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Home My WebLink AboutPermit Electrical 2004-1-26 I' .'" . j . . . . .. l / " r.o .' to, .'~ ..' .', '>' ~ .:1 . ~. .~ :: \,.' .. CITY OF SPRINOFIELD?~9~.;EQ,o.;N .<~.:., .C) ~\.~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (.[;Ja1~I"}r1-f-0007g Date f-Zb--OL( Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Resideriiial $ 25.00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 :::~::t;~::::~:: sale, lease or rent. ~~l\~~\Wll~~ 1~;:;!~t,;~~~;,;~':;;~2i:~~~;;surCharge~ b AU1\,\On R\S ABA~'U\M~.," ..'",..'- '." ..'. r.OMMt~~~~ ~E~~late Surcharge 3 Z Z A~'l ,\SO 10% Administrative Fee If 60 5'3~ I. LOCATION OFINSTALLA110N . kHZ MA-Ns h/=--L.0. LEGAL DESCRIPTION 170323~ '-I JOB DESCRIPTION //100 Ab~ Z c:.l~-'..f-~ Permits are non4ransferable and expire if work is not started within 180 da)'s of issuance or if work is Suspended for 180 days. H~ .~ ".1, '"r, , ...j,\T : :':-' - ~,..,.,. ~... .~;~,.,:. ,'~".~.:'. "-'"'''. ' ',coNnuctoitms'rAiuTioN.ONLir. 2. \;. .' _... ',.:_ . :"'_..~:i ;; . ,/': . ' : .;~':; ,~,' ',.:~.' ....(.' ,..~ " <:-..: .~._..: .',< Electrical Contractor JB Electric, Inc. Address 4685 Isabelle Street City Eugene 97402Phone 687-5770 37587-C 10/1/03 Supervisor License Number 3872-5 10/1/04 104929 3/14/04 Expiration Date Constr. ContI'. Number Expiration Date Signature / =tl.1'Vle (A.~ b4Z I1l,4ns H(,-d) Owners Name Address City S?IC,~ Phone Inspection Request: 726-3769 3. COMPLETE FEE SCHEDULE BELOW A. New Rcsidential- Single or 1\lulti-Family per dwelling unit. 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 $50.00 - , '. ~' ."" . 0 ......: .'. "" \ ~ " . '. "," .~. . . B. Services or Feeders -,Installation, Alterations or Relocation: , ! - .. ,,,'to ...;:;:. '.~. '. ". .~. '..v .".' ",' - . .~~. \.':" . , . 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only 0'" "0'$ ~.oo ..",.,.....-.... H -'..t\O\'\\~~.t~~" ofI~.~{\'. '.' ,..,. C '-Te'mp.o"'p'c,...'<'4~1te!l' oTJ\e~i1ers-:", " .~\,,'" ,".'" ". .~ \., ,:. , . ~11c;N\;:;;>~\e~;~~; tU\i&s~~ esa.oo~" : 1'l~~~l!/ilrd~~~og{6~we~~, \~ ~~m ' UJ()", s~~, \e.\fI 001> 'r.a .."0\,>')0:\1 tl 2Q'l Q~ ,\(8dQ<ilt.\'ln~~et. ~t-lo\8. ~\~';'j ",0\ii'g9\~ 40}oel}&'\Wg;Qtl&..~e OtagOtl ~~2 2~A4')$1 00.00 ove~.~~J~~~~J~~:~:;:ab.~~;.;,,_....:;...., .. i; <'. ,.J D. :}~f~~~~lftr~~'~~{~'J/~':f.f!.';"':')?~.';r~,~...f;~(('~~:.:.1.~::.~: ',; ...." ""t~':; New Alteration or Extension Per Panel One Circuit I $ 43.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 tl J .3 '~""-,,,, .;.~.~ ">'''-'',---: f'I;;'t.(I"',. ':'".,~:" :;.~, ',-\ .-', . ",'. " E. ,.Misc~lia'~~o'~~ (SeM'i~elie'e'der Iioi in~iuded) -Each'lnstaUati~n " . ~ v'" ~,.....:. .'- oJ:' " '.' t,. _" i:..... .-, ," , ' ., TOTAL Shared Drive(T:)JBuilding FonnsJElectrical Pennit Application I-OJ.