HomeMy WebLinkAboutPermit Electrical 2005-4-6
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL ffq,J1lT -#'~L!fJt1JtlON
City Job Number L';~- W~ate
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i\OB DESCRIPTION
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Permits are non-transfer Ie nd expire if ork Is
not started within 180 d s issuance or If work Is
Suspended for 180 days.
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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
$50.00
2. fi~~mt{~ B. ~~~"ilf n tili i
Electrical Contractor Pch ~ E)e( fr/(!J,7!&\CE: 200/:,:~s orl~~IRt IF lHE WO\1\(
Pi f3 2f3 I THIS PERw.~Ql.Amps~oF400 An\P~)MIT IS ~lnT
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Address () flY 2 . "THORIz~~%~mps to 600 'Amps NED COR
,wI . "n 1(' ~R~NDO r
1.10MMENC.6.9J~ ~s:to~ 000 J\:mps
City 1;". Y'o.Q JlQ _ Phone 6~b-SJ-i4'f.'lY 1BO Lqy~rHOOO!AmpsIVolts
~ .,. Reconnect Only
Supervisor License Number ~ ILl 1.\ S
Expiration Date \ 0 I D \ \ () --,
Constr. Contr. Number \ S I", In I p.,
Expiration Date ~ I \ Y ) D 5
Signature of Supervising Electrician
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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
.~ \9~1o'6441
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
C.I::~~::~~:;:::~
200 Amps or Ur.t'OAR Ian Cent,,~ 1'1 by t~e~g^F: You to
201 Amps to <tr199'u?W952-001-ofl1fJ ~u:ie~~r~ ~ Ull//l}'
401 Amps to 60@;drin])~U may Ob.,.,:_'JI/O~sto~ ,.:;031 fOrth
I ng I e.c" ~Uples f -~-UUl
Over 600 AmpslOrnl!Sl P QI.p: ~arl!'B" . ,. 0 the ru .
D. 1>>1t5:~tl;JWc .. ~ ..
New Alteration or Extension Per -p'qaI332-234~ I i~ 00
One CIrCUIt , $ 43.1f6 ~
Each Additional Ci,cuit or with I '2 00
Sel'VlCe or Feeder Penmt $ 3.00 .1_ .
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E. i~~.itl:.!'~' !'Yi.s.w:~~!t'1!'~.2n!'.sr.'i!!ffil~ a !~I ,0
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.0.0
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.~~j~
7% State Surcharge
10% Administrative Fee
4((J .00
8. Vv
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TOTAL
Shared Drivc(T:)lBuilding FonnsIElectriclll Permit Application 1.Q3.doc
.
. CITY OF SPRINGFIELD
Building/Combination Permit
I>ERMIT NO: COM2005-00344
ISSUED: 04/0112005
APPLIED: 03/28/2005
EXPIRES: 10/0612005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1245 KENRA Y LP
ASSESSOR'S PARCEL NO.: 1703281103100
Sprillglield TYPE OF WORK: Heating System
TY!'E OF USE: Addiliull
Residential
PROJECT DESCRIPTION: Install gas furnace, ac and water he"ter
Owner: TINA ROSS
Address: 1245 KENRA Y LP
SPRINGFIELD OR 97477
Phone Numher: 541-741-0240
I CONTRACTOR I'<FORMATION J
Contractor Type
Eleelrical
Mechanical
Plumhing
Contractor
ROBS ELECTRIC INC
HOME COMFORT HEATING & AIR
HOME COMFORT HEATING & AIR INC
Liccnse
15667X
84164
84164
Expiration Date
08/14/2005
06/25/2007
06/2512007
Phone
541-686-5444
541-345-2838
541-345-2838
BUILDING INFOI{"'ATIO~'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
. Secondary Construction Type:
# of Bedrooms:
VN
# of Slur-it.'s:
IIl'ighlorStnll:ltlrC
Type or lie,,::
Water Type:
Range Type:
En('rg~' Path:
Sprinkled Building:
Lol Size:
Sq Ft 1,1 Fluor:
Sq Ft 2nd Fluor:
S<1 Ft Basl'IIH.'nt:
Sq Ft G"rage/Carport
Sq Flath,',.:
Occupant I.oad:
R-3
ilIa
I DEVEUlI'i\IENT I~FOI{\I.-'.:'.:I~
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
O\'l'rl,,~' Disl:
# Sln'i.'t Tn'es Rqd:
Paved IJri\'l~ Rqd:
'X, of Lot CU\'l'r:lge:
Tutal:
11,,"dicapped:
Cllll1pact:
I PUBLIC 1\I!'ROYI.\H:N'i'Sq
Street Improvements:
Storm Sewer Availahle:
Special Instruction:
ATTENTION: Oregon law reql!,lres you. ~
Notes: follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through O('.R952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Olegon Utility Notlflcalion
Center is 1-800-332-2344).
