HomeMy WebLinkAboutPermit Electrical 2000-4-5
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DATE:APR 05 2000
ANT RECD:2 $ 22.00
," CHANGE.:
.' CASHIER: 004
ELECTRICAL PERK!T APPLICATION . .
The. following project as ,submitted has the following
zomng, and does not require specific land use
approval. fl.-"
Zoning Lv
225 FIFTH STREET Date I..j -'5" -oi) .
SPRINGFIELD,OREGON ll;?Md.7z.Qd. S.i.gnatur' ~
INSPEctION REQUEST: 726-J7fJ'f
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
19 It( [0,", ~O'/ ,;41/<
LEGAL DESCRIPTION
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JOB DES~PTION
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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 INSTALLATION ONLY
Electrical Contractor ADT Security
Address 1501 Pearl St,
City Eugene, OR
Phone541-342-1313
Supervisor License Number 853J1E
Expiration Date 10/02
Constr Contr. Number 26209CLE
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Expiration Date
10/01/00
Sign~~UI} of Supervising Electrician
/tr~ ~'
Ollners Name L,,)
l)l- ~,ty.
Addres:; J 1 { c.r ~ "...,'~ ;-Iv-<
Ci ty ~ t7./z.i?y r;.. {f Phone 7 Cf Cf'~ f{ to
,
OWNER INSTALLATION
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The installation is being made on
property I .own which is not intended
for sale, lease or rent.
Owners Signature:
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DATE:
RECEIl'T I:
RECEIVED BY:
3. ;~;;:;;:~~=*
Service Included:
. A.
Items
1000 sq,ft, or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd Home, or
Modular'Dllelling
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 -----
Cost
Sum
$ 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
200 amps' 'OT 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" above
"
Nell, 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 ~o
Limited Energy/Comm $ 36,00
5. ~BTOTAL OF ABOVE
State Surcharge
% Administrative Fee
TOTAL
~o
I. 'f 0
. "II
:1.2...00
.
.
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Job# 00-00524-01 I
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Page 1 of2
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CITY OF SPRINGFIELD? OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00524-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1914 LOMOND AVE Spr
Assessors Map#: 17032512
Lot: Block: Addition:
Tax Lot #: 00500
Subdivision:
Owner:
Address:
LES SPENCE
1914 LOMOND AVE.
Phone Number: 541-744-3180
City/State/Zip: SPRINGFIELD" OR 97477
Alteration Value: $0
Scope Of Work: Single Family Residence
INSTALL SECURITY SYSTEM IN SF RESIDENCE
Contractor Type
Electrical Contr
Contractor
Adt Security Services Inc
1501 Pearl St, Eugene, OR
Registration # Expiration Date
Phone
541-342-1313
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
Electrical'
Low Voltage
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
[Ar~a (Sq. Feet)
_ Mam: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Electrical
04/05/2000 0001149
Value/Quantity
Fee Amount
Limited Energy - Residential
1
$20.00
I
.
.
,.I
Job# 00-00524-01
Paid On Receipt#
Electrical
04/05/2000 0001149
04/05/2000 0001149
Fee
Page 2 of 2
ValuelQuantity Fee Amount
State Surcharge For Electrical Permit
Electric Administrative Fee
T atal Electrical
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 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 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
during construction. / /
~-l~ L/-/S:-/M
Sig!iature O'te /
$1.40
$.60
$22.00
$22.00