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HomeMy WebLinkAboutPermit Signage 1996-02-26SIGN PERMIT APPLI Tton' 225 Fifth Street Springf ield, OR 97 477 SPR!,{GFtELO JOB MBER lnspection Line: 726-3769 Office: 726'3759 SITE ADDRESS:\\ ASSESSORS MAP: OWNER: ADDRESS: f CITY: u1-'f \PHONE:b?>G -53 ) STATE:o L 9fqorztP'. TAX LOT: a?\r">(^111 (,lvri,.>nBUSINESS NAME, FIRT.T ETC. DESCR|pTtoN oF pRoposED slGN(S): (please check and complete all appropriate information) Wall Single Face Dimension from Grade to bottom of Sign Enclosure: Material Sign is constructed of: Square Footage: -lb' llr' Vertical Dimension of sign or enclosure: ts Total Height above Grade: Horizontal orenclosure: *2D' q rr Xx _ Freestanding _ Double Face _ Proiecting _ Billboard _ Roof _ Other _ Marquee rc'a t1 ti 2 It?G $X*o VALUE+ OF SIGN: CDElectrical lnstallation: (lf yes additional electrical \ List ALL existing signage and attach a photograph of each slgn:No firST rUG St 6,JS (a) Type (c) Type Sq. Ftg.. Sq. Ftg. (b) Type (d) Type Sq. Ftg Sq. Ftg CONTRACTOR/IN STALLER:t T PHONE: U]C- 53ZO ADDRESS: lZtO DA ?,,\tc* fZD CITY: e <.STA CONSTRUCTION CONTRACTORS REG rsrRArloN NUMBER: ll lZAb * 7tP: EXp,RES: ^ry - )-Q Z CITY BUSINESS LICENSE NUMBER:b RES:-? t- OFFICE USE Sign Dir Zoning: Sign Permit Fee REOUIRED INSPECTIONS: _ Site to be made prior to sign placement Footing prior to placement of concrete Land Use: Code Section Approved By: Attachment after fasteners are installed/prior to cover Ouad Area: Electrical prior to energizing electrical installation _ Final completion of sign installation b DATE: Additional Comments and/or Conditions: B'y signatui'e, ! statc onC agiee, that I have carefull'; examined the ccrnp!etcd applicaticn and dc hereby certif,v that all infcrmaticn 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 oI the State of Oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the street, that the permit card is located at the f ront of the property, and the approved set of plans will remain on the site at all times during the installation oJ the sign(s). Date a abSignaturee/YlJ- Amount Received:. art>Date Paid:Validation: Receipt Number:Az-o?f t Received ay: fl . ffl Ael.r FrDCt 3)c SIGN PEBMIT APPLICATION The application on the reverse side needs to be completed entirely. lf you are the sign contractor/installer' or if You are hiring a contractor, you need to make sure that uotn ine city of springfielo Business License Number and the Registration Number from the State of Oregon Construction Contractors Board are listed on the application along with the expiration date of each. lf the sign you are proposing to install is illuminated, an electrical permit application also needs to be comPleted and signed by either a supervising electrician, limited sign electrical contractor, or if you are the business owner who also owns the building in which you are occupying, and you will be performing the electrical installation yourself, you may sign the electrical application. lf there are existing wall and/or freestanding signs, a photograph(s) of each existing sign noeds to be attached to theapplication. The size of each existing sign also needs to be listed on the application. PLANS To submit for a sign permit, you need to prepare two complete sets of drawings showing all dimensions, total height, anda plot plan indicating where the proposed sign will be located. lf you are institting a freestanding sign which excieds 20feet in total height, the footing detail needs to be prepared and stamped by a registered engineer or architect. After theplan review process is completed, and, if your sign(s) is approved, one set of plans will be returned to you. The approvedset of drawings need to be at the site when an inspection is requested for the inspectors reference. INSPECTIONS , Depending on Your sign(sl, you may be required to request one or all of the following inspections during the installationof your sign: Site: To be requested after indicating on the lot where the proposed sign will be