HomeMy WebLinkAboutPermit Electrical 2000-07-28Job# 00-01167-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of ?
SPR!NGFIELD TRnlle+ . fl 1 -nnnrJT''lrlI l\nl\Lrtt ' UI UUUL { Ul
DflTE:JUL ?E :0fi$
AHT RE[D:1 S 1OC.CO
CHANGE:$ 45.ilO
IASHIER:059
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 3095 Yolanda Ave Spr
AssessorsMap#: 17021933
Lot: Block: Addition:
Job Number: 00-01 1 67-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 01201
Subdivision:
ctTY oF SPRfiNGFfiEL4 OREGON
Owner:
Address:
Scope Of Work: Electrical Only
Pump sub panel
Phone Number:
City/State/Zip:
Demolish Value: $0
NOTICE:
office use _TH|S pERtVilT SHALL EXptBE TFTHE WORK
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Land Use:
Zoning Code:
Bedrooms:
Range:
AUrHoRlzEr* wBlfi djdbupEHM tr ts NUl"
cotui tui ENC Eooft l&ne$i@6uFD FoF
ANY 180 DA\ttt&tffirrce:
Sq. Footage:
To request an inspection call the 24 hour recording at726-3769. 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
Electrical rutes aclopted by the Oregon Utiliti
Center Those rules ar€ set fot:
Rough Electrical
Final Electrical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main
- Prior to cover.
-When allelectrical
Accessory:
work is complete.
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
oAF 952-001 -001 0 through oAB 952-00r
't)90, You may obtain copies of the rulos b
calling the c€fltet. (Not6: the tel€phone
,, , rmber lor the Orcgon Lltili$ Nofrllcatio"
'':-l^' ;.- ' 'l^^. ?n?.t!a4A\
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
Permanent: 200 Amps or Less
State Surcharge For Electrical Permit
07t2812000
07t28t2000
$50.00
$3.502702
1
Job# 00-01167-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
Electric Administrative Fee
Tota! Electrical
07t28t2000 2702 $1.50
$55.00
Grand Total $55.00
Signature Date
CITY OF SPR"VGFIELD, OREGO'V
SPFT. -iFIELC,
Th_e loilowing pro1ect as submittect has the followinozonrng ano does nol regurre specrrrt'ianj,ule,,,yapproval
Zoning L-
225 FIFTE STREET DAIE 7-z?- n
SPRINGFIELD, OREGON 976il,lnzeo Srsnarure
INSPECTION REQUESTz 726-3769 -
OFFICE: 726-3759
1. IOCATION INST
EIJCTRTCAL PERHIT APPLICATION
ty Job Nunbe. aO'6f
3. COHPI,ETE PBE SCEEDTILE BBLOS
A. Nev Residential-Sing1e or
Multi-Family per dvelling unit.
service rncluded t
aa"rns cost
1000 sq.ft. or less $ 85.00
gach additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or
-Hodular Dvelling
Sertice or Feeder . S 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
_ol
ot r-o 1
DESCRIPTION
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. CO}ITRACTOR INSTALI.AIIION ONLY
E1 rical Contractor
Address
Ci ty one
Supervisor Li Number
Expiration e
Cons t r tr. Number
tion Date
ture of Supervising Electrician
Ovners Name
Address
Ci ty Phone gA
OVNER INSTALI,,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
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 voIT
200 amps or less I
201 amps to 400 amPs _401 amps to 600 amps _
601 amps to 1000 amPs_
Over 1000 amps/volts
Reconnect 0n1y
SUBTOTAL OF ABOVE
7% State Surcharge
3Z Administrative Fee
TOTAL
IJGAL
{7r>
DESCRIPIION
2-\q,v3
$s0
S60
s100
s130
s300
s40
Sum
aSove-
00
00
00
00
00
00
s 40.00
s ss.00
s 80.00
s[')5A-
-
c.
D. Branch Circui ts . .-
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
s see ItBr'
-Each installation
Pump or irrigation S
sign/outline Lighting- $
t iilitea Energy/Res
-
$
40.00
40.00
20.00
36.00
oO
5
RECEIVED BY:6-
,i()