HomeMy WebLinkAboutPermit Signage 1994-5-24
SIGN PERMIT APPLlCATIO.
~
JOB.BEn q'\O\~
no "0111, Stleel
Sprilluli"hJ, on 97~77
Inspaction Una: 720.3769
Oftice: 726-3759
l.OCATlON OF Pnoposm wonK: 3660 Gateway Street, Springfield OR 97477
ASSfssons MAP:
17-03-15-00
TAX Lon 5101 & 5102
OWNEn: SMITH'S HOME FURNISHINGS (WALT MULVEY) PHONE: 682-3222
ADDnESS: 25600 SW Parkway Center Drive, Wilsonville. OR 97070
CITY: Wilsonville
STATE: Oreaon
ZIP: 97070
BUSINESS NAME. FtnM ETC,: SAME AS ABOVE
[)[SCflWTlON OF pnOPOSED SIGNISI: Iplease check and complete all appropriate informationl
X Wall
Freestanding
_ Projecting
Roof
Marquee
Single Fnce
Double Face
Billboard
Other
Square Fuol3ue: .0_' 95' sq.
TOlal Height above Grade:
lq I
Vertical Dimlmsioll of siUIl or enclusure:
4'0"
Horilont(1! Width of sign or enclosure:
23'9"
t)ill'\{~nsiull lrom Grade
II) lJotlOlO 01 SifJlI: 15 .
Electrical Installalio
lit yes additional p
t2~~[ --1
No
,VALUE: $4,000.00
;vlateri:ll Sign is constructed of:
A
..ist ALL existinu siunage and attach a photograph of each sign: New Construction/No existing signs
101 Type __.0' Sq, FtO, 1111 Type Sq. Ftg,
Ie) Type
Sq, Ftg,
Id) Type
Sq, Ftg,
:ONTftACTon/INSTALLER: HEATH SIGNS
PHONE: 232-2620
\oonESS:
4644 SE 17th Ave.
:ITY: Portland
STATE: Ore<Jj:ln
ZIP: Q77n7
:ONSTnucrrON CONTRACTORS nEGISTRA TION NUMBEn: 64263
EXptnES:
;I/q/q<;
:rry BUSINESS LICENSE NUMBER: _9302~_______
EXPIRES:
6/30/94
OFFICE USE
;iOl' District::::I:.-:_~
~ .6
;iUn Permit Fee: __.!:\~~_
Land Use:
o ~ Quad Area: \~
Code Section:, q: '\ - \ ~ (\ '\
Approved By: ~
E:
e;.~~.~4
~ollino:
IEOUIRm INSPECTIONS:
____ Site
u be !nade prior
o sian placement
Footing
prior to placement
of concrete
~ Attachment
after fasteners are
installed/prior to cover
-K Electrical
prior to energizing
\/ Final
~ion of sign
installation
\tJdilion:l1 Comments DIH.JIor Conditions:
Iy siUll<lture. I staw and agree, that I 11ClVC carefully examined the completed application and do hereby certify that nil informntiun Ilcre;n
~ lIue .:llld correct, nlld I further certily th,H ally (Ind all work perl armed s~1(J1I be done in accordance with the Ordinallces or the City 01
;prill!Jlillld. and tllC Laws of the StoW of Oregon pcrwininy to tl10 work described herein. I further certify that only contr[lctors [lnd
11lpluV(:cs who are in compliance with ORS 701.055 willlJe used on this project.
turttwr auree to en~ure tlla1 all required inspections are requested at the proper time, that project address is readable from the street, that
lIe permit CUft '. lCtlt' at the f t 01 tt (openy, and the approved set of plans will remain on the site at all times during the inswllation
" tile signlsl,
Date 4/26/94
;iUnJtUlc
Received By:
~
lalidtlliun:
OSTERMAN _ .
Amount neceived: ~1.~
Receipt Number: \&-qO,~
Date Paid:
.
.