located but prior to any work being performed for the installation of the sign. This inspection is required if there is a question on the location of the proposed sign. Footing: To be requested alter excavation and the forms are installed, but prior to pouring concrete. lf there will be electrical conduit placed in the footing, it must also be in place prior to requesting this inspection. Attachment: To be requested when all fasteners are installed but prior to cover. Electrical: To be requested after the electricaltonnection to the sign is made, but prior to energizing. Final: After all required inspections are conducted and approved and the sign installation is complete. The inspections that are required for your sign installation will be indicated on the application during the plan review process. Failure to request ANY ol the required inspections could result in sign removal in order to inspect the sign at the required intervals of work. To request an inspection, phone 726-3769. This is a 24 hour recording. On the recording you will need to leave your City Designated Job Number, location ol where the sign is being installed, the typs of inspection you aro requesting, and when you will be ready for the inspection. All inspections called in to the recorder prior to 7:00 a.m. will be made the same working day, all inspections phoned in after 7:00 a.m. will be made the following work day. lf you have any questions regarding the application, required plans or inspections, please feel free to phone the Building Safety Division at 726-3759 City of Springfield Building Safcty Division 225 Fifth Street Springfield, OR 97477 ?. SIGN .PERMIT APPLICATION 225 Fifth Street Springfield, OR 97477 SPRINGFIELO JOB'"I Zfr, lnspection Line: 726-3769 Office: 726-3759 ')\ \d o(' 9-tSITE ADDRESS: ASSESSORS MAP: OWNER:Se t'co re d it Un,on PHONE (,-5 3ZO TAX ADDRESS D* CITY U L STATE: NL TlqotZIP.. BUSINESS NAME, FIRI.T ETC , -V.\ a> Cred + tJn r D(\ DESCRIPTIoN oF PROPOSED SIGN(S): (please check and complete all appropriate information) x Wal K singte race Square Footage: _ Dimension from Grade to bottom of Sign Enclosure: Material Sign is constructed of: Electrical lnstallation: _ Yes r (lf yes additional electrical permit i Freestanding _ Proiecting Double Face _ Billboard _ Roof _ Marquee _ Other Total Height above Grade:l?' L'lz" ao'q" Ll3, t L,' Verticat Dimension of sign or enclosure: aLo l/2 " Horizontal \\' ot' n or enclosure VALUE ) OF SIGN: *5oo o(J s ListALLexistinssisnageandattachaphotographof each"isn, NU €Xt>itUC 5/(>ds (a) Type (c) Type Sq. Ftg.. Sq. Ftg. (bl Type (d) Type Sq. Ftg. Sq. Ftg. CONTRACTOR/INSTALLER +C PHoNE: {Bs--s'sL/{" ADDRESS lZro OoLplr?H cb (L ZIP:q-7L,(02- J-:- q2CITY:STA CONSTRUCTION CONTRACTORS REGISTRATION NUMBEB:lllzw*,EXPIRES CITY BUSINESS LICENSE NUMBER:D3q)RES: 0-7o-9b OFFICE USE Sign District: Zoning: Sign Permit Fee BEOUIRED INSPECTIONS: _ Site to be made prior to sign placement Footing prior to placement of concrete Land Use: Code Secti Approved By: \/'- Attachment after fasteners are installed/prior to cover Ouad Area: Electrical prior to energizing electrical installation '/l-'/ Final Enornptetion of sign installation DATE: Additional Comments and/or Conditions: By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein iS true anci uorrect, and I further certify that any and all work performed shail be cione in accorcjarrce with the Ordinances of the City ol Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the street, that the permit card is located at the f ront of the property, and the approved set of plans will remain on the site at all times during the installation of the sign(s) Signature A/Yra )l2bDate !qc Validation: Receipt Number: L'U)k3 t Received By: >2rr-7Qdn)Amount Received:Date Paid: SIGN PERMlT APPLICATION The application on the reverse side needs to be completed entirely, lf you are the sign contractor/installer, or if you are hiring a contractor, you need to make sure that both the City of Springfield Business License Number