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Home My WebLink AboutPermit Electrical 2000-11-08CITY OF SPRINGF'ELD, OREGO'U i-nr f ollowtng projecl as suDmitted has: . .!ng ano does not require specific.rpploval Zoning 225 FIFTB STREET SPRINGFTELD, OREGON 97 477 INSPECTI0N PGQUEST | 726':3769c srsrraturc OFPICE: 726-3759 1 LOCATION O PERHIT APPLICATION Ci ty Job Nurnber EO ^ C> tt 7^O COHPI,ETE FEE SCMDUI,E BELOS Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Hodular Dvelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 B. Services or Feeders InstalIation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps _40L amps to 600 amps _ 601 amps to 1000 amps_ Over l-000 amps/voIts Reconnect 0n1y C.Temporary Services or Feeders Installation, Alteration or Relocation SPRINGF!ELE, the rotlowing land use One Circuit Each Additional Circuit or vith Service or Feeder Permit Limited Energy/Res Limited EnergY/Comm 5. SUBTOTAL OF ABOVE 7% State Surcharge 32 Administrative Fee -fl 11 3 A LEGAL DESCRTPTION\3'ZZ O JOB PTION Cc Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTAII.,ATI El-ectrical Contractor Address ci ty-Phone Supervisor License Number Exp iration Date Constr Contr. Number Exp iration Date Signature of SuPervising trician Ovners N, Address Phone 7,U-5VL 200 amps''or less 201 amps to 400 amPs - Over 401 to 600 amps over 600 amps or fbOO voTTs L Branch Vtt,cL-,t) Nev, A1 Circui ts teration or Extension Per Panel $ 3s.00 (troo Sum $ s0.00 s 60.00 s100.00 s130. 00 s300.00 s 40.00 $ $ s s Ci ty INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DATE: Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Out1ine Lightirg-s 40.0Q, $ 40.G E 40.00 55.00 80.00 ee trBil a6ove $2 00 { :f> :t>$ 2o.og $ 3o.qg -4z-m r-n. t-lEf-q3iz,." 4'HU !r'.J <: Fr I(=(3O L'.1 -_lL'](nRECETVED '( otr oo TOTAL ctrY oF SPR1NGFfiEL4 OREGON SPRINGF!ELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: AssessorsMap#: 17033522 Job# 00-01177-01 RESIDENTIAL PERMIT City Of Springfield Gommunity Services Division Building Safety Page 1 of 2 10 g il Job Number: 00-01 177-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 01800 n: 541 S oR97477 $800Value: tLc Lot:Block: Owner:Cialin M Address: 1017 MillSt "1". Scope Of Work: Miscellaneous si o t(r," k. r)6rieqt4gi)l 4 tta v lr{ k,, ,i1 Contractor Type ntractor Registration # Expiration Date Phone 541-726-5772GeneralCo Quad Area: # Of Units: Gonstr. Type: Water Heater: ioN Steven 97477 Ra To request an inspection call the 24 hour recording a1726-3769. 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 lnspections Building Ceiling lnsulation Framing Walllnsulation Drywall FinalBuilding Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: - Prior to cover. - Prior to cover. -Prior to Cover -Prior to taping. -when all required inspections have been approved and the building is complete. # Of Stories: Height (feet): Current Units: Proposed Units Census Code: Does not apply Accessory Total: C # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: Job# 00-01177-01 Page 2 o'f 2 Fee Paid On Receipt# Value/Quantity Fee Amount Buildi Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 0B/01/2000 08/01/2000 08/01/2000 2717 2717 2717 800 $15.00 $1.05 $.45 $16.50 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 $16.s0 requested at the is located at the du constru proper front of time, that the project address is readable from the street, that the permit card the the approved set of plans will remain on the site at all times Date ,B /,n