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Home My WebLink AboutPermit Electrical 2003-3-5 , '.. 1\ ' CITY OF &.~_JNGFIELD, OREGON . C),I' " . ,,"" . .. t as submitted has the following 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~d?~,1Jffii~689'OI reqUIre specific land use ELECTRICAL PERMIT APPLICATION Zoning----.k-DtZ- e:ityJobNUmber (1f)filJtJr;3- O7J11e, Date ~- &'7-03 O.te "2._""-O~ I. I LOCA110N OF INST4LLATION! 3. I COMPLETEFEE'scHEfjm}E!'BE!..~'H /;;{J;) x,,{~ S-I/lo./J .....,\\0 A. l.qiie~,:R~'ia~tial- Siil"le or Multi-Family per dwelling unil. \\::i:.>>"" ":!"'- .~ '\' ,. "t::o . ,a'l'l aI6l\- c.e\ lv, ' _u,o" ,,\,\\e Servic",lncluded ' . .,v 6'Ch ,\e"'~90~':i'---'O JOB DESCRIPTION . 1'" ,u" 609\e ,\\OSe \'~W2JSq; t!: ~b"ess ) C ~ / ;{f@'\-tl"''1S'OC r,.el:-; ,,,,'o~Each a.dilirionab500 sq. ft. or . J' .....e'. ....0 \.". . ",Co v ,nO" :(\ :;, A<; UII/\Aa.l'1/ ,.' ,<n'; ,\'I()'. COlporriomJ:!ien;o(:a.\\O I ""C"" c:.?\JV' ~\'3-\'\I ,<\.\'\1'" ~O\\WJ Permits are non-transferable and expire.iflwork.isj 0 ,1~OEach;Manufact'd Home or . r I,,","~ .n'vo ~e'" ')\\'. r:'\""" not started within 180 days of issuance.or.iLwork ise'\l e"OIModuhfrDwelling Service or l\\) ':'\I'" - 01 '" <>:'~ Suspended for 180 days. ,'.\)'" ',\i'\l~ I \:'\Ie -'2pFceder ("'0,: "..\0'< \c-'" 2. I COlfTRACTORINSTALLAJION:()NJ.!Y'( - 8.1' Services!i~ Feeders -lllsiallation, AlterMions o~ Relocation: LEGAL DESCRIPTION Electrical Contractor /::s E/",dric..J Cd'>\.(utf. ~ . Address O. Q. l>CJ?C. J..f'?3J City Pu {'IAA.D .I Phone {j I-e r;...<A../ , 0 $ 106.00 $ 19.00 $SO.OO 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 7S.00 $12S.00 $163.00 $37S.00 $'SO.OO .upervisor License Number 3 V9 7 S C. Ihillporary,ServicesorFc~ders Expiration Date I 0 // ~ ~/ Installation, Alteration or Relocati?n ,N01ICE: ~~f~rro'fIif!'WORK . $ SO.OO Constr. Contr. Number 7 ().Fcf- '1H\~ Dr::RM\1 SHAll 2 \A~'i\'N~qol~rMll $ 69.00 / ., /- }<U1HOR\IEO UNOER4 I 1f1Rf~'trP~~ps $100.00 Expiration Date /,;L../ .J 0/ t:J 0G:,~!.~.:.Mrr::[) OR ~So~~tr 6~0 Amps or 1000 Volts see "B" above. Signature of Supervising Electrician AN'< 180 OA'< PE ~.l.~ranchC;,;cUits.- ' " ' , l'~_J~ Owners Nanne 1(;0} l).~ JoR./J()./lv Address / d.. J)... '..:n'(A'A.-O Sf 12 t"~1 City S 6W/.J Phone 77"(,-[YClO OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. 'Owners Signature: . Inspection Request: 726-3769 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit I I $ 43.00 43.- $ 3.00 '3. - E. I iVllscellalleous (Se~vie~ifeeder. not iu~lnded) -Each Installation I Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ SO.OO $ SO.OO $ 2S.00 $ 4S.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 Sl{ln-QTA!-. OF ABOVE 01-1/" - 3. ();}--> 4. (po 53. 't '2--- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Permit Application 1-03.doc . Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1232 ISLAND ST ASSESSOR'S PARCEL NO.: 1703342200214 . CITY OF SPRIr~ld<lliLD Building/Combination Permit PERMIT NO: COM2003-00119 ISSUED: 02/27/2003 APPLIED: 02/26/2003 EXPIRES: 08/27/2003 VALUE: Springfield TYPE OF Mechanical Only PROJECT DESCRIPTION: Gas Piping & Venting Owner: JORDAN THEODORE H& DIANAJ Address: 1232 ISLAND Sf SPRINGFIELD OR 97477 TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Owner Contractor KS ELECTRIC COMFORT FLOW JORDAN THEODORE H & DIANA J I BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy P'rimary Construction Type Secondary Construction # of Bedrooms: # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: License 70889 460 Expiration Date 12130/2004 06/27/2003 Phone 541-686-6236 541-726-0100 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: I DEVELOPMENT INFORMATION I SETBACKS Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lnt Coverage: REQUIRED PARKING Total: Handicapped: Compact: IPUBLIC IMPROVEMENTS I Street Storm Sewer Available: Special Instruction: NOTICE: Notes: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: I Downspouts/Drains r, .- ~,. 'IUI\l.Ult:::gOfltaw felllow rules ado te reqUIres you 10 ~tOtitlcatjon Cent:" T~ by the Oregon Utility , OAR 952-001-001 0 t~~o~ru/es are set fort: vosa. You may obtain . . gh OAR 952-001 ' calling the center (NcoPI.es of the rules b; number for the Or' ote.. t.he telephone C~nte' i< 1 ~go~n UfllJty Notification ~ ',-. -332-2344). I of 3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00119 ISSUED: 02127/2003 APPLIED: 02126/2003 EXPIRES: 08/27/2003 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Val\lll\ion Descriotion I Description Type of Construction $ Per Sq Ft Square Footal!e Value Date Calculated Total Value of Project I Fees Paid I Fee Description Amount Paid Date Receipt Nwnber -Mechanical Issuance Fee-- $10,00 2/26/03 2200200000000000528 + 10% Administrative Fee $4.50 2/26/03 2200200000000000528 + 7% State Surcharge $3.15 2/26/03 2200200000000000528 Gas Outlets 1-4 $16.00 2/26/03 2200200000000000528 Minimum/Adjustment Mechanical $23.00 2/26/03 2200200000000000528 Vent Fan $6.00 2/26/03 2200200000000000528 + 10% Administrative Fee $4.60 2/27/03 2200200000000000531 + 7% State Surcharge $3.22 2127/03 2200200000000000531 Add, Alter, Extend Circ $43.00 2/27/03 2200200000000000531 Add, Alter, Extend Circ Ea Add $3.00 2/27/03 2200200000000000531 Total Amount $116.47 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. AIl 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 Relluired Tnsoections I I Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2 Final Gas: When all gas work is complete. 3 Rough Electric: Prior to Cover 4 Final Electric: When all electrical work is complete. 2 of 3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00119 ISSUED: 02/27/2003 APPLIED: 02/26/2003 EXPIRES: 08/27/2003 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 carefuUy 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 OCCUP ANCY 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 wiD be used on this proj ecl. 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 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number COM2003-00119 COM2003-00119 COM2003-00119 COM2003-00119 Payments: TWe of Payment Check Paid By Description Add, Alter, Extend Circ Receipt #: 2200200000000000531 Date: 02127/2003 Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee K&S ELECTRIC Received By Check Number Confirm No lkw 3448 Page I ofl 2/27/2003 1O:26:43AM~ City of Springfield Development Services Department Public Works Department Official Receipt . Amount Paid 43.00 3.00 3.22 4.60 Line Item Total: $53.82 How Received Amount Paid In Person . Payment Total: 53.82 $53.82 cReceiplrpt