and the Registration Number from the State of Oregon Construction Contractors Board are listed on the application along with the expiration date of each. lf the sign you are proposing to install is illuminated, an electrical permit application also needs to be completed and signed by either a supervising electrician, limited sign electrical contractor, or if you are the business owner who also owns the building in which you are occupying, and you will be performing the electrical installation yourself, you may sign the electrical application. lf there are existing wall and/or freestanding signs, a photograph(s) of each existing sign needs to be attached to the application. The size of each existing sign also needs to be listed on the application. PLANS To submit for a sign permit, you need to prepare two complete sets of drawings showing all dimensions, total height, and a plot plan indicating where the proposed sign will be located. lf you are installing a freestanding sign which exceeds 20 feet in total height, the footing detail needs to be prepared and stamped by a registered engineer or architect. After the plan review process is completed, and, if your sign(sl is approved, one set of plans will be returned to you. The approved set of drawings need to be at the site when an inspection is requested for the inspectors reference. INSPECTIONS Depending on your sign(s), you may be required to request one or all of the following inspections during the installation of your sign: Site:To be requested after indicating on the lot where the proposed sign will be located but prior to any work being performed for the installation of the sign. This inspection is required if there is a question on the location of the proposed sign. Footing To be requested after excavation and the forms are installed, but prior to pouring concrete. lf there will be electrical conduit placed in the footing, it must also be in place prior to requesting this inspection. Attachment: To be requested when all fasteners are installed but prior to cover. Electrical: To be requested after the electricaltonnection to the sign is made, but prior to energizing. Final:After all required inspections are conducted and approved and the sign installation is complete. The inspections that are required for your sign installation will be indicated on the application during the plan review process. Failure to request ANY of the required inspections could result in sign removal in order to inspect the sign at the required intervals of work. To request an inspection, phone 726-3769. This is a 24 hour recording. On the recording you will need to leave your City Designated Job Number, location of where the sign is being installed, the type of inspection you are requesting, and when you will be ready for the inspection. All inspections called in to the recorder prior to 7:00 a.m. will be made the same working day, all inspections phoned in alter 7:00 a.m. will be made the following work day. lf you have any questions regarding the application, required plans or inspections, please leel free to phone the Building Safety Division at 726-3759 City of Springfield Building Safety Division 225 Fifth Street Springfield, OR 97417 SIGN PERMIT APPLICAT O!"gPRINOFIEL()\8tOJC UMBER 225 Fif th Street Springf ietd, 0R 97 47 7 ,ispection L;ne: 7 26.37 69Ollice: 726-3759 LOCATION OF PROPOSED WORK:q ASSESSORS MAP ^1D3 TAX LOT owNER:sglcp PHONE: ( o ?"b-3zo ADDRESS CITY: lDs STATE:OR ztP q .7YOI BUSINESS NAME, FIRM ETC.:\c,o Cre di+ \r nion t DESCRIPTION OF PROPOSED SIGN(S): A wrtt Frees -X Singte race Doubt (please check and complete all appropr atc rrf ormation) tanding - Projecting ___-... Roo I t e Face _ Billboard Other _ Marquoc: I Dirnension irom G to bottom of Sign: rade lr'o" Square Footage t)ll o Total Height above Grade' j3"' zt/au Vertical Dimension of sign or enclosure 2' ztt z"Horizo nta I of sign o, enclosure: 2 o,q" Electrical lnstallation: yes (lf yes additionat pefr-f,Ts req Material Sign is constructed of : List ALL existing