HomeMy WebLinkAboutPermit Electrical 2001-01-30SPEINGFIELD
Job# 01-00085-01
RESIDENTIAL PERMIT
Gity Of Springfield
Community Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 3900 Oregon St Spr
AssessorsMap#: 17023141
Lot: Block: Addition:
Job Number: 01-00085-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 04200
Subdivision:
ctTY oF SPR7NGFiELD, OREGOTV
Owner: MandrellRoss
Address: 3900 Oregon
Scope Of Work: ElectricalOnly
new service and 4 circuits
Phone Number:
City/State/Zip:
Alteration
541-746-3797
Springfield, OR
Value: $O
Contractor Type
ElectricalContr
Contractor Registration #
Able Electric 92506
1300 Anderson Ln, Springfield, OR 97478
Expiration Date
7t16t2003
Phone
541-726-6701
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 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
ilo?l{
Rough Electrica!
Electrical Service
Final Electrical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
- Prior to cover.
-Must be approved to obtain permanent power.
-When all electricalwork is complete.
Required lnspections
Electrical
# Of Stories: Height (feet):
Current Units: Proposed Units:
Gensus Code: Does not apply
Main:Accessory:Total
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Job# 01-00085-01 Page 2 ot 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
Permanent: 200 Amps or Less
Branch Circuits With Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
0113012001
0113012001
0113012001
0113012001
4342
4342
4342
4342
1
4
$50.00
$8.00
$4.06
$1.74
$63.80
Grand Total $63.80
Signature Date
(
SPFIII(iFIELO
,--
Job Husber
1. -, !r.,\iiinal
not require specific 'll""l"'l"#ttcrsrcAr PSRHIT APPLICATIONlroiLlct as s ubmitted has
225 FTFTE SIXEET
SPRINCrIELD OREGON
INSPEffION REQUEST
OFPICE; 7 2.b-3159
l.OT IN
tr
i-; J(.;llS97477 '
726.37'59
Tirninq
p
,ol
I
t
;tgirului t'
FEE
Res ioen t
I'1ult i*FamilY
Service Incl
SCEEDUI.E BELO1I
ia1-Single or
per dvElling unit'
uded:Items Cost
Permrts are non-transle:able anc expire
if vorit is :'rot =i"tttA vithin 180 days
of issuanee or ii-"otr' :s suspe::ced for
180 daYs '
2.. COI{IEAC,TOR INSTATI'ATIOT{ ONLY
L.SGAL DESC"JPTION
JOB
Electrical Contrac[0r G\\e Etrcrt{*r
p
Address
Ci tY Phone 1 - bqo
Superv i' snr L!cense lrunrber @ 23 ,f
ExPiratioii Date a/ol
Conslr ConLr' Nurber - l/G '1L
Expirati on Date o
Signature of Supervising Electrician
.;J
0wners itane
Address
nP;'rone ,1q
Ci ty
OIINER INSTIiLLATI0II
made on
oi in tencied
DATE:
i ooo so. ft, or less
e*"h ,daitional 500
sq. ft or Portion
thereof
Each Hanuf'd-Home' or
Hodular D'"Ieltlng
Servlce or Feeder
Services or Feeders
Iiuiiir..ion, Alterations
or Belocation:
20C amPs or l-ess \
201 a;rPs 16 4C0 ari'rps
-
401 an-ps to 600 amPs
-
60i ainPs to 10C0 ?r'PS.-iu=t :-boo amPslvolts .-
Recoanec" Only
TemporarY Services or Feeders -
installation, aiilt=tion or Relocat'io;i
200 amPs''o':r iess :
201 am-Ps to /*00 anPs
-
:
over 4bi. to 600 amP!^- l
Over 5C0 arBPS or 1C00 volts s
Branch Circuits
Nev, 4-lteration or Extension Per ?ar:eL
one circuit 4 $ 35'cc 'g
Sach AdCitional-:i;;:::"1'rxlll.'"'"'Eq g 2-oo 6l-
Hiscellaneous (Service/ieeder not includ
-Each installation
punp or irrigation .-
siEnzoutline Lighting-
iiiitei EnergY/Res
-
Lirni ted EnergY/Cornm
SUBTOTAL OT ABOVE
7"l State surcharge
3f, Admini'sirative Fee
TOTAL
Sum
a
$ 85.00
A a: n4) lJ.uv
$ 4C.00
$ 5C.oc
$ 60.00
$100, ca
$130.00
$300.00
$ 40.00
Il
5C
C
40
55
t*-
a bo'J(llBil
80
00
0c
00
co
$ 40.
$ 40.
$ 20-
$ 36.
.00
.00
.00
ee
E
The installalion is b
oior"t tY I oun r*hicl':
ior'sa1e, Iease o1' re
Orrners Signature:
e: ng
fsn
nf.
RECEIVED BY:
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