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HomeMy WebLinkAboutPermit Electrical 1992-12-3 ...., ~,J '",. ....',/f ~". , . ':"I(~'J'flt;f [!P'''Ojro.. . -"1" ., .JC~ ,,;~! "3 "1;6 ELECTRICAL PERMIT APPLICATION 97477 '. "0",.. "Uk b ".01)' Nlf&, ""elf) 726-376~.,Q- ~'J...(()~"{:JeCifi/liJ"'Y"ido.~ Number 9:2 /'1'2tt' ~or. >~~~' 9. ~ <11;80 "'It'd ~,"'" "-~ 3. PLETE FEE SCHEDULE BELOII 1. LOCATION OF INSTALLATION c:..... "'0 S /~ h{#~ ~/R"'.E fc.J~ New Residential-Single or . i-Family per dwelling uni t. SerVl cludedl 225 FIITH STREET ., SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 LEGAL DESCRIPTION /:?~"g~'::l'7f.~ ~~~. , b JOB D~. IPTION ~ . ~ . . '7'~. - .. .. ." - 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 ContractorJ)\u'\ 0E1112Jr ~ Address 6y\L\O -VJ !\AIlN\1\Y City (f:~~ Phone ~~ Supervisor License Number ~~~ Expiration Date /~-,/~y Constr Contr. Number~k'7~ Expiration Date ,~:;l'~ ~ Signature of Supervising Electrician _~A~ . Owners (lame ~:".~ //#~ Address City Phone OIlNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent~ Owners Signature: ~~~;~--Ti=-I--~~------------------- RECEIPT II: /,(}t12--'1 RECEIVED BY: INiAJ~ Items Sum Cost 1000 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 $ 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 ~ 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 $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ~ $ 35.00 $ . ~ 2.00 ..g. E. Misc.ellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lightinl1' $ 40.00 Limit~d Energy/Res $.20.00 Limited En~rgy/Comm $ 36.00 5. SUBTOTAL OF ABOVE t/~ .".p 5% State Surcharge 7. ye:> TOTAL ~~. 0/ L:> RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSrD WORK. \ q C\. (') '\ ASSESSORS MAP: \QD38,4CO LOT. BLOCI'. CITY. DESCRIBE WORK. NEW REMODEL ADDITION . Qa\4-W JOB NUMBER SUBDIVISION: ~ bP.~ NF. ~. ~i\~ {I STAT". I 'f1-.../ z'P:~18 - OFrlf'7i'T*\- LAND USE: \ (/"'l~ N OF UNITS' CONSTR. TYPE: HEAT SOURCE: RANGF. o Rough Mechanical - Prior to cover. . D Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. ~ramlng - Prior ~o cover. ....L. Wall/C.elllng Insulation - Prior to l6Lcover. ~rYWall - Prior to taping. o Wood Stove - After Installation. o Insert - After flreplaco approval and Installation of unit. o Curbcut & Approach - Alter forms are erected but prior to placement of concrete. DEMOLISH OTHER CON ST. CONTRACTOR'!) NA~ (\ \ :.1. ~ESS f) n~CO)\l~~qrO~N GENERAL: fX(\Q V. \Of\l'jJWC\Ury....( ~dl vJ ,0 M:\.OO "-----. ).. PLUMBING. MECHANICA' . ELECTRICA' . OUAD AREA: l)Q (\;{\/ N OF BLDGS. OCCY GROUP: N OF STORIES. WATER HEATER: ~~~TcT3 ~. FLOOD PLAIN: ZONING CODE: N OF BDRMS. SECONDARY HEAT: SOUARE FOOTAGE: To request an Inspection, you must call 726.3769. This Is a 24 hour recording. 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 work day. REQUIRED INSPECTIONS o Temporary Electric D Site, Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. o Footing - After trenches are excavatod. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected bllt prIor to concreto placement. o Undorground Plumbing - Prior to fillIng trench. o Underfloor Plumbing/Mechanical _ Prior to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation ~ Prior to decking. .. . o Sanitary Sewer - Prior to filling trench, . O Storm Sower - Prior to filling trench. o Wal~r Line - Prior to filling trench. I"'. o Rough PlumbIng - Prior to cover. o Sldewalk.a. Driveway - Alter excavation 15 complete, forms' and sub.t:?ase material In place., o Fence - Whe'n