sisnage and attach a photograph of each sisn: tU D EX (ST lU 6 S tbf{5 $500VALUE (al Type (c) Type C ONTRACTO R/IN STA LLER St Sq. Ftg Sq. Ftg (b) Type (d) Type Sq. Ftg Sq. Ftg PHoNE:SgS- ADDBESS: \Z\oA \<p ILH €-D CITY CONSTBUCTION CONTRACTORS REG ISTRATION NUMBEB STATE: f)R ztP EXPIRES:3-q" CITY BUSINESS LICENSE NUMBER 9s qrl EXPIRES: OFFICE USE Sign District: Zonirrg Sign Permit Fee REOUIRED INSPECTIONS _ Site to be rrade prior to sigr.r placement Footing prior to placement of concrete l/ Artachment after fasteners are installeC/prior to cover V Fnar completiorr ol srg;n installatiorr q) Land Use: Code Section: Approved By: Ouad Area: t Etec trical prior to errergizing DATE: Additional Comments andlor Conditions: By signature, lstate and agree, that lhave carefully examined the completed applicatiorr and do hereby certify that a1 inforrration hereinis true and correct, and lfurther'certify that any and all work perforrned shall be dorre in accordance with the O,rdinances ol the City ofSpringfield, and the Laws of the state of oregon pertaining to the work described hcrein, lfurther.irtirv ri., on,, corrrractors andernployees who are ln compliance with oRS 7o1.o5s will be used on this project. I lurther agree the perrnit card ol the sign(s). to ensure that all required inspections are requested at the ploper tirne, rhat project address is readablc Irorr t]rtr street, thatis located at the front of the property, and the approved set of plans will remain on the site at all timcs durinQ tlrr: rnstallation Signature 5. O1J Date Paid: 3 Date D-t, lqaAmount Received Beceipt Number: Va lidation: ()Lo8>t Becerved By n-fnxn tda 5 D2_ SIGN PERMIT APPLICATION I'1e apptro(rrron on the reverse srde rreeds to be cornpleted enlirely. lf you are the sign contractor/installer, or if you are irrrrrrg a c0rrractor, you need to make sure thal both the City of Springtield Business License Number and the Begistration Nurnbcr frorn !he State of Oregon Corrsrrucrion Contractors Board are listed on the application along with the expiration dute ol cacii. i lr ttre srgrr you are proposing is illumirratcri, an electrilal permit application also needs to be completed and signed by either a supervrsirrg elecrrician, timited sign etecrrical contractor, or if you are the business owner who also owns the building in wnich you are occupying, and you will be performing the electrical installation yourself, you may sign the electrical application. \ li tlrere art: existing wall arrd/or lreestandrrrg signs, a photograph(s) of each oxisting sign neods to bo attached to the a1,lgtlicatiorr. The size ol each existing sigrr also needs to be listed on the application. PLANS [!, sr]t)rri( lOr o si0rt perrlrit, you rrccd to t)rct).lrc two cornplete sets of drawings showing all dimensions, total height, and l1-tle1 p1311 rrtdicatirlg where the proposcd sigrr will be located. lf you are installing a freestanding sign which exceeds 2O Icct irt t0tal lteight, the footing detail rreeds to be prepared and stamped by a registered engineer. After the plan review l)rocess is cornpleted, and, i1 your sigrr(s) is approved, one set will be returned to you. The approved set of drawings need lo be at the srte when an inspection is requested for the inspectors reference, INSPECTIONS OL:pt:rtdrrg On your signls) t-rl your signl you rnay llu rctluircd to request one or all of the following inspections during the installation Srte To be requested after irrdrcatr|rg on the lot where the proposed sign will be located but prior to any work being per{ormed lor the irrstallation of the sign, This inspection is required it there is a question on the location of the proposcd srgn. .: I- o o tirrg AltJClrrtrcnt Electrical: Frrlai: To [:e requested alter excavatror'r arr<j the forrns are installed, but prior to pouring concrete. ll there will be electrical conduit placecJ in the looting, it must also be in place prior to requesting this inspection, To be requestpd when atl fastencrs are installed but prior to cover. To be requested after the electrical connection to the sign is made, but prior to energizing. After all required inspectiorrs are conducted and approved and the sign installation is complete. 