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Home My WebLink AboutPermit Electrical 2000-07-11SPRINGFIELD Job# 00-01082-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 AICTS : 100-00000-4256CII S : 01-0002536/H0l'1E CDHF0RT J0Efi:00*01810-01 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 272 Smith Lp Spr AssessorsMap#: 17023231 Lot: Block: Addition: Job Number: 00-01 082-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01918 Subdivision: ctTY oF SPRfiNGFfiELq OREGON Owner: Great Western Homes lnc Address: 62939 Hwy 97 Scope Of Work: Manufactured Home on Private Lot Phone Number: City/State/Zip: New 541-385-3151 Bend, OR 97701 Value: $O ac circuit Contractor Type ElectricalContr MechanicalContr Contractor Jb Electric lnc 4065 W 1 1Th #18, Eugene, OR 97402 Home Comfort Heating & Air Condit* Po Box 24205, Eugene, OR 97402 Registration # 104929 Expiration Date 3114t04 Phone 541-687-5770 541-345-2838841646t25t01 Quad Area: # Of Units: Constr. Type: Water Heater: 1 (VN) Wood Frame Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: OccupancyGroup: Dwelling Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. 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 !nspections Electrical Rough Electrical Final Electrical -Prior to cover. -When all electricalwork is complete. Construction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: # Of Bedrooms: Handicap Access? (sq. Store # Of Stories: Height (feet): Current Units: Proposed Units:1 Census Code:New Mfg Home Main:Accessory:Total: Job# 00-01082-01 Page2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Electrical Branch Circuits WO Feeder or Service State Surcharge For Electrical Permit Electric Administrative Fee Total Electrical 07t11t2000 07t11t2000 0711112000 2534 2534 2534 $3s.00 $2.45 $1.05 $38.50 Mechanical Minimum Mechanical Permit Mechanical Administrative Fee Less than 100,000 BTU Mechanical lssuance State Surcharge For Mechanical Permit Total Mechanical 07t1112000 07t1112000 07t11t2000 07t11t2000 0711112000 2536 2536 2536 2536 2536 1 $e.00 $.45 $6.00 $10.00 $1.05 $26.50 Grand Total By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify 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 requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the propery, and the approved set of plans will on during construction. $65.00 7-tz-dA sig re I Date 1 ,C'TY OF L zontng. and does not reguire specitic land useapproval Zoning k>,2- iJate has the tollowing COHPTJTE FEE SCEEDI,LE BELOV Nev Resident j.a1-Single or HuIti-FamilY Per dvelling unit Service Included: S,T .NGFIELCI PBRHIT APPLICATION City Job Nunbe (>o - ()l OKZ -C) h, .-tt -fr 225 FIFTE STREET .l,rirrorized Signature SPRINGFIELD, OREGON 97 477 inspBcrroN REQITEST z 726-3769 OFPICE: 726-3759 t 1. LOCA TION OF INSTALLATION PTION DESCRIPTION 3 A Electrical Contractor Address fu-* Ci ty Phone ( g z D Supervisor License Number 7 *t* Expiration Date ta/oy; Constr Contr. Numb er3 1<91 Expiration Date t Signature ising EIec trician 0wners Addrgss Ci ty PhoneTq4 -1{09?- OIINER INSTALLATION The installation is being made on piop"tty I ovn vhilh is not intended for sa1e, lease or rent' 0rners Signature: DATE: Items 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereo f Each Manuf'd Home' or Hodular DveIIing SerVice or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less ior .ri" to 400 amps -401 amps to 600 amps --601 amps to 1000 amPs- Over L000 amPs/volts --Reconnect 0nIY Service TemporarY Services or Feeders inil.ffuiion, Alteration or Relocation Cos t s 8s.00 s 1s.00 s 40.00 s s0.00 s 60.00 s100.00 s130.00 s300.00s 40.00 .00 .00 .00 flBlr $ 2.00 Sum Permits are non-transferable and expire ii vort< is not started vithin 180 days oi i""u"nce or if vork is suspe^nded for ieo a"y" . 0n7I 2. CONrRACTOR INSTAII,ATION ONLY c B C 200 amps''or less,oi ;,;; io aoo amps -Over 401 to 600 amps -----_Over 600 amps or 1000 volt D. Branch Circuits : Nev, Alteration or Extension Per Panel one (ci rcui t nach\ Additional CiLcuit or with ;;-F;;J"; Permit I l/E. MisCe llaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/OutIine Lighting- Limited EnergY/Res - Limited EnergY/Comm 5. SUBTOTAL OF ABOVE -12 State Surcharge 1Z aa,ninistrative Fee TOTAL s40$ss $80s see $ 40.00 $ 2s00_- aE6vE- 1-,.re $ 3s.00 1{ Z,C'f{+ r.fl .CJ FJ RECEIVED B c>-7 a o -Jrt t