HomeMy WebLinkAboutPermit Electrical 2001-5-10
./-
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16 to oWing project as submitted has the folio
lOnlng, and does not require specific land u
approval
Zoning 00j
Date 5- (b - 0 I. \
jl,.tI'wnzed Signature g<~
97477
7.26-3769 .
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
oJ 276
DATE:MAY 10 2001
AMT RECD:2 $ 40.70
CHANGE:
CASHIER: 001
ELECTRICAL PERMIT APPLICATION
City Job Number 0 }-O()DS7- 61
3. COMPLETE FEE SCHEDULE BELO~
1. LOCATION OF INSTALLATION
JI'fS" S, . if rOo/CLy/J S /, A.
LEGAL DESCRIPTION /705 LfLt ~ ()>>f?!V
, \ A ~~ /f,q 116tV't
JOB DESCRIPTION
N~IV ()~;:-t::d
Expiration D~te \0- r~()1
Constr Contr. Numbel.- 4d-Cjv
Expiration Date r').,.~--lO -0 ~
stZu;; ~ ::rViSing Electrician .
~ D.
Owners Name li:f;, f" S /..J6L1l/JC.~I1G fr<,.
Address p,,() C tJ ~ 2'1 J7J>
City ~u(;tNE Phone ~'tfo-12~L
OVNER INSTALLATION
The installation is. being made on
propeity I owp- which is not intended
for sale, lease or rent.
~vne ..' ature:
~. ~Fvr JllfC.~6J1.041l~ :rtJL:.
~ .
D~~E~~-::/-()~-()~----~-----------
RECEIPT #:
RECEIVED BY: /7, ma(l},af/U
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
C.
Items
Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
Permits are non-transferable ~nd expire thereof
if work is not 'started wi thin 180 days Each Manuf'd Home. or
of issuance or if work is suspended for Modular 'Dwelling
180 days. Seri,ri?cef.orT~Ee'e'dh'!gon law 1'0qui$3f4:0110G)
,,", "" r ,'."'!, ~. , ,follow rules ack)~)ted by the Oregon Utility
2. M' CONTMbTOR INSTALLATION ONLY 'B. Sen1'.j,.g~E?!$o~c.Q~l)nl\~@,dl~'r,sThose rulas are set forth
Ele'9:~I,~\;~:~~~:~~1J'~~~~t~~~ ~~~'eG+("CJ n~~~s :;J~11:~t{~;, :~~~~:~.;~~~~ t~:t;~ ~r;~e9r~~~~O~~
P..,; I , '\n:2.I..1 ~~ ,j'}hif'\ OR camn~ tbe center. (i\lote: the teleohone
Add res.!?:. :~:'hf~::;El~~($llmwJluONED F . 200 amRs....,.o;,I;f'+,E1f,~ ""1"81''''''''''< it.1Hy l\$~tP,19;aqgn
<.IV': .' .' 201 agu~,uro '4'00'1;:: a'ih: i/," H'_ IS'" 60.00
City\ffAjC(lp(~~E~Q9. Phone 4'(S-09d:;l 401 am~s toC%loor~m\~~O~ 223-23'$"200.00
J. . 601 amps to 1000 amps $130.00
Supervisor License Number .'3~CYl'-:::5 Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
$ 85.00
$ 15.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amp~'oT less
201 amps to 400 amps
Over.401 to 600 amps
Over 600 amps or 1000
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
,.
r
One. Circui t $ 35.00 'J!
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00 2.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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1 4 () 7~
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Job# 01-00057-01
Page 1 of 2
I
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00057-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 1545 S Brooklyn St Spr
Assessors Map#: 17033444
lot: Block: Addition:
Tax lot #: 02800
/ Subdivision:
Owner:
Address:.
Lane Shelter Care
Phone Number: 686-126-2
1790 W 11th
City/State/Zip:
Eugene', OR
Value: $11,000
Scope Of Work: Commercial Alteration
2 interior walls and 1 exterior door for office
Contractor Type
Architect
Contractor
Fred Tepfer
1380 Bailey Ave, Eugene, OR 97402
Registration # Expiration Date
Phone
541-343-1318
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Required Inspections
Building
Framing -Prior to cover.
Drywall - Prior to taping.
Final Building - When all required inspections have been approved and the building is complete.
,..- ---- '~D--::--' , -I Electrical
~9h Electrical Prior to cover.
~nal Electrical - When all electrical work is complete. .
1 Mechanical
Rough Mechanical
Final Mechanical
- Prior to cover.
- When all mechanical work is complete.
..
~
I Job# 01-00057-01 I
Page 2 of 2
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Building
01/22/2001 4288
01/22/2001 4288
01/22/2001 4288
11,000
Value/Quantity
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
, Electrical
05/10/2001
05/10/2001
05/10/2001
, I
2
Minimum Mechanical Permit
Administrative Fee - Mechanical
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Mechanical
01/22/2001 4288
01/22/2001 4288
01/22/2001 4288
01/22/2001 4288
\
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state tha~ only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time, that the project 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
duri ons ruction.
Fee Amount
$86.50
$6.06
$2.60
$95.16
$37.00
$2.59
$1.11
$40.70
$15.00
$.45
$10.00
$1.05
$26.50
$162.36
S-//(j/O/
Date/
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