1'lre irrspecLrqns that are required for your specif ic sign will be indicated on the application during the plan review process. Fariure to rcq'uest ANY of the require<j irrslrcctiorrs could result in sign removal in order to inspect the sign at the required intervols c-lf work. 1'cr request an irrspection, phone 726-3769. This is a 24hovr recording. On the recording you will need to leave your City Desigrrated Job Number, location of where the sign is being installed, the type of inspBction you are requesting, and whenytlu will bc ready lor the irrspectrort. All i,tspections called in to the recorder prior to 7:00 a.m. will be made the same r'rorkirrg day, all inspections phoned irr af ter 7:00 a.m. will be made the Iollowing work day. ll vou ltave any questions regarrling thc application, required plans or inspections, please feel free to phone the Building S.rfety Drvrsion at 726-3759. ('itl rrl' Spr irrgi'iclri llrrilding Srrl'e ty Divisiun 225 Fil'lh Si.cet Sgrrirrgl'icld, OII 97 4'77 OREGONCITY OF SPFTIfiIGFIELO The lollowing Prc4eq as EuhrnittnEl has the require sPec approval. %zoning, and does not 225 FTY.IH STREET SPRINGFIELD oREGON 97477 Z. INSPECTION REQTIBST:726-3769 OFFICE: 726-3759 orlzed 1 OF JOB fsi\o Elec t ri ca I Contractor EStA eddress IZI o oAtL?AfLr-t zu Ci ty e,^t Phone {gs-ssv0 Supervisor Licens e Number 51c st b Expiration Date )o- t -1L, Constr Contr. Number I l\zgu Expiration Date )-)-11 BI,ESTRICAI PBRHIT APPTICATION City Job Nunber q 5 BELOg Nev Residential-Single or MuIti-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 Modular Dvelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: i200 amps or less 201 amps to 400 amPs - 401 amps to 600 amPs - 601 amps to L000 amPS- Over l-000 amPs/volts - Reconnect OnIY 3 A C D E Sum Permits are non-transferable and expire if vork is not started vithin 180 days oi i""u"nce or if work is suspended for 180 days. 2. CONTRACTOR INSTATLATION ONLY B $ s0.00 $ 60.00 si00. 00 $130.00 $300.00 $ 40.00 $ $ $ s Temporary Services or Peeders Insiallation, Alteration or Relocation of Supervising Electrician 200 amps or less 201 amps to 400 amPs -0ver 401 to 600 amPs Over 600 amps or 1000-volTsSignature ' J c.nM--/ Ovners Name Ct<d ,+ Uvr iorr Address IOS O V" ci ty eq Phone 08c-532-o OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent' Ovners Signature: DATE: RBCET 40.00 5s.00-80.00 - ee ftBtt aEove Branch Circui ts Nev, Alteration or Extension Per Panel one Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit - $ 2'00 Miscelfaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/OutIine Lighting \Limited EnergY/Res Limi ted Energy/Comm SUBTOTAL OF ABOVE 52 State Surcharge 3Z Administrative Fee TOTAL s 40.00 s 40.00 s 20.00 $ 36.00 5 BRECEIVED .Vt ry SPRII{GFIELD JO: JMBER oSIGN PERMIT APPLICATIOI 225 Fifth Street Springfield, OR 97477 lnspection Line: 726-3769 Office:726-3759 2oll N. lq+hSITE ADDRESS: ASSESSOBS MAP: OWNER:PHONE:Gbb'SbZD TAX ADDRESS: lC' CITY:STATE:c(.ZIP: BUSINESS NAME, FIRtVl ETC., Sol.,o C re rl r I Uvr, on DESCRTPTION OF PROPOSED SIGN(S): (please check and complete all appropriate information) - wall X rr."rtanding - Projecting - Roof ..2 .3-s,dedA Single Face _ Marquee Square Footage 1oQ . oog' Vertical Dimension of sign or enclosure: Dimension lrom Grade to bottom of Sign Enclosure: Double Face _ Billboard _ Other Total Height above Grade:qt1" 5'q"Horizontal Width of sign or enclosure:tz'(>l' Electrical lnstallation: X Y.. - No (lf yes additional electrical permit is required) VALUE OF SIGN: '/5,ooo O\u r"vrrn I T---1 List ALL existing signage and attach a photograph of oach slgn:trYt5T\N(- St(3N\ 5 Sq. Ftg Sq. Ftg I{D (b) Type (dl rype Sq. Ftg. Sq. Ftg. (a) Type (c) Type CONTRACTOR/IN STALLER:t T \7 r it c)/q \(p A tLA YzC)b PHoNE: qAS-Sqt ADDRESS: SrATE: Df(ZIP:QlLtozCITY: CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:ntzbb