HomeMy WebLinkAboutPermit Electrical 2001-1-11
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Job# 01-00037-01 I
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.... . Page 1 of 2
. TRAN8#:01-0004239
DATE:JAN 11 2001
AMT RECD:2 $ 55,00
CHANGE:
CASHIER:059
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COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00037-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1703 Concord Ave Spr
Assessors Map#: 17033443
Lot: Block: Addition:
Tax Lot #: 01800
Subdivision:
Owner:
Phone Number:
Address:
Scope Of Work: Electrical Only
City/State/Zip:
Remodel
Value: $0
Contractor Type
Electrical Contr
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,)\.~~~<,-:~~.9~~~se/)\ # Of BU!,ldings:
,0 ~.~.~!Jln~.;~o~e: Occ~ean~,y Group:
.~qs r,Bedr:ooms: Heat Source:
. v- _'\..v .>!..y'," "c.,"
Water Heater: ~Range: %Sq.t...o.otage:
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To request an inspection call the 24 hour recording at 726-3769. All insp.ecf~s~~~uest~ before 7:00
a.m. will be made the same working day, inspections requeste~~er 7iQ.o>a~t'wi~6evmade the following
working day. ~,<Y ~$ca '0~<V ~~
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eqUlre : m:u~e.c 1011,~' r5..'- a\.\J
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-Must be approved to obtain perm~ner:i~pow&.
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Contractor
Phone
541-687-5770
Quad Area:
# Of Units:
Constr. Type:
Electrical Service
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#
Electrical
01/11/2001 4239
Value/Quantity
Fee Amount
Permanent: 200 Amps or Less
1
$50.00
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.1
".
Fee
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Grand Total
Signature
.
Job# 01-00037-01
Paid On Receipt#
Electrical
01/11/2001 4239
01/11/2001 4239
.
Page 2 of 2
Value/Quantity Fee Amount
$3.50
$1.50
$55.00
$55.00
Date
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SPReIELO'.
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225 FIFTH STREET
SPRINGFIELD, OREGON 97 4fJi/te "'.
INSPECTION REQUEST: 72~utJJrfi~d Signature
OFFICE: 726-3759
DEVELOPMENT SERVICES DEPARTMENT
b .tt d has the toll owing
ThetolloWindgdPor~~e~~~~:~Ui~~ sepeCifiC land use
zOning, an ..
approval. /li ~
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Zonmg .-
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Kw
225 FIrTH STREET
. SPRINGFIELD, OF? 97477
(541 i 726-3753
FA,X (5'11) 726-3689
~:.
ELECTRICAL PERMIT APPLICATION
etty Job Number
OI-@OOJi-Gr
3. COMPLETE FEE SCHEDULE BELOV
. . ~~~I~on (lr}r!tTICGlml1Jl)!r1 ')
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J ~ LE~. DESeR!. PTION 0 c,.O' 0
..L:r u;)-'3~/43 - I Q
JOB DES~PTIO~
N~Yo.~
Permits are non-transferable and expire
if' work is not siarted within 180 days
~f issuanc~ ot if work is suspended for
180 days.
,
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq.ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY . B. Services or Feeders
. ..TJ ~ I .....,,-()I~. Installati~n, Alterations
Elec tncal Con trac tor.;cj ")j--{ c:C.t_K....-lL )'Ilt, or Reloca tlon: .
AddressJ) ~toS-II J. / r{!) .ft-: [~ .200 amps or less I
I . - <0.-, '.'- . ." . 201 amps to 400 amps
Ci tyCUC e.ne., phone(tSS? ~ 7- -::;-0 401 amps to 600 amps
, '.. IJo . Q 601 amps to 1000 amps
Supervis~~ License Number" ')67/J l.J Over 1000 amps/volts
i . Reconnect Only
Expiration Date i() / J /01
. . I
Cons tr Con tr. N~mber \':)-=ts?r~c
Expiration Date' / D/t ) Il J
. ;.} I {
Signature of ~pe V~lectr~cian
/(1. YJ/J (! / . L ):. D Branch Circuits
OYners Name:t:lj/cfin J1_r/a~ .
Address ) 7-(),-~ (Jtm(l/)r~
City DJc:yne- I 0It. Phone 7-31r! q L/ it;
I etiJ /~n W~d.) .
OVNER INSTALLATtON
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
~
C. . Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
----------------------~----------------
E. Miscellaneous (Service/feeder not included)
-Each installation .
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm . $ 36.00
. 5. SUBTOTAL OF ABOVE ~(). 00
. 7%, State Surcharge ~. &=)()
3% Administrative Fee -/0.'50
TOTAL .5.&)~ 00
The installation is being made on .
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE:
. RECEtPT :it:
RECEIVED BY:
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