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SIGN PERMIT APPLlCATIO~
:!~G I-Ilt/l SlfClH
Sprinoli"ld, OR 97~77
~
JOB.BER
Inspaction Lina: 720.3769
Office: 726-3759
q~~3
l.OCATlON OF PROPOSED WORK: 3660 Gateway Street, Springfield OR 97477
ASSESSORS MAP:
17-03-15-00
TAXl.OT: 5101:1& 5102
OWNER: SMITH'S HOME FURNISHINGS (WALT MULVEY) PHONE: 682-3222
ADDRESS: 25600 SW Parkway Center Drive, Wilsonville, OR 97070
CITY: Wilsonville
STATE: Oreqon
ZIP: 97070
BUSINESS NAME. FIRM ETC.: SAME AS ABOVE
[)Estrlll~TlON OF PflOPOSED SIGNISI: Iplease check and complete all appropriate information)
X W"II
Freestanding
_ Projecting
Roof
Marquee
Sino I" Fnce Double Face
Billboard Other
Total Height above Grade: ~2.'
SquarE: Footaue: 951 sq.
Vl:f1iC;ll Oimvllsioll of sinn or enclusure:
4'on
tal Width of sign or enclosure:
23'9n
Din'WIIsiul1 frorn Grade
10 lillll",n 01 Sion: 28'
Electrical InsWII"ti
(If yes additional
No
VAl.UE: $4,000.00
Matcti;l] Sign is constructed of:
(}UwJ~ /~
/
l.iS! All existino $.ionaoe and attach a photograph of each sign: New Construction/No existing signs
I,,) Type _____
Sq, FtO,
lul Type
SQ, FIO.
lei Type
SQ. Ftg,
Idl Type
SQ. FtO,
CONTflACTOR/INSTAllER: HEATH SIGNS
4644 SE 17th Ave.
PHONE: 212-?ji20
AQDnESS:
CITY: Portland
STATE: Ore ann
ZIP: q77n7
CONSTHUCTION CONTflACTORS REGISTRATION NUMBER: 64263
EXPIRES:
2/9/95
CITY OUSINESS LICENSE NUMOER:
EXPIRES:
OFFICE USE
-
SjUI\Ojstrict:~~
Zonino: (' ~
Sion Permit Fee: -}-J.D 00
land Use: ~() OuaJ.Area: \~ JO.,..t...)
Code Section: {~- '1. I ~ ( ,"\
APprOVedBY:~~(w.r .....DATE: ~.2.3.~
REOUIRED I,NSPECTIONS:
Site
to be Illade prior
to sign placement
Footing
prior to placement
of concrete
X Attachment
after fasteners are
installed/prior to cover
$ Electrical
prior to energizing
-X-Final
completion of sign
installation
AdditionJI CornnH!nts <llld/or Conditions:
By sio"ature, I staw tlnd agree, that I have carefully examined the completed application and do hereby certify that all informatiun herein
IS liue Jlltl correct, and I further certify thilt any and all work performed sh<.lll be done in accordance with the Ordimlllces of the City ul
Splingfield, nnd the Laws of the Stilte of Oregon pertaining to the work described herein. I further certify that only contractors <lnd
t~lllploy(:cs who arc in compliance with ORS 701.055 will be used on this project.
Ilurttll..:r aUree to ensure tl1at all required inspections are requested at the proper time, that project address is readable from the street, that
the permit C<.If( '. >cat I at the' t of t roperty, and the approved set of plans will remain on the site at all times during the instnllation
of Ihe $ionlsl.
Signature
Date 4/26/94
AN OSTERMAN
Receipt Number:
,-Ci)
1~q3~ /
Date Paid:
Received By:
,y~
1)
-
V:llidatiull:
Amount Received:
.
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The following proJ.ct as submmed hIlS the following
zoning, and doc:s not require specH'lc land use
225 FIFTH STREET approv.I, ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zon!n" tv (]..1I\\./'I,"J..__
INSPECTION REQUEST: 726-3769 ' City Job Number --~ ~~ )
OFFICE: . 726-3759 Deto_5~_~'f
SMITH'S HCME FURNI~l;Il~~,d Sh1no.ture JJ."" 3 .
