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Home My WebLink AboutPermit Electrical 2003-12-22 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~1&~iH'~689as submitted has the following ELECTRICAL PERMIT APPLICATION zoning, and does not require specific land use / 0 '? approval ""'r--.O City Job Number COt-41 ZOO 3 ~ 0 /2 b 0 Date 12 -- Z Z - ~ Zoning L\..1 f- e'''''', . ."..'..'T""'F','./.., .~' \2:.2.3__,93 3. ',f:J.gl)Jl{LETE ~2'E,~!1:PS1!~!Lt,::llE1-Y.11~ '..c:K.~ Authorized Igna ure 1. 4~ 7 l Fe R.. 5'1 n+ (tit- LEGAL DESCRIPTION I <6()1-0 5(.. I tK E-Slf) e.v-c...~ 0 0 ~ 0 JOB DESCRIPTION f+()O C.(~lr ~~ filAr rp~p 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, Electrical Contractor BM.fl-v . ( 5nLIJ/({1t cfiJC thf) ~~cnuC A. per dweHing 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 B. Relocation: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps , 601 Amps to 1000 Amps . City G~ P~hone SLl(- 7J.,6-o7qJ Over 1000 Amps/VoIts 9 7 5?-fo Reconnect Only $ 63,00 $ 75,00 $125,00 $163,00 $375,00 $ 50,00 Address ~ Supervisor License Number '-I f:::f(J ~ , 'i (!) - (!) (- Ot.{ Constr. Contr. Number J 5 :l.. 17 3 I - 3 [ -04' Expiration Date Expiration Date :S::ZT2:= """- ~ Owners Name J4L GcL6rz- Address LfJ 71 h?1L$ y T1f1/4- E. City 5Pt2.lwG-C-U:.-LI) Phone 74 (- 3~3() OWN,ER INSTALLATION The in.stallatifH)1'ip.~ made on property I own which IS not llltenderHfs SP~R~lsr ~HATL EXPIRE IF THE Owners Signm1HORIZED UNDER THIS PERMIT IS NW COMMENCED OR IS ABANDONED FOR ANY 180 DAY PFRlon Inspection Request: 726-3769 c. $ 43,00 :j Lj 3,01) j 3.DD $ 3,00 Pump or in'igation $ 50,00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25,00 Limited Energy/Commercial $ 45,00 Electric Permit Inspection Fee is $45.00 + Surcharges Lf b, Of) '3 -Z 2 I.f 60 S-~ 82- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonl1s/Electrical Penl1it Application I-03,doc ~~~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4371 FORSYTHIA ST ASSESSOR'S PARCEL NO.: 1802052100800 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2003-01266 ISSUED: 12/1812003 APPLIED: 12/18/2003 EXPIRES: 06/22/2004 VALUE: Springfield TYPE OF WORK: Heating System PROJECT DESCRIPTION: Install heat pump and associated ductwork Owner: ALBERT GOLETZ Address: 4371 FORSYTHIA DR SPRINGFIELD OR 97477 TYPE OF USE: New Residential Phone Number: 541-741-3630 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor BARRY ELECTRIC EUGENE HEATING & COOLING License 152173 149452 Expiration Date 07/31/2004 10/22/2005 Phone 541-726-0793 541-726-7654 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer AvailableN01\CE: HE WORK Special Instruction: lHIS PERMIT SHALL EXPIRE IF 1 \T \S NOT D UNDER lHIS PERM Notes: ~~~~~~;ED OR IS ABANDONED fOR ANY 180 DAY PERIOD. Pal!:e 1 of3 REQUIRED PARKING Total: Handicapped: Compact: '/OU\O Sidewalk Type: {eQU\{es, ~\\\\W on \e.'\N ~o(\ u D~~~~~~\he orvv e $6\"01'\ ~1\E.~ \e6 adOP\e 11'$)$e fU\aS ~~ gS2.oo to\\OW rr 0 ceotet. '\ 0 \\'\toUg\\ ~, \\\e ru\es \ ~ot\'\ce.t 'k~\1\O 1-\"..eop\9S 0 \e\et>t\o~e , Op..f\ 9 "e.~1 (Jo\'& No\e~ \"e ~~ca.t\O(\ ,{\ gO. 'lo~:rf\ center. ~ \,)\\\\\'11'\0 I 00 \\\00 \t\e OtegO(\ ",?_2.~At$. ce: ( tor tne -\ P.nn-~' n.u~\)e ~,..... \c - " '('r-"'~ Status 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 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Cire Ea Add Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-01266 ISSUED: 12/18/2003 APPLIED: 12/18/2003 EXPIRES: 06/22/2004 VALUE: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $10.00 12/18/03 2200200000000001899 $4.50 12/18/03 2200200000000001899 $3.15 12/18/03 2200200000000001899 $12.00 12/18/03 2200200000000001899 $33.00 12/18/03 2200200000000001899 $4.60 12/22/03 1200200000000002641 $3,22 12/22/03 1200200000000002641 $43.00 12/22/03 1200200000000002641 $3.00 12/22/03 1200200000000002641 $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. L..Reouire~nsnections I 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Electric: Prior to Cover 4 Final Electric: When all electrical work is complete. Pal!:e 2 of3 ~~~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2003-01266 ISSUED: 12/18/2003 APPLIED: 12/1812003 EXPIRES: 06/22/2004 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 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 Pal!e 3 of 3 Date 225 Fifth Street ,:;; Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-01266 COM2003-01266 COM2003-01266 COM2003-01266 Payments: Type of Payment Cash Change Job/Journal Number COM2003-01266 COM2003-01266 COM2003-01266 COM2003-01266 Payments: Type of Payment Cash Change Receipt #: 1200200000000002641 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BARRY ELECTRIC BARRY ELECTRIC Received By djb djb Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By BARRY ELECTRIC BARRY ELECTRIC Received By djb. djb Check Number Batch Number Authorization Number Check Number Batch Number Authorization Number ; City of Springfield Official Receipt Development Services Departmt!'nt Public Works Department Date: 12/22/2003 8:47:40AM Amount Paid Item Total: 43,00 3,00 3,22 4,60 $53.82 How Received In Person In Person Payment Total: Amount Paid $55,00 ($1.18) $53.82 Amount Paid Item Total: 43,00 3,00 3,22 4,60 $53.82 How Received In Person In Person Payment Total: Amount Paid $55,00 ($1.18) $53.82