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Home My WebLink AboutPermit Electrical 2003-5-29 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:~n6 ELECTRICAL PERMIT APPLICATION approval . ? ~ ~~ City Job Number L6lN\ We:. J _ DC;] '7 b Date S - z;r- 0-.:> Date .c;-~C;-(1 ~ 1. I LOCATION OF INSTALLA110N 3. I COMPLETE FEJ!lSIiIJfAlj)tflvGl&'LOW c:Kt-J l, Co:3 AJ 0 {J~+f.. Ii r15 ,P LEGAL DESCRIPTION 1703 Z-b ( 7... (') (I.{ l2 JOB DESCRIPTION /), R /~,,,,{p~/ ~T PUAf}- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CONTRACTOR INSTALLATION ONLY I Electrical Contractor i( ~ F.J t".rtJur / ~JI- Address O. (j I> VI,6 Z ff' 33 o City ~ r~ J .Phone ~f~ -02..::Jb .upervisor License Number . :]' {If r 7 S Expiration Date 10/ / loy ....\\)~~-( r r ~'(,. ~v' Constr. Contr. Number '7 L) g*",:&.,'\ :SC\~ ~\' ~\'&.'\) \- Expiration Date I~.~J~~ . ";)\"..l~'<;'~- S. <'t-Sfi. .00n: -6l~ ..I): Ignature~, ~~~Sl\f",,(e~l$>la~ ~~~~~~~ . ~,~\;, ~ <:,~ ~'Q . Owners Name ~Z,..., R.f~' ~ II- Address 1",?3 '}/d/-t.'~/, . . G> Phone ;;Vb ~C/iJ 70" City ~ 6' ,Vl 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 ecl as submitted haslhe following not reqUire specific land use A. I New Residential - Single or Multi-Family per dwelling nnit. 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 B. I Services or Feeders - Illstallation~ Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163,00 $375.00 $ 50.00 c. I Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 VOIIS see "B" above. D. I Branch Circuits . '10'" New Alteration or Extension Per r."nel~s \)\1\\\'1 oJ<lte",~ ,0(\ ..~ One Circuit 0\ \ 1'3' f"lte j $63,00 Each Additional Circuit!b} (Xithl \~~ \ectlO :~?OQ\ Service or Eee&~'P~it\a -0' Sa tU : ,!l.~$"3~00:; '0. 1(,.-' S \>~. '\~ 1\ ~ t\)\~ j)..\ ..,,\0 \~p."(. _.'~,,"U<;.\ _ ~ ~"e .,......A E. I Mist'ellan~Qus' (s~~Yic.lf~~deT nOt j~e.l~de'd)~~'aClilhslallatioll I NO"" g>:><- - OlJ"" ~O\'<>.'. ~U'" pump,\qf.i~1iati9li. {1\a.'Ica(\\at. ~ ~(\ \)\\\1\1,,$,5'0.00 . ~(l' 'na ate"" <,<--. Sign/Outline Lig!lling .~e <,\""-'3-' $ 50.00 .. Ca.'" -::.!,ot '. . ~.u Limited Energy{Resloenl1al; IS $ 25.00 n"" - ea\ ,,- Limited Energy/Commercial $ 45.00 l-O :> Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 SUBTOTAL OF ABOVE Lfb ']21 1./60 S3K~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application l.o3.doc . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-00396 ISSUED: OS/22/2003 APPLIED: OS/22/2003 EXPIRES: 11128/2003 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 663 NORTHRIDGE AVE ASSESSOR'S PARCEL NO.: 1703261201418 Springfield TYPE OF WORK: Heating System TYPE OF USE: PROJECT DESCRIPTION: Install heat pump, air handler and ductwork New Residential # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Owner: HIATT SHARI R TE Address: 663 NORTHRIDGE AVE SPRINGFIELD OR 97477 ~\)~'f.. \'(.. -""i\ - ~r \ :'\ \~ ' , CONTM0TOR~~Il@RMATION I ~\..". io-';)' ~'(,.v' Contra~.t~.\::. :\ 'O\\~\)S~ \~",~\)\J KS EI:EC.TRI~\~ \)~ \'0 ~ COMm~f'.'K~g-~\) \)~ ~{~\). HIATT'$H~RI,,~~n;--d '?~ . c,1J~~'\'C1;:) i "BUILDING INFORMATION I \0 "'~ . \leS 'l~\})\i\i\'l # of Stories: ,,'lecCot,Size: \0(\ \,0." Gi'e~- -. Height of Structure . legOl1 t\'le S'l<trtst;FW~h'l Type of Heat: ~ \ \\J\~'V ~teo 'O'l e I~Sq'F!.