1. LOCATION OF INST~'tIQt!.... -
3660 s.. --"-".., -, M.( .,(:2(\0 t':"(~'1 I \ A.
J!lm~?PiON
Of1\O \
JOB DESCRIPTION'
ALARM SYSTEM
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 HONEYWELL
Address 15495 SW Seauoia Pkwv Ste 100
Ci ty Pnrt-l Finn
Phone....9.I"R_<<nn
Supervisor License Number 527JLE
Expiration Date 10-1-96
Constr Contr. Number
57824
Expiration Date
1_27-95
io
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~;;::;::--<:;;~~----
COMPLETE FEE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
_ 1000 sq. ft. ,or lee_ss
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular Dwelling
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
unit.
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
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 100ll
volts
$ 40.00
$ 55.00
$ 80.00
see uB"
above
Signature of Supervising Electrician
O~//
J.j,.,L" h~ D., Branch Circuits
owne~s NameU21; 1 t J...J}...) ,
Address~ ~<:i1 J,'SIlJ.rY1f'Jl.J
Ci t~J/',-1iLbhone !JJJ,!),. ?'^Ef)
OVNER INSTALLATION
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 1 $ 36.00 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
36.00
lotiU
--17,80
.
.
c'-,IID2.
~0:---L
Tha following projact as submlttad h.. tha folio,,"
zonIng, and does not require specific land use
225 ,ru... STREET approval, ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoning <l:: 0"" >A.
INSPECTION REQUEST: 726-alt~9 S- 2.-<=1<{ City Job Number 7 r{) Ir3
O~~~~A: 726-3759
Authorized Signatura ,.:J 3;"'\-COMPLETE FEE SCHEDULE BELOII
1. LOCATION OP INSTALLATION
3t;,c..~ 6i~,
LEGAL DESCRIPTION ,,(
J~LJ~ /< EJ/J {)$/n/
JOB ,DESCRIPTION
SMlT"-"S f:/.,- FU"IU~~l..... oS
, .
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 Contractor51011ee E./eullk...
Address 2.70/ 6.S. J.,Ttt,
City~. <::>2.. ~h.one z.3~ - 3(.3/
, Supervisor License Number 3"19 (,. S
Expiration Date 1t:!J - 1- 'is'
Constr Contr. Number '-I 'ig z 3.
,Expiration Date
3 - 20 - ,~ S
Supervising Electrician
, 7r.O~_
.~
Siltnature of
yfj;J*L.o
,
, ,
owners N,,;me .s,..;JU::.
, "
Address leJal:. :kA) :!>t11/_v
Ci ty &J/.I4MJ"
9,..t,s:Phone 2.ZZ..7ZS'B'
u'''''''', INSTALLATION
The installatioi:t is, being made on
property ,I own_which is not intended
for sale, lease or rEmt.
Own~rs Signature:
.'i,' .
..' .
~/:i/r{.
. . a...tiU- F
-:..rr:??<-~
-~ -
DATE:
RECEIn', f: '
RECEIVED BY:
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
B. Services or' Feeders
Installation,' Alterations
or Relocation:
200 amps or less $ 50,00
201 amps to 400 amps .3 -$ 60.00 11l~. e>C>
401. amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only - $ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to ,400 amps $ 55.00
Over 401 to 600 amps ' $ 80.00
Over 600 amp~,or 100U,vo!ts see nBn
above
$ 35.00
$ 2.00 1137-.}.-
E. Miscellaneous (Service/feeder
-Each installation
Pump or, irrigation'
~ Sign/,Outlin,~Lighdng
Limited EnetgylRes
,Clmi ted ,EnergylConi~
5,.
SiIBToTALOP"ABOVE
5% 'State ,Surcharge
,TOTAL ',' '
D. Branch Circuits
Eu,8J1!!. L:M;"-- PMmlll'-~r, ", '..'
