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Home My WebLink AboutPermit Electrical 1998-07-17225 FIFTE STREET SPRINGFIELD, OREGON INSPECTION REQTJEST: OFFICE: 726-3759 97 477Aulitwd 726-3769 1 ON OF r0N IV LEGAL DESCRIPTION L>1o JOB DESCRTPTION 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 INSTALT.ATTON ONLY Electrical Contractor Address Ci ty NOTICE:Phone Supe rv i -s Expirati cons t r c"tryY J S0,P#bY"FER|oD. Expiration Date Signature of Supervising Electrician l{x) ELECTRICAL PERHIT APPLICATION b Number QQotr r 3. COHPIJTE FEE SCHEDIJLE BELOV A 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 -Modular DvelIing Service or Feeder t s 8s.00 $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: zoning, and apprwal, pro,od @ sabm[lsd not roqullo SP GFIELE' SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAI Sum B I Ci ty Phone 7L{7 4z u7 OVNER INSTALLATION 0vners Si gntrure: DATE: D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Addi tionalCircuit or vith Serviceor Feeder Permit $ 2.O0 200 amps or Less 201 amps to 400 .*ps - * _401 amps to 600 amps _601 amps to L000 amps over 1000 amps/voIts -Reconnect Only 200 amps''or less 201 amps to 400 amps -Over 401 to 600 amps Over 600 amps or 1000-rrc-ITs Miscellaneous (Service/feeder -Each installation Pump or irrigation $ Sign/Outline Lighting- $ Limited Energy/Res - S Limi ted Energy/Comm $ 4o oA $ s0.00 s 60.00 s100.00 s130.00 $300.00s 40.00 C E Temporary Services or Feeders Installation, Alteration or Relocation s $ $ s 40.00 s5.00 80. o0 ee ttBtt aEove not included) 40.00 40.00 20.00 36.00 Ovners Name Address CftJ d/^r l/ /7 tf 2- d,/ I ,2-Ll1.20RBCEIVED B 5 The installation is being made on property I ovn r,rhich is not intended for saIe, lease or rent. Permit #: g(f tef IZ I #1v Address Issued by:C,!Date: l/n /lt Statement: lnformation Notice to Property Owners About Construction Responsibi lities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before abuilding permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3,{ or 38: I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A'. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. k*9 A--.u.-L llt?/fow(Signature of permit applicant) (White copy to issuing agency permit file, pink copy to applicant) OR 6"t")- ",.CTTY OF SPRINGFIELD, OREGOA' SP' FIELE, zoning, and apwo/d. re$&o opoc8o *"144.3> 225 FIFTE STREET sPRTNGFTELD, oREGoN gzt#-hd INSPECf,ION REQIIEST: 726-3769 OFPICE: 726-3759 1 LOCATION OF E ON FEE SCEEDTILE BELOS o$.Nev Residential-Si ngle or velling I tems MuIti-Family per d unit. $N'{Service Included: hnd tno PERHIT APPLICATION 1$rs +es Job Nurnber Qv ot /s \t$ JOB DESCRIPTION Permits are zDoD-transferable and expire if vork is not started vithin 1"80 days of issuance or if vork is suspended for 180 days. 2. COI{TRACTOR INSTALLATION ONLY ectrical Contractor 1000 sq.ft. or fess Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 s 15.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less I 20L amps to 400 amPs - 40L amps to 600 amPS - 601 amps to 1000 amPs- Over 1000 amps/volts - Reconnect 0n1Y C.Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"or less S 40.00 over 4b1 to 600 amps - $ 80.00 Over 600 amps or r.bOO voEs see rrSrr uffi Branch Circuits ; .. Nev, Alteration or Extension Per Pane1 One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/Out1ine Lighting- Limited Energy/Res - Limited EnergY/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL B Cost Sum .00 .00 Ci ty Supe Expi Cons Expi S 0vners Address Phone 00 00 00 00 00 00 50. 60. 100 130 300 40 $ s $ s $ s s $ $ $ =' rvisor Li ration Date tr Cont Number ra Date r ture of Supervising EIectr an D v Ci ty Phone OVNER The installation is being made on property I ovn vhiih is not intendei for sa1e, lease or rent. Ovners Signature: DATE: : '-4 art4i- 0040 0040 20 36 RECEIVED 5 00(o <.L*. l) L) Permit #:/5 Address 15? n tyil-il IL Issued by:Date Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential butlding