EXPIRES a-2- 1l CITY BUSINESS LICENSE NUMBER:PIRES: G-b-q b OFFICE USE Sign Zoning: Sign Permit Fee: BEOUIRED INSPECTIONS: _ Site to be made prior to sign placement c) \.r" Footing prior to placement of concrete Land Use: Code Section: Approved By: Attachment after fasteners are installed/prior to cover V El""rri"ul pt'- t" energizing electrical installation /rin^t completion of sign installation Area: Z DATE: Additional Comments and/or Conditions: By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that ail iniormation herein is tru; 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 ol oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I {urther agree to ensure that all required inspections are requested at the proper time, that pro,iect address is readable lrom 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 times during the installation of the sign(s) Signature Date Lb L0Amount Received:Date Paid:Validation Receipt Number: 22C:76 Heceived By: I ,V \co 0re-di+ \l t ()lr J Q-tqot .,1q Material Sign is constructed of: SIGN PERMIT APPLICATION The application on the reverse side needs to be completed entirely. lf you are the sign contractor/installer, or if you are hiring a contractor, you need to make sure that both the City of Springfield Business License Number and the Registration Number from the State of Oregon Construction Contractors Board are listed on the application along with the expiration date of each. lf the sign you are proposing to install is illuminated, an electrical permit application also needs to be completed and signed by either a supervising electrician, limited sign electrical contractor, or if you are the business owner who also owns the building in which you are occupying, and you will be performing the electrical installation yourself, you may sign the electrical application. lf there are existing wall and/or freestanding signs, a photograph(s) of each existing sign noeds to bo attached to the application. The size of each existing sign also needs to be listed on the application. PLANS To submit f or a sign permit, you need to prepare two complete sets of drawings showing all dimensions, total height, and a plot plan indicating where the proposed sign will be located. lf you are installing a freestanding sign which exceeds 20 feet in total height, the footing detail needs to be prepared and stamped by a registered engineer or architect. After the plan review process is completed, and, if your sign{s} is approved, one set of plans will be returned to you. The approved set of drawings need to be at the site when an inspection is ;equested for the inspectors reference. INSPECTIONS Depending on your sign(s), you may be required to request one or all of the following inspections during the installation ol your sign: Site: To be requested after indicating on the lot where the proposed sign will be located but prior to any work being performed for the installation of the sign. This inspection is required if there is a question on the location of the proposed sign. Footing: To be requested after excavation and the forms are installed, but prior to pouring concrete. lf there will be electrical conduit placed in the footing, it must also be in place prior to requesting this inspection. Attachment: To be requested when all fasteners are installed but prior to cover. Electrical: To be requested after the electricaltonnection to the sign is made, but prior to energizing. Final: After all required inspections are conducted and approved and the sign installation is complete. The inspections that are required for your sign installation will be indicated on the application during the plan review process. Failure to request ANY of the required inspections could result in sign removal in order to inspect the sign at the required intervals of work. To request an inspection, phone 726-3769. This is a 24 hour recording. On the recording you will need to leave your City Designated Job Number, location of where the sign is being