New, Alteration or Extension Per Panel
s...~TII 't:ro ' '
One Circun
,Each Additional
Circuifor wi'th Service,
or Feeder Permit ";;" 197
...... ,
'. '
not included)
$ 40.00
$ 40.00
$ 20.00
$36.60
.$SS"'. eD
2. 7. 70
, .$ S9/. 70
.
.
srRINCFIELD
",
BACKFLOW PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING. SAFETY DIVISION
225 Fifth street
Springfield, Oregon 97477
Office: 726-3759,
INSPECTION LINE: 726-3769
Job Location: ~\O\oC) Cl~Qj.. .1..1, ~~'"\-
Assessors Map #: \'1 [),?\\~('D . Tax\JJt #: OS\D\
owner:~\'-\r\~ ','
Md'~~'d. ~, ~1'l'Q;V Ph", 1~''1.Q'$ .
City \~~. State: - l\)l~ DJ)'\..J Zip: c.n~
Backflow Pennit is $15.00 + $0.75 State Surcharge -t.k "
Contractor\ (\. .J'\tf,tn 0 fl . (i\. '
City: \(\~, state:l~~. ZiP:~V\~
Constru'~tion Contractors Registration #: 5~\ 12) Expires: \.~ \ .qs
By signing this permit/application, I agree to call for an inspection once the
backflow prevention device has been installed and is visible for inspection
(726-3769). I also state that all information on this application/permit is
correct.
t1 tsk!,
'~
t - '7 -fc(
uate
FQR OFFICE USE
Date of Application: Co.fl ~9:~ __ J Job #: ~~~~
Receipt #: \~OJ Issued By: e5{LCJ ~
Total Amount Collected: \\o.?D, '
1---
i.
.
'" h f'll " tiJ '
! Thelollowing project as submitted has t e 0 OWl, , '
225 FIFTH STREET i zoning, and does not requira spacll!c land mlECTlUCAL PERMIT APPLICATION
SpRINGFIELD, OREGON 971/71 approval. .9 (.!/
INSPECTION REQUEST: 726-.3769 Zonina ,", City Job Number CJt.Jo/l/3
OFFICE: 726-3759 I' ~ -1-4LJ
I Date -/
1. LOCATION OF INSTAL~TJA~tf,01.i?Jllj Signature
3""0 6..A-TEWftv '51.
3. COMPLETE FEE SCIffiDULE BEWII
,.J.,.-- ,
a. ~ev Kesloential-Single or
Hulti~F~mily per dwelling unit. '
Service Included:
, LEGAL DESCRIPTION !
/7"3 !~~r:; tal
, ,':
@~ OB DESCRIPTION i 1000 sq.ft. or less
.x. ntercom. Paoino & iData Teler.omrr.JIDjcations Each additional 500
'_' ' .. I sq. ft or portion
Permits are non-transferable and expire thereof, ,
if vork is not started vi thin 180 days Each Manuf"d Home or
'of issuance or if vork is suspended for Hodular'Dwelling
'laO days. Service or Feeder
(~ COllTRAL-rOR TNSTALI:..,TION DNLY B. Services or' Feeders
l_:;J , SOutnernoregon ielecom, Inc. Installation,' Alterations
, Electrictll Contractor!, or Relocati,on:
Address1951 NW MulhollJnd. Suite 4 200,amps or less'
I 20l'amps to 400 amps
Phone ,672-3198 401 amps to 600 amps
I 601 amps to 1000 ,smps
, Supervisor License Number 1589RET Over 1000 amps/volts
I Reconnect Only
Expiration Date' 10/01/96
Items
Cost
Sum
$ 85.00
$ 15.00
\
$ 40.00
Ci ty ,Rose burg
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
,
"
Constr Contr. Number 176552
Expiration Date 9/1t/94 ,
. . .'. ,", .... ',..' . ..
