HomeMy WebLinkAboutPermit Mechanical 2004-04-30o
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2004-00504ISSUED: 0413012004APPLIEDz 0413012004EXPIRES: 10/3012004
VALUE:
SITE ADDRESS: 2600 5TH ST
ASSESSOR'SPARCELNO.: 1703233409800
PROJECT DESCRIPTION: Heat Pump and Air Handler
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New Residential
Owner: RyBKA JERRy p & KEILA ANN
Address: 2223 ROSE BLOSSOM DR SPRINGFIELD OR 97477 ON: Orego n law requires you to
by the Orego n UtilitY
Contractor Type
Electrical
Contractor
KIDD ELECTRIC INC
0090. You o
calling
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Yo of Lot ICE:
PERMII S
N
0
Phone
54t-942-1352
REQUIRED PARKING
Total:
Handicapped:
Compact:
E lt lHE w0![
PERMIT IS NU I
is1
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
cor..$0J
l HiS HALL EXPIR
NDER lHIS
AN
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Downspouts/Drains:
Total Value of Project
Paee I of2
DEVELOPMENT INFORMATION
Description Type of Construction Value Date Calculated
EI
I
through OAR 952-001
coPies ot the rules by
Valuation Descriotion I
F
Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00504ISSUED: 0413012004APPLIED: 04/3012004EXPIRES: 10/3012004
VALUE:
Fee Description
+ l0o Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
Amount Paid
$4.60
$3.22
$43.00
$3.00
$53.82
Date Paid
4t30t04
4t30t04
4t30t04
4t30t04
Receipt Number
1200400000000000s92
1200400000000000s92
1200400000000000s92
1200400000000000592
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature Date
Reouired Insnections
Pase2 of2
Ieesfarq I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Fty of Springlield Official Receipt
,velopment Services Department
Public Works Department
RECEIPT #: 1200400000000000s92 Date: 0413012004 10:24:43AM
Job/Journal Number
coM2004-00504
coM2004-00504
coM2004-00504
coM2004-00504
Description
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ l0o/o Administrative Fee
Amount Due
43.00
3.00
3.22
4.60
Item Total:$s3.82
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
CreditCard KIDD ELECTzuC ddk 000370 030734 In Person $53.82
Payment Total :
-553.-67
4/30t2004 Page I of I
5a
\tl
225 FIFTHSTREET . SPRINGFIELD, Ok97477 r PH:(541)726-3753 oF
E LECTRI CAL P ERMIT AP P LI CA
City Job Number
LEGAL
JOB DESCRIPTION
t/_$(Lapprovalo.'Zoning
AUthorized Signature
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
3
ln
Each
A. New llesidential - Single or NIulti-Faruily per drvclling unit'
$ 106.00
$ 19.00
law requires Yc
Permits are non-,transferable and exPire if work is
not started within 180 days of issuance or if work is
Suspended for 180 daYs.
1
Electrical Contractor
Address
Pnone 22€ ro
?aa-/2
Supervisor License Number
Expiration Date ,/o * Zoo 4
Constr. Contr. Number
Expiration Date
of Supervising Electrician
Owners Name
Address
Phone
IN
The installation is being made on properfy I own which
is not intended for sale, lease or rent.
Owners Signature:
5 C. Temporar."- Sen'ices or Feetlers
Installation, Alteration or Relocation
200 Amps or less $ 50'00
201 Amps to 400 AmPs $ 69.00
401 Amps to 600 AmPs $100.00
$50.00
Feeder
callin center
One
se ru
trt
City
201 Ar@rfE{001600-l
401 Amps to 600 AmPs
601 Amps to 1000 AmPs
Over 1000 AmpsA/olts
Reconnect Only
e
regon UtilitY N
332-2344),
fl6ritltP
.iftryHE w
EfiM,I
$ 63.00
s 7s.00
$125.00
$163.00
$37s.00
$ 50.00
$ 43.00
$ 3.00
$ s0.00
$ s0.00
$ 25.00
$ 45.00
,Lz oO
).oo
0
,-
Over 600 Amps or 1000 Volts see "B" above'
D. Branch Circuits
iJ0}tt?& Alteration or Extension Per Panel
/
A
UUM fti
E.-Each lnstallatiott
Ciry Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
Minimum Electric Permit Inspection Fee is $45.00 * surcharges
4+,n
lYo State Surcharge
10% Administrative Fee
TOTAL 57 8v
Inspection Request: 726-37 69
4.