~I,l'd~F1~~~:o. Water Type: t:.~ 'eS a,OO ,inOS . 'lSq<Ft Basement:, J"-' t\}\ :\.e\O \r'I~ov.J I'f H'''' r.n~ Range T~B~,;)';oJ . II Cen .\)\)'1\)\\' ,,~q,Ft ~~[.~iiiijCa\w.ort Energy Path:,ce.\\O"-,,.\)\)'1 ",.~ill cO:,SqIFt'Other;:Ce.\\ ~O\" 9"" 0"'<' ~\O\~., ~IU" O",t'> (\\e.'l 'el. ,\.. I"lP'~ljvlous ~urface Area: ",(\ ,,"U _,,(\\ .....'C"\ U I"'If:\A&.\l I DEVELOPMENl'lNF.ORMAT{(~N31~1~.eCl(\''-'~'' - ",0'" tel,J REQUIRED PARKING n\}I" cell Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: License 70889 460 Expiration Date 12/30/2004 0612712003 Phone 541-686-6236 541-726-0100 Contractor Type Electrical Mechanical Owner R-3 VN SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Total: Handicapped: Compact: Rearyard Setback: Solar Setbacks: % of Lot Coverage: 'PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsffirains: Notes: Pa2e 1 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00396 ISSUED: OS/22/2003 APPLIED: OS/22/2003 EXPIRES: 11/28/2003 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft SQuare Foota2e Value Date Calculated Total Value of Project Fpp< PlIilIJ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fe..... $10.00 5/22/03 1200200000000001304 + 10% Administrative Fee $4.50 5/22/03 1200200000000001304 + 7% State Surcharge $3.15 5/22/03 1200200000000001304 Air Handling Unit Up to 10,000 $8.00 5/22/03 1200200000000001304 Heat Pump $12.00 5/22/03 1200200000000001304 Minimum/Adjustment Mecbanical $25.00 5/22/03 1200200000000001304 + 10% Administrative Fee $4.60 5/28/03 2200200000000000939 + 7% State Surcharge $3.22 5/28/03 2200200000000000939 Add, Aiter, Extend Circ $43.00 5/28/03 2200200000000000939 Add, Alter, Extend Circ Ea Add $3.00 5/28/03 2200200000000000939 Total Amount Paid $116.47 I Plan Reviews I 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. I J?P'lWrN' Tn~ 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Electric: Prior to Cover 4 Final Electric: Wben all electrical work is complete. Pa2e 2 of3 -iF . . U 1 :t' OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00396 ISSUED: OS/22/2003 APPLIED: OS/22/2003 EXPIRES: 11/28/2003 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 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, ond 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 Pa2e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00396 COM2003-00396 COM2003-00396 COM2003-00396 Payments: Type or Payment Check 5/28/2003 City of Springfield' Development Services Department Public Works Department; Official Receipt Receipt #: 2200200000000000939 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee I'aid By KS ELECTRIC 10:55:27AM Received My djb Date: OS/28/2003 Amount Paid Item Total: 43.00 3.00 3.22 4.60 $53.82 l:beck Number Confirm No . How Received In Person Payment Total: Amount Paid 53.82 $53.82 . Page I ofl cReceiPLrpt '-~ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00396 ISSUED: OS/22/2003 APPLIED: OS/2212003 EXPIRES: 11/22/2003 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 663 NORTHRIDGE AVE ASSESSOR'S PARCEL NO.: 1703261201418 Springfield TYPE OF WORK: Heating System TYPE OF USE: PROJECT DESCRIPTION: Install heat pump, air handler and ductwork New Residential Owner: HIATT SHARI R TE Address: 663 NORTHRIDGE AVE SPRINGFIELD OR 97477 VN I CONTRACTOR INFORMA nON I --\u- .