HomeMy WebLinkAboutPermit Electrical 2000-1-31
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:~~i~~,IO:~gd~~~e~~~~eSU~mjtted h.B,s the following
approval. qUire specific land use
Zoning I (),<.--
'- Dale / - 3,- O'i) j-
225 FIFTH STREET
SPRINGFIELD, OREGON 974'tJhonzeo Signature et<:
INSPECTION REQUEST: 726-3769
OFFICE: AE~-?f5h,..,l" r I nv
1. LOCANo'J>O). ~ON~ u
j"Q7- LCf (11)1 r; UJ d:::.l=-
I ~tf::lD8~Pg02:l F; q 0 0 . Jdl-
'G~O~f)SC~W)Qr ~~r . (1
permit~ansferable an~xPire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~ ~
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name f1 ,I ~ ciA.~".
Address f. 0 ,0'fr'7C If) 30
Ci ty CI!.~5/')f (f Phone 7s ~t{
OVNER INSTALLATION
11frJ
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Olffiers Signa tury .
A-J J.t i(d . .
_:_i_______~y__ ~--------------------
DATE:
RECEIPT #:
RECEIVED BY:
:~CTRICAL PERMIT APPLICATION
Ct'ty Job Number
3.
COMPLETE FEE SCHEDULE BELOY
-
0/1 / (p9C,
uni t.
Items
Cost
Sum
A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular'Dvelling
Service or Feeder
.B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amps"or less ~
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00 ~
$ 55.00
$ 80.00
see "B" alJOVe
.'
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
not included).
Miscellaneous (Service/feeder
-Each installation
Pump or irtigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
.3% Administrative Fee
TOTAL
$
$
$
$
4;,rtO
-f-~~ ,)
1~1J
#,dP
40.00
40.00
20.00
36.00.
.~'" ... f".
.
.
I Job# 99-01695-01 I
Page 1 OffRANStl:01-0000411
DATE:JAN 31 2000
AHT RECD:2 $ 44.00
CHANGE:
CASHIER: 059
SPRINGFIELD
~
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 99-01695-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4229 Cole Way Spr
Assessors Map#: 18020524
Lot: Block: Addition:
Tax Lot #: 6900
Subdivision:
Owner:
Address:
AV Chapman
PO Box 1030
Phone Number: 541-954-9960
City/StatelZip: Creswell, OR 97426
New Value: $0
Scope Of Work: Single Family Residence
Contractor Type
General Contr
Contractor
AV Chapman
PO Box 1030, Creswell, OR 97426
Registration # Expiration Date
Phone
541-954-9960
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,
Temporary Power
Required Inspections
I Electrical I
-Approval required prior to SUB energizing pole,
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
iArea (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
e:lectrical
01/31/2000 411
01/31/2000 411
Value/Quantity
Fee Amount
Temporary: 200 Amps or Less
State Surcharge For Electrical Permit
1
$40.00
$2,80
.,.'
.
Fee
Electric Administrative Fee
Total Electrical
Grand Total
Job# 99'{)1695'{)1
Paid On Receipt#
Electrical
01/31/2000 411
.
Page 2 of2
Value/Quantity Fee Amount
$1.20
$44.00
$44.00
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 pertainin~ 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 701,055 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 properly, and the
approved set of plans will remain on the site at all times during construction,
n.(). fOk-r/)~- -
Signature r
1- >I'~
Date