SU, p.erv~sn Electr~~an ,
I) ~/~;f7
, ,..--:".. D..
pvners N~me 5rM/#;-A ruJ?.NntlRf:
)
Ci ty / ~hone
/ ' I
OItNER :INstALLATION
. I
'. :
c.
Temporary Services or'Feeders
Installation, Alteration or Relc,cation
200 amps or less
201 amps to;400 amps
Over 401 to 600 amps
Over 600 amp~.or 1000,vo!ts
Branch Circ.uits
$ 40.00
$ 55.00
$80.00
,see, "B"
,
, I
"1
1 ~"'i
above
Nev. Alteration or Extension Per Panel
Address
On~ci~cun
,Each Additional ,
I Circui,t',or w.ith Servi,ce,
6r'FeederPefml t "
$ 35.00
$ 2.00
iiA~E: . Co . J .q::f' 'I \ A IL-
RECEIPT, ,., .' _~' '. ',' .' J,J\H- J
RECP.IVED BY: _( W). J ,
- i-- .
, 5,.
E. . Miscellaneous (Service/feeder not included)
" '-Each installation
, Pump or, ii:r;gation$40.00
Sign/OutlJn~ ,Lighting $ 40.00
L,iinited Em!tgy'tRes$21J.00
,LiIIii ted~n~r&r/Co~"1 J '.' $36.60(~b,~'
SUBTOTAL 01' ^BOVE '3'- 00_
5% 'Suite ,Surchar'ge I.~V '
To;r/lL ',:" ~ Ut:?- .Lv; I
"4,3C:JIo'Mm'\{\ \f~~ ; l,oa-~r>3cf.I~K .
- - - - - - - - - - - .::-..,.....~__, ---I' . ,
- - - - - - - - - - - - - -
.
.
.7'
The, following project 85 5::'-- ',,- :i has the tollowl
zOning, and does not reqUl. "j ~iti I d ng
225 FIFTH STREET approval. ,0 c an use ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Z DI l-~
INSPECfION REQUEST: 726-J~~ ~' Ci ty Job Number ~#G:> /~3
OFFICE: 726-3759 D.ta~' ~ 4/--q4-
_ '-, ~3.
1. LOCATION OF INS~~ ,_.
~.t::/':) 4~1A;A.. y ?7:
LEGAL DESCRIPTION '
~ l7...0~-/~..t:u::>.- ~/.o/f 5/LJ~
~~~,:,~~~"
f work is not started within 180 days
of issuance or if work is suspended for
180 days.
CONTRACfOR INSTALLATION ONLY
2.
Electrical Contractor E/f>,..-r.:~m...y;;. L)c
~ddress t: // /} ,.1/, G. U,:, r' A.,u..f?
W :~ty /-f//~- 01- PhonejlC?'dll'.;1'77FI
~superVisor License Number 976-7'1 E
'/o-p/-1{. .
piration Date "c . Sl~
C.
~ Constr Contr. Number -::;;?:.- g'1(,? L.L~
~ Expiration Date It? -c / - '11./
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: tS .
RECEIPT lI:
RECEIVED BY:
-
~ -)
J iL), 4J
COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi~Family per dwelling
Service Included:
uni t.'
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
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Signature of Supervising Electrician
,,- - ~ ...Q..--~~ f)" .\D' Branch Circuits
Owners Name"~\;M"\.C::; r \..~~.
s J)id ~ ::i -0 .s.o\)~ New, Alteration or Extension Per Panel
. 1 ^lV" 1M ~i One Circuit $ 35.00
Ph~ne~ Each Additional
Circuit or with Service
OVNER INSTALLATION or Feeder Permit
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '
$ 40.00
$ 55.00
$ 80.00
see liB" above
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36,00
'?C.oo ,a
/. ~O +- \.vo
7?7. gO
3t ~8"
The, following project as submitted h"" the following
ZO~tng. and does not require specific land u:;e
225 FIFTII STREET approval. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zoning (' r;, () A,,'4 "":)
,INSPECTION REQUEST: ,726-37f>'!2.LJ.JZU City Job Number~...:)
OFFICE: ,726-3759 O"le O-,~/
, Authorized SiQnature I.J.~. COMPLETE FEE SCDEDULE BELOV
1. LOCATION OF INSTALLATION
3660 Gatewav St. A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL 'DESCRIPTION Service Included:
MapJl 17-03-15-00, Tax lots 5101/5102 Items Cost Sum
: "j".