Shared Driv{T:/Building Forms/Electrical Permit Application I {3'doc
1.LOCA:I'ION OF INS:TALIATION .
.
included)
4zs;
q
uh$b
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-00504ISSUED: 0413012004APPLIED: 04/3012004EXPIRES: 10/3012004
VALUE:
SITE ADDRESS: 2600 sTH ST
ASSESSOR'S PARCEL NO.: 1703233409800
PROJECT DESCRIPTION: Heat Pump and Air Handler
Springlield TYPE OF WORK: Heating System
TYPE OF USE: New Residential
Owner: RyBKA JERRy p & KEILA ANN
Address: 2223 ROSE BLOSSOM DR SPRINGFIELD OR 97477
Contractor Tvpe
Electrical
Mechanical
Contractor
KIDD ELECTRIC INC
DEAN M SCHULTZ
Expiration Date
01t27t2005
02t23t200s
Phone
541-942-1352
541-767-0626
License
154009
133733
CONTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Overlay
# Street
Paved
o/o of Lot
Lot Size:
Sq Ft lst Floor:
2nd Floor:
o{
$.s
Handicapped:
Compact:
Area:
PARIilNG
1$
,\9
Sidewalk Type:
Downspouts/Drains:
Notes:
Pase 1 of3
I -1 Lr,
ItUllJl-rl-t\t, It\It l(rYrArr(ri\ l
Frontyard
Side I
Side 2 Setback:
Energy Path:
Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00504ISSUED: 0413012004APPLIED: 04/3012004EXPIRES: 10/3012004
VALUE:
Description Tvpe of Construction
Fee Description
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ l0oh Administrative Fee
+ 7oh State Surcharge
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Heat Pump
Minimum/Adj ustment Mechanical
Total Amount Paid
Total Value of Project
Date Paid
4t30t04
4t30t04
4t30t04
4t30t04
4t30t04
4t30t04
4t30t04
4t30t04
4t30t04
Value Date Calculated
Receipt Number
2200400000000000457
22004000000000004s7
1200400000000000592
2200400000000000457
1200400000000000s92
1200400000000000s92
1200400000000000s92
2200400000000000457
2200400000000000457
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Amount Paid
$10.00
$4.50
$4.60
$3.1s
$3.22
$43.00
$3.00
$12.00
$33.00
$116.47
tr'pps Peid
Plan Reviews
To Request an inspection call the24 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.
2 Rough Electric: Prior to Cover
1 Final Electric: When all electrical work is complete.
3 Rough Mechanical: Prior to Cover
4 Final Mechanical: When all mechanical work is complete.
Paee 2 of 3
L LL
Valuation Descrintion I
Keouired Insnectrons
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-00504ISSUED: 0413012004APPLIED: 04/3012004EXPIRES: 10/3012004
VALUE:
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 at the proper time, that each address is readable from the
street,permit card is located at the of the , and the approved set of plans will remain on the site at all
D
Owner or Contractors Signature Date
Page 3 of3
T
o
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
city of Springfield Official Receipt
velopment Services Department
Public Works Department
RECEIPT #: 2200400000000000457 Date: 0413012004 2:08:31PM
Job/Journal Number
coM2004-00504
coM2004-00504
coM2004-00504
coM2004-00504
coM2004-00504
Description
Heat Pump
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
+ 7Yo State Surcharge
+ l0% Administrative Fee
Amount Due
12.00
33.00
10.00
3. l5
4.50
Item Total:$62.65
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check DIH,INC jmp 216 In Person
Payment Total:
$62.6s
-562i-f
4/3012004 Page I of I
rc