~~~ .",06~Lic'inse"", Expiration Date .v n~ 0" ~v ,olJo;O,eF'46!!<:i ,~'/: '\; 06/27/2003 .~~ 'IY q)J ':,.,0"" ,\: ,V\.0 ",l'o _~ ,A"). _0. -,. .. n ~ ... -J U" :\0' I BUlLDING'INFORMA:nON'I'~0~~ ~O )"'. ",O\r ",," t<:-,..r. fl."" 0,0 ~,c, ~ '-'II ofiStori~S:!\~'1 rO~'0''S' ,,\~O '-'. Lot Size: "(.,,, .f>J coV'....,q ,<\.v ~. .~,., ~l>l' ....\ ,,'Height of.Structure.O . ,-is:-' n<:J Sq Ft 1st Floor: ....' ~' .\' ~". ,,"," ~ V n.v T' ~O ~'!'YP'~of~~iit:l\.0" 'r:b0~ ~~... Sq Ft 2nd Floor: ,0 ~,c, JY81er\Typ!:,:~ 0,0 ~\j'0' Sq Ft Basement: ~O o~Railgi T'Ype:~0 . Co'\' Sq Ft Garage/Carport .... rh'" ... \:... .~ ~C?Eit~rID' ~a'thk-\.0' Sq Ft Other: \j c,'I>' ~'Q0 00 ImperviQ/ls Surface Area: -,,\: .....Q.~ I DEVEUjPMENT INFORMATION I '\'(..~ ~~~\)'\ \<(-.~ \\~'\ \~QUlRED PARKING Overlay Dist: \51J.. ~S 'X~ ~~\) <;; Total: # Street TreesJ~qd: S'(..~~~<(-. '\~ ,:?--~\)\:j Handicapped: Paved Drlv.fftqd:}.\\ ,\~\:j "-- ~'O Compact: ~~ '\ ~~' \) v . \.., % of DOt €~~ra&f;~ \) \)~ ~\)\). '\ \'\\'(..I,)\G~"~ ~ 'X~ \>..V ,.J\\.. (\~ _...~ \~\ I PUBLIC IMPROVE.~ENfS I , Phone 541-726-0100 Contractor Type Mechanical Owner Contractor COMFORT FLOW HIATT SHARI R TE # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsffirains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft Square Foota2e Value Date Calculated Pa2e 1 of2 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L.F~~s P3id I Fee Description -Mechanical Issuance Fee- . + 10% Administrative Fee + 7% State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical Amount Paid Date Paid $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 5/22/03 5/22/03 5/22/03 5/22103 5/22103 5/22103 Total Amount Paid $62.65 I Plan Reviews I . CITY OF ~rKJ1'lt.FIELD Building/Combination Permit PERMIT NO: COM2003-00396 ISSUED: 05122/2003 APPLIED: OS/22/2003 EXPIRES: 11/22/2003 VALUE: Receipt Number 1200200000000001304 1200200000000001304 1200200000000001304 1200200000000001304 1200200000000001304 1200200000000001304 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. 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 tbe Ordinances of tbe City of Springfield and tbe Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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. i~,~l;n~~U-o ~ L.Reouired-w~n~~t\llmJ 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. Pa2e 2 of2 ~J7)j63 Dat; I - l 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00396 COM2003-00396 COM2003-00396 COM2003-00396 COM2003-00396 COM2003-00396 Payments: Type or Payment Check 512212003 City of Springfield '. Development Services Department Public Works Department " Official Receipt Receipt #: 1200200000000001304 Description + 7% State Surcharge + 10% Administrative Fee Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Paid By COMFORT FLOW 1I:20:l0AM Received By djb Date: OS/22/2003 Amount Paid Item Total: 3.15 4.50 8.00 12.00 25.00 10.00 $62.65 . (;heck Number Confirm No Amount Paid How Received In Person Payment Total: 62.65 $62.65 . Page 1 ofl CReceipLrpl