: 12/18/2003 8:12:09AM 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 . .