HomeMy WebLinkAboutPermit Electrical 1992-12-3
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., .JC~ ,,;~! "3 "1;6 ELECTRICAL PERMIT APPLICATION
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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\~. ;)
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