completed.' i o Final. Plumbing - When all plumbing work Is complet.e. D Final Electrical - When all electrical work Is complete. o Final Mechanical - When all mechanical work Is complete. ~ .. FInal Building - When all equlred, InspectIons have beon approved'and building Is . completed. o Other ,. MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. . . o Plumbing Connections - When home has been connected to water' and 'sewer. [~~l 'Ele~:iilcaIJ.c~1nectlon '-4Wh~h' .' . I bI.O.:c~I,~g~i~_~t.uPI'~and IPlu,rrybl.'1g; : '. Inspectlons~have been approved :~and :thethome.ls' connected to' ;' ., : ~thes~rvl.~." penel. . : , , ~:,~inal.::";::,A;;i'ei~~1I required .' ," ....,,;~fi.: ";':'. ._: :.::~..r!Q.s,p..~9Jl.o'l)s;\are:a'p'p.r.o~ed' ,ahd Slreet Trees - When all required . 'porches, skirting; decks, and trees arc planted. venting ,havo"been.lnstalled; o ., :~~. ' Lo! (?lces . ./:~..' '.:' .',,: Lot Sqi Itg:;',.' ,~'. ..."_""....,.. ,- '1 .. Lot coverage ......... . , Topography Total height Lot TY. Setbacks ':;".:Igi~rior; .' .. '~'; 'P.L HSE' GAR J ACC '.' ~;!~~a,~~t;'t,'y:-': .::'y ,~""''':-1' :~-:~.tV ,:': '\',!"~ "~I:r' ~"r. ~Coi;'er N. .. /: ":P~'~"~~~dle 1 S ' -. Iw _ Cul.de.sac IE BUILDING PERMIl: ITEM SO. FT. X $/SO. FT. Main , ' Garage Carport Total Value Building Permit Fee State Surcharge Total Fee VALUE (A) . JJ f~~ Ii .40 c94Cf .q{) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sower Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge FEE N' FT: FT. FT. Furnace MECHANICAL PERMIT (C) ,. Exhaust Hood Vent Fan Dryer Vent Wood Stove/lnsert/Flreplace Unit N' MechanIcal Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge " . Sidewalk Curbcut Demolition Stale Surcharge It It Total Miscellaneous Permits (E) "',.' . TOTAL AMOUNT DUE (excluding electrical) (A. B, C, D. and E Combined) 6J.40 qO ...ISTHE PROPOS!OD WORK IN THE ........:.....S I' HISTORICAL DISTRICT, OR ON I THE HISTORiCALRE'GISTEf'1? . If yes, this ~'PPllc;;;on m~s; ~e Slgne>~;' ':. ..1 and approved by the .Hlstorlcal., Coordinator prior to permit Issuance. 'Ii APPROVED: _' ,BUILDING VALUE,PLAN CHECK AND BUILDING'PERMIT . This pennllls granted on the express condition that tile said construction shall, in all respects, conform to tlle Ordinance adopted by the Clly 0\ Springfield, Including the Development Code, regulating the constructlon and use of buildings, and may bo suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Date Paid: Receipt Number' Received By: Plans Reviewed By Dato Systems Development Charge is due on all undeveloped properties wllhln the City limits which are being Improved. ADDITIONAL COMMENTS By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information Ilereon Is true and correct, and I further certify that any and all work performed shall be done in accordance wllh the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining t~ the work described herein, and that NO OCCUPANCY will be made of any structure without permission of tho Building Safety DivisIon. I further certify that only contractors and employees who are In compliance with ORS 701.055 wilt be used on thl~ project. I further agree to Qnsure that all required Inspectlons 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 property, and the approved set of plans will remain on the site at all limes during construction. Signa/. @- __,;~~o _____ Datn!~ VALIDATION: I. t1 RECEIPT NUMBER. a t01 ~ 'I DATE PAIl' [\). aq..a./+-' AMOUNT RECEt'V!'f> ~,J1:r) RECEIVED BY ?'-f-,.;f f\~. ;) \, / J~ ~J\. /