installed, th€ type of inspection you are requesting, and when you will be ready for the inspection. All inspections called in to the recorder prior to 7:00 a.m. will be made the same working day, all inspections phoned in after 7:OO a.m. will be made the following work day. lf you have any questions regarding the application, required plans or inspections, please feel free to phone the Building Safety Division at 726-3759 City of Springfield Buiiding Satety Division 225 Fifth Street Springfield, OR 97477 @ 1:ll,ifl':Ili%g?S't;xP:^$*,hr.T:1;lfodne st,rl .tEl.tf ELECTRICAL PERHTT APPLICATION225 FIT'TTI STREET SPRINGTTELD, oREGON 97 477 tt*rspgctroN REet EST z 726-3769 oFFICE: 726-3759 h Job Numbe' QS l&loOCi ty SCEEDTIIJ BELOTI New Residential-Sing1e or Multi-FamiIy per dvelling unit. Service Included: I tems Cos t TI 5r A DESCRTa-5 Sum Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. JOB DESCRIPTION 2. CONTRACTOR INSTALI-ATION OI.ILY Electrical Contracto Address 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf 'd Home. or -- Hodular Dvelling Sertice or Feeder s 8s.00 s ls.00 s 40.00 Services or Feeders fnstallation, Alterationsor Relocation: 200 amps or }ess I 201 amps to 400 amps 401 amps to 600 amps -601 amps to 1000 amps- Over 1000 amps/voIts Reconnect Only C Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps"or less I S 40.00 40 "(P 201 amps to 400 amps - S 55.00 over /r01 to 600 amps - S 80.00 Over 600 amps or 1000 voT[s see "B' a66[e D. Branch Circuits New, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.OO E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Si.gnlOu tline Ligh t ing-- Limi ted Energy/Res -Limi ted Energy/Comm SUBTOTAL OF ABOVE 52 State Surcharge 3Z Admlnistrative Fee TOTAL B 00 00 00 00 00 00 $300 $ Sso S60 s100 s130 50j, Ci ty \ Supervisor VLi cense Nunrber Expiration Date \trr.\'Qs Constr Contr. Number E.xpi ration Date 4f lq6 Signature of Supervising Electrician Cvners llame tca /rdrJ ress ci ty EL(:IEDts " (nK(o53N OVNEfi, INSTAI.,LATTON The installation is being made orr property I ovn vhich is not intended lor sale, Iease or rent. Omers Signature: DATE: ,non"lAb$AV 40 tDn $ 40.00 $ 40.00 $ 20.00 s 36.00 5 RECEI\TED qa 6D 4 99The lollowlng Proiect zonrng, and doee nor require specitic lald uae approval 26-3769 s, _.^rGFtELt) ELECTRICAL PERHIT A.PPLICATION225 FIFTI STREET SPRINGFIELD, OREGON 9 INSPECTION REQUEST: OFPICE: 726-3759 '*lqq'o"J>r. A Job Nunbe. 95 lSbcr City 3. COHPLETE FEE SCEEDT'I^E BELOV Nev Residential-Single or HuIti-Family per dwelling unit. Service Included: I tems Cos t 1000 sq.ft. or less gach additional 500 sq. ft or portion thereof Each Hanuf'd Home. or -Hodular DvelIing Service or Feeder s 8s.00 s 1s.00 s 40.00 Services or Feeders Installation, Alterations or Relocatiott: 200 amps or less t 201 amps to 400 amps -401 amps to 600 amps 601 amps to 1000 amps__ 0ver l-000 amps/volts Reconnect Onty C ON Sum JOB DESCRIPTION Permits are non-transferable and expire if vork is not started uithin 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALT,ATION OIIY Electrical Contracto Address Ci ty Supervisor icense Number Expiration Date \t-).\-Q= Constr Contr. Number 4\\19 Expiration Date Signature of Supervising Electrician Cvners l,lame et&) hddress ne ('oKo 53Vt) Temporary Services or Feeders Insiallaiion, Alteration or Relocititin 200 amps"or less t S 4O.OO /1D'P 201 amps to 400 amps - S 55.00 over 4b1 to 6oo amps - S Bo.oo over 600 amps or rbOO voTIs see uBu a66TE- B 50 6Ds s0.00 s 60.00 s100. oo s130.00 $300.00s 40.00 Ci ty OVNER INSTAI,LATION The installation is being made ott property I ovn vhich is not intended for sale, lease or rent. Omrers Signature: DATE: 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 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation _Si.gnl0utIine Ligh t ing_ Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.strative Fee TOTAL -D. tDn rr s 40.00 s 40.00 $ 20.00 s 36.00 5 RBCEII'ED B q0 6D l, ,non"lAb$d, M-6- F,t t( =o DB O+P{ae o\a- Cl 11 Zetz' qF-:a =5--.>r.