HomeMy WebLinkAboutPermit Electrical 2001-4-2
'.
DEVELOPMENT SERVICES DEPARTMENT 1 !Iowlng
s submItted haS the 0 e
-rhe10\IOWlngprolect~ reql1l1e specIfIC land uS
and doe~ nO <
zoning Itl
approval (\ \.L..-
225 FIFTH STREET Zoning - ~~. 0 If
SPRINGFIELD, OREGON 97477 ci><JJJ. -
INSPECTION REQUEST: 72'6~3f69 l",e
OFFICE: 726-3759 AUmonz.o Signa
Expuatlon Date Ib/I/1l1
SIgnature o;uherVISIng ElectrIcIan
/?;::V'-
I
Owners Name 1(L~'/~ WerJ~t72-
Address dID \ (i~" \~ .,J3H_
Cl ty /t;f/ZI/J' :(fie::lP Phone '~7 - fXr:4D
OVNER INSTALLATION
The InstallatIon IS beIng made on
property I own whIch IS not Intended
for sale, lease or rent.
Owners SIgnature.
------------------------r--------------
DATE: V L-f - oL., - 0
RECEIPT 11: ~ r)7
RECEIVED BY:!7 Ana fiha dO
...
, . "
'" y.,
225 FIFTH 57 REET
SPRINGFIELD, OR 97477
(5,) 1) 726.3753
: FAX (541) 726.3689
.~CTRICAL PERMIT APPLICATION
CIty Job Nwnber n / O() 5'// 01
3. COMPLETE FEE SCHEDULE BELOll
New ReSIdentIal-SIngle or
MultI-FamIly per dwellIng
ServIce Included
Items
unIt.
Cost
Sum
1. LOCATI9N OF INSTAJ.LA'qil~1 D
;::).( fl \ ('FJ!\iF,{\\ ~\ I~\ \ A.
/703;;>5 Y'-i 01760
LEGAL DESCRIPTION I
.lliil) r\ Dr''i'\Tc, <>!- Sl3ZtiCE ~
ATJOB. DESCRIPTIONa\~ ~qUlre~ ;o~ :u 1000 sq. ft. or less
fnllnr.;)I,'-dBti[)~r 1\IthpOreoon UIII.!.' Ea;:.h,)"At*Ional 500
Not,f'(/illOn GEJri1'7' Tnos& rUlei:' 3re self?r sg ft or' portlon
P,ermI~~5ar&'J nO~1 trans ferablea and)(expue th'ereo'fRMITSHALL EXPIPr:: Ir::TH@\{I,~u5h' 00
If'{.'6rK: ;-; nbt' st'a'~'tue"dj'\,';th~n.."180'b'days EachTManuJ;!.d Home or f\
"flh' Yolll"l~\'('O);f'I' 11l"p.S(I("'.-'Il'''''d d f M'o'du'l'avr'"D'wCeL.lrtl'I"n'gr-Fi I HIS PERIvlITIS NO",
o lssuance or 1 wor~ IS suspen e or
180'::FdMy'S tn&cenlel \1~Ota (lie telep"one se'r'\Yi'~'ijNSf,:[F€'eder'\BAIIJDONED I$Ji'.o 00
nurntJer!ortht:o Olf:)~gor, Lt~"tyNollfICatlon ANY 180 DAY PERIOD
2. CONTRACTOR INSTALLATION)ONLY B. ServIces or Feeders
" T' - - ..,0,,0 InstallatIon, Alter,atIons
Electncal Contractor, ) ')1- t kCJ~ JIlt or RelocatIon
AddressJ) ()((}S- (I ') Il"l'\ :/:::l::: [~ 200 amps or less \
_ - ,. .. 201 amps to 400 amps
CI tyt:.UClellv Phon<l/~~7 CS 71-D 401 amps to 600 amps
~ /)0 C 601 amps to 1000 amps
supervI~b+ LIcense Number. 'J () f,:;? (. ) Over 1000 amps/volts
. Reconnect Only
ExpuatIon Date In II /01
. I
Constr Contr Number ,?>"=t-c;~' 1--(1.
$ 85.00
)
$ 50 00
$ 60 00
$100 00
$130 00
$300 00
$ 40 00
r;;'/)fJfL
C.
Temporary ServIces or Feeders
InstallatIon, AlteratIon or RelocatIon
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch CIrcUl ts
$ 40 00
$ 55.00
$ 80 00
see "B" above
New, AlteratIon or ExtensIon Per Panel
One CUCUI t
Each AddItIonal
CIrCUIt or WIth ServIce
or Feeder PermI t 17-
\'
E.
MIscellaneous (ServIce/feeder
-Each InstallatIon
Pump or IrrIgatIon
SIgn/OutlIne LIghtIng
LImIted Energy/Res
LImIted Energy/Comm
$ 35 00
$ 2 00 '24 ~
not Included)
$ 40.0~
,,-! .
$ 40.0~t::l""
$ 20; -:::; ~
$ 36 >::'~
L-J .. :J:".
riX? en f-' '0 <:)
SUBTOTAL OF ABOVE ",,?y ~ ':';1.., "" 'I'
7% State Surcharge "" ~\) -'j"A-ri": f-'",:5
3% AdmInIstratIve Fer04 J 1i i::06'J:i2
TOTAL =:l2 01 o 0... oogl
, ___ .~.... P -.J
5.
I Job# 01-00311-01 I
Page 1 of 2
.E&EJ"j"':I"'[qill~~:I.:t"~
RESIDENTIAL PERMIT
City Of Springfield
Community Services DIvIsion
BUilding Safety
Job Number 01-00311-01
225 North Fifth Street
Springfield, OR 97477
Office 726-3759
Inspection Line 726-3769
Location Of Proposed Site 2701 CENTENNIAL BLVD Spr
Assessors Map# 17032544
Lot Block Addition
Tax Lot # 01700
SubdivIsion
Owner
Address
Norton Lavendar
2701 Centennial Blvd
Phone Number
City/State/Zip
New
Springfield, OR 97477
Value $0
Scope Of Work Electrical Only
Contractor Type
Electrical Contr
Contractor
JB Electric 'nc
4065 W 11Th #18, Eugene, OR 97402
Registration #
104929
Expiration Date
3/14/04
Phone
541-687-5770
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 700
a m will be made the same working day, mspecllons requested after 7 00 a m will be made the following
working day ,
ReqUired Inspections
Electrical
Rough Electrical
Electrical Service
Final Electrical
- Prior to cover
-Must be approved to obtain permanent power
- When all electrical work IS complete
Construction Types
Occupancy Groups
# Of BUildings
# Of Bedrooms
Handicap Access? D
[Area (Sq F;." ,)
_ Main . Accessory
# Of Stories
Current Units
Census Code Does not apply
Height (feet)
Proposed Units
Total
Fee
Job# 01-00311-01
Paid On Rece.pt#
Electncal
04/02/2001 4817
04/02/2001 4817
04/02/2001 4817
04/02/2001 4817
Permanent 200 Amps or Less
Branch CircUits With Feeder or Service
State Surcharge - Electrical
Admlr1lstratlve Fee - Electrical
Total Electncal
Grand Total
Signature
Page 2 of 2
Value/Quantity
1
12
Date
Fee Amount
$50 00
$24 00
$518
$222
$8140
$81 40