- .
Sidewalk Type:
Downspoutsffirains:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
P:l~l' I uf J
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00344
ISSUED: 04/01/2005
APPLIED: 03/28/2005
EXPIRES: 10/06/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
1~l3tion ()escl~'1~d
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Fout,:'gc
or llid Amount
Value
Date Calculated
Tolal Valllc or Project
~'s Paid ~
Fee Description Amount Paid flatl' Paid Receipt Number
-Mechanical Issuance Fee-- $10.00 4/11G5 1200500000000000413
+ 10% Administrative Fee $9.50 4/l/lJS 120050000lJlJOOOO0413
+ 7% State Surcharge $6.65 4/1/lJS 120lJ5lJlJOOlJOOOOO0413
Appliance Vent $12.00 4/1105 1200SlJlJOOlJOOOOO0413
Boiler/Comp 3-15 HP $22.00 4/1/~:5 1200501l00UOOOOO0413
Fixture $14.0lJ 4/I/lJ5 I20050lJOOOOOOOO0413
Furnace - up to 100,000 btu $12.0lJ 4/1/lJ5 1200SlJlJlJlJlJOOOOO0413
Gas Outlets 1-4 $4.0lJ 4/1/lJ5 I20050lJlJlJlJOOOOO0413
Minimum/Adjustment Plumbing $31.00 4/1 /OS 120050lJlJlJOOOOOO0413
+ 10% Administrative Fee $4.6lJ 4/6. :JS nOOSlJlJlJlJlJlJOOOO0395
+ 7% State Surcharge $3.22 4/6/0S 2200SlJlJOOlJOOOOO0395
Add, Alter, Extend Circ $43.0lJ 4/(,/OS 2200SlJOOOlJUOOOO0395
Add, Alter, Extend Circ Ea Add $3.00 "'/6/05 22lJlJSlJlJOOlJOlJOOO0395
Total Amount PaId $174.97
I Plan Reviews i
To Request an inspection call the 24 hour recording at 726-375lJ. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be lIIadc the following work
day.
I Rt.::...:.\iwIJJlSJleJ'liol1s ~
Rough Plumbing: Prior to cover and includillg rl'(IUircd fl'sling.
Final Plumbing: When all plumbing work is compll,tc.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical n'ork is l'ClIl1plctc.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is completc.
I'a!.!.t'::! IIf3
.
. CITY OF SPRlNul'U,LU
Building/Combination Permit
Status
Issued
PERMIT NO: COM2005-00344
ISSUED: 04/01/2005
APPLIED: 03/28/2005
EXPIRES: 10/06/2005
VALUE:
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 "xamined Ihe eumpleled applieation 'lIId do hen"'" eerlify that all
information hereon is true and correct, and I forthl'r ('l'rlify IhHI :lll~' and :lll work !H.'rfnrmcd shall he ,lone in accordance with
the Ordinances of the City of Springfield and the Laws or the Slate ur On'~un perla;uing 10 the wurk deseribed herein, and
that NO OCCUPANCY will be made of any structure withoul permissiuu ur Ihe CUlllmunily Seni,"'s Di\'i"jun, Building Safety.
I further certify that only contractors and employees who arc in eumpl;anee with ORS 701.005 will h,' used un this project.
I further agree to ensure that all required Inspections arc requesled at Ihe pruper time, that each adun'" ;s readable from the
street, that the permit card is located at the front of the property, and the "pprowd set of plans will reu",in on the site at all
times during construction.
Owner or Contractors Signature
D"le
P"ue 3 of 3
225 Fifth Street
Springfleid, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00344
COM2005-00344
COM2005-00344
COM2005-00344
Payments:
Type of Payment
CreditCard
Il
Il
Il
4/6/2005
.
RECEIPT #:
.~A1.N~"'"","~,_ ... ~"'...
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JiJ..ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
2200500000000000395
Date: 04/06/2005
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
ROBS ELECTRIC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
IIh 63414 Phone
Payment Total:
Page I of I
1:42:36PM
Amount Due
43.00
3.00
3.22
4.60
$53.82
Amount Paid
$53.82
$53.82