JOB DESCRIPTION, ' '
INSTALL (2) EXTERIOR SIGNS (fascia ) ;::'
1500 sq,ft. or less
Each additional 500
'.,"
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
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
$ 15.00
$ 35.00
,Electrical Contractor HEATH SIGNS
B. Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
Address 4644 SE 17th Ave.
Expiration Date
10/1/96
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
City Portland ,Phone 232-2620
, 97202
Supervisor License Number ~L 3U;> .Vb-
Constr Contr., Number 64263
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
2/9/95
Ian
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
vver 600 amps or 1000 volts
$ 35.00
$ 40.00
$ 80.00
see "B" above
Signatur~iSingE
/ 4, /tI~
/~Name~\,
, Addres~ 1022:!/.4J ~
,Ci~~Phone ~fJ:)..')~~,
. I. . . . .
D.
Branch Circuits
New, Alteration or Extension Per Panel
· OWER INSTALLATION
One Circuit
,Two ,to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00
$ 50.00
$ 15.00
The installation is being, made on
property I .own which is not intended
, for sale, lease or rent.
Owners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00
Sign/Outline Lighting-111-, $.~\OO '80.00
Signal Circuit or
limited energy panel $ 36.00
DATE:
, RECEIPT I:
RECEIVED BY:
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
S80.00
4.gg
B4. '
The following project as submitted hoo the fr.rJowing
225 FIFTH STREET zen lng, and does nol require specific land u;;c ELECTRICAL PERMIT APPLICATION
ClDDrOval.
SPRINGFIEIJ), OREGON 97477 /1 /) q A" \A "'J..
INSPECTION REQUEST: 726-376'9ning L..-V Ci ty Job Number ~
OFFICE: 726-3759 [Ho '5-2.44'-' '
! I.. 1 .J. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALt:tiT1:ONj Signature f'" 111\ . ,
3660 Gatewav St. A. New Residential-Single or
Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
Map. 17-03-15-00 Tax lots 5101/5102 Items Cost Sum
JOB DESCRIPTION
BORDER TUBE NEON INSTALLATION
AROUND PITCHED ROOF FEATURE
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 da,Ys.
2. CONTRACTOR INSTALLATION ONLY
1500 sq;ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 35.00
Electrical Contractor HEATH SIGNS
B. Services or Feeders (10 Branch Circuits
included), Installation, Alterations
or Relocation:
Address 4644 SE 17th Ave.
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Ci ty Portland ,Phone 232-2620
97202 3(PI.P5/b-
Supervisor License Number .', ~
Expiration Date
10/1/96
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
Constr Contr. Number 64263
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
2/9/95
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
vver 600 amps or 1000 volts
Si~~ing'E
</ bJ" .~. D.
, ~rs Name l, ,'" ' ~
Address 1D22..8JJ ::... '
,Ci~Ph~neJ9QQJ7~
ian
Branch Circuits
$ 35.00
$ 40.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
,Two to ten Circuits
Each Addt'l ten or
portion thereof
OVNER INSTALLATION
The installation is being, made on
property I own which is not intended
for sale, lease or rent.
$ 35.00
$ 50.00
$ 15.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00
Sign/Outline Lighting 3 $ 46,00 '120.00
Signal Circuit or
limited energy panel $ 36.00
Owners Signature:
~ATE: --~FY~~-: ,
RECEIPT I: - ~. '_
RECEIVED BY: ~ )
.
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
120.00
6.00
126.00