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Home My WebLink AboutPermit Electrical 2003-7-29 (2) 225 FIFTH STREET . SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION 5007 Forsythia LEGAL DESCRIPTION JOB DESCRIPTION Heat Pump Exchange & electric to electric 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. CONTRACTOR INST ALLA TION ONLY Electrical Contractor JB ELECTRIC. INC. Address 4685 Isabelle SI City Euoene. OR 97402 Phone 541.687.5770 Supervisor License Number 3872S Expiration Date 10/1/04 ELECTRICAL PERMIT__LICA TION City lob Number C0M2003-oo64I . The 10110W1091J1Ujt;l\.o1 a;;, "uumitted has the follOWing d.::-I4.lJ'tU,~ll.d does not require speCific land use 3. COMPLETE FEE SC,~~ HELOW U (l. ZOning :D A. New Residential-Single or 7 - J.!1-O.3 . Multi-Family pWlfweumg urut.cr)W Service IncludedllllOI'lZO" Signature Items Cost Sum 1000 sq. ft.. or less $106.00 $ Each additional 500 sq. ft or portion thereof $19.00 $ Each Manufd Home or Modular Dwelling . S. Feed ATIEON IIUN:UregOr~la~JellUlres you to . eI'Vlce or er .. SUt 0 rl_,: _':.. I '.'rty folloWrI,l,,,,,,,vvt',ad y e_:-a:.. _JI B. Services or Feeders Notification Canter. Those rules are set forti Installation, AlteratiCllllilAR 952-001-0010 through OAR 952-00' Relocation: 0090. You may obtain copies of the rules l calling the center. (Note: the telephone 200 amps or less number for the OregS63.l<i<JilitS Notification 201 amps to 400 amps Center Is 1-8iSI)5:lJ'02-;$344)- 401 amps to 600 amps $125.00 $ 601 amps to 1000 amps $163.00 $ Over 1000 amps/volts $375.00 $ Reconnect Only $50.00 $ Constr Contr. Number 37587C CCB C. Temporary Services or Feeders 10492i Expiration Date 10/1/03 3/14/04 Signatur~~ian Owners tame: Dave King Address: 5007 Forsythia City Sorinofield. OR Phone 726-0219 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: JB Job # 03-524 200 amps or less 20 I amps to 400 amps Over 40 I to 600 amps Over 600 amps or 1000 volts see B above $50.00 $ $69.00 $ $100.00 $ $ D. Branch Circuits New, Alter"!i.ta'l'{e~on Per Panel One Circuit THIS PERMIT SHALL EXf'JIRE 1R3.b[VSOR4~.oo Each Additi~JJr~OOllg,Q.\liiISeMceMI::' PERMIT IS NOT orFeederP~t1MENCEO OR IS ABANDOI\$XPllOI$ 3.00 ANY 180 OAY PcHIOD. E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting _ Limited EnergylRes Limited Energy/Corom $50.00 $ $50.00 $ $25.00 $ $45.00 $ 5. SUBTOTAL OF ABOVE MINIMUM 7% State Surcharge 10"/0 Administrative Fee "'.00 $ $ $ 46.00 3.22 4.60 TOTAL $ 53.82 . . CITY (JI< ~t'K1j~GFIELD Building/Combination Permit PERMIT NO: COM2003-00641 ISSUED: 07/18/2003 APPLIED: 07/18/2003 EXPIRES: 01128/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5007 FORSYTHIA DR ASSESSOR'S PARCEL NO.: 1802042202600 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: InstaU heat pump and air handler. ---l"r,n".or 'r.o.nn.r1I~W reoUtres "IOU to ,." ,.:I .. - - 0 n UtllllY Owner: KING DAVID H & DIANE J ~Jollow rules adopted by the rego . Address: 5007 FORSYTHIA DR SPRINGFIELD OR 974(.fotification Center. Those rules are set fort _ _ __ _^" "''' n thrnllnh OAR 952-00 III vru '''''...- ... - . I s l ~':Jin copies of the ru e I CONTRACT~FORMt'1]ON'I, (Note: the telephone Gl:1l\1f,J ..Iv:: ..~r. lItilitv Nqtification nu,"bertm:enspre9EQp~a"o~Mate Phone <HilI9~ IS 1-80U-;jo:i7i~)2004' 541-687-5770 25790 12123/2003 541-747-7445 Contractor Type Electrical Mechanical Contractor JB ELECTRIC MARSHALLS INC BUILDING INFORMATION I # of Buildings: 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 Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 SETBACKS I DEVELOPMENTINFORMATION I REQUIRED PARKING OVerla:l;p.i"'i~ Total: # Streef,.TJ.!e~ lNllT SHALL EXPIRE IF THE J,l/lilil,~.pped: Paved DJI~l?N,. UNDER THIS PERMIT ~o/ll'pact: AIITHO IZED . % ofL06&RKM~~'eED OR IS ABANDONED FOR (),~IV 1 RO OAY PERIOD. I PUBLIC IMPROVEMENTS I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: S~reet Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Pae.e 1 of3 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 Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge, Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid . I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00641 ISSUED: 07/18/2003 APPLIED: 07/18/2003 EXPIRES: 01128/2004 VALUE: Value Date Calculated Total Value of Project Fpp< P~itl J Amount Paid Date Paid Receipt Number 1200200000000001792 1200200000000001792 1200200000000001792 1200200000000001792 1200200000000001792 1200200000000001792 1200200000000001841 1200200000000001841 1200200000000001841 1200200000000001841 To Request an inspection calI the 24 hour recording at 726-3769. AII 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 folIowing work day. $10.00 $4.50 $3.15 $8.00 $12.00 $25.00 $4.60 $3.22 $43.00 $3.00 7/18/03 7/18/03 7/18/03 7/18/03 7/18/03 7/18/03 7/29/03 7/29/03 7/29/03 7/29/03 $1l6.47 I Plan Reviews I ~~~ Tn~Jlections I I 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. Paee 2 00 . . CITY OF ~rKll~l>-t<l1!,LJJ Building/Combination Permit PERMIT NO: COM2003-00641 ISSUED: 07/18/2003 APPLIED: 07/18/2003 EXPIRES: 01128/2004 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 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 Page 3 00 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0064I COM2003-0064I COM2003-00641 COM2003-0064I Payments: Type or Payment Check . . ~~.,--~~~~..."'............... , WI.'.o.;...........................'... I' : ""....... . w . '" , , ;;. \ -.....,.......'..,..._r.","'''':" , Receipt #; 1200200000000001841 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By IB ELECTRIC Reeeived By ddk Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 07/29/2003 8:42:37AM 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