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00078 ISSUED: 01127/2004 APPLIED: 01120/2004 EXPIRES: 07/27/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 642 MANSFIELD ST ASSESSOR'S PARCEL NO.: 1703233411100 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install gas furnace and ac unit Owner: CAMERER LIVING TRUST Address: 642 MANSFIELD ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION' Contractor Type Electrical Mechanical Contractor JB ELECTRIC CHITTIM ENTERPRISES IINC License 104929 47396 Expiration Date 03/14/2004 03/08/2005 Phone 541-687-5770 541-461-2101 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 SETBACKS I DEVELOPMENT INFORMATION' REQUIRED PARKING Overlay Dist: NOTICE: ;rqf!l~ ~ WQ.RK # Street Trees R<il'HIS PERMIT SHALL EXPIRH,Ui, ~~~~eWOT Paved Drive Rqdi\UTHORIZED UNDER THIS ~~ k % of Lot CoverageDMMENCED OR IS ABANDONED FOR ,.' ANY 180 DAY PERIOD. Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer A vaUable: Special Instruction: . w requireS yoU to '\ITEN1\ON:oregon lathe Oregon Utility ,.... dopted by set tort tollow rules a lhoSe rules are 2-00 'iotitication center. through OAR 95 OAR 952-OQkRO~91c'0"ies ot t~ rullills \ n y obtalO t' \ phone 0090. '(ou ma {Note: the te e. . . \\ing'the center. Utili'" NotlhCatlon ca h Oregon 'J nu\1l1ber tor t e. p(1()_~~2-2344). ,..."...+...... Ie 1_ Sidewalk Type: DownspoutsIDrains: Notes: Pal!elof3 r , , Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit Up to 10,000 Boiler/Comp Up To 100,000 btu Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add Total Amount Paid . I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00078 ISSUED: 01127/2004 APPLIED: 01120/2004 EXPIRES: 07/27/2004 VALUE: Value Date Calculated Total Value of Project F pp~ tiJiL.I Amount Paid Date Paid Receipt Number 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000099 1200400000000000110 1200400000000000110 1200400000000000110 1200400000000000110 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. $10.00 $4.50 $3.15 $8.00 $12.00 $12.00 $4.00 $9.00 $4.60 $3.22 $43.00 $3.00 1/23/04 1/23/04 1/23/04 1/23/04 1/23/04 1/23/04 1/23/04 1/23/04 1/26/04 1/26/04 1/26/04 1/26/04 5 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 4 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 3 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 1 Final Gas: When all gas work is complete. 6 Rough Electric: Prior to Cover 7 Final Electric: When all electrical work is complete. $116.47 I Plan Reviews I I l?pn~rlln.,nprtin'li.l Paee 2 00 . . CITY OF SPRIl''<Iut<1~LJJ Building/Combination Permit PERMIT NO: COM2004-00078 ISSUED: 01127/2004 APPLIED: 01120/2004 EXPIRES: 07/27/2004 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 employecs who are in compliance with ORS 701.005 will be used on this project. 1 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 Page 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00078 COM2004-00078 COM2004-00078 COM2004-00078 Payments: Type of Payment Check r JiO~:~. Iil~.. "'~"""~."~'="", '," '. _. . -.. - I ;. '. l .,......": . . ~'. ~ ";....=""""""~,.----' ".../' ...:' Receipt #: 1200400000000000110 Description Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 7% State Surcharge + 10% Administrative Fee Received By dim Check Number Batch Number Authorization Number Paid By JB ELECTRIC INC 136895 City of Springfield Official Receipt Development Services Department! Public Works Department: Date: 01126/2004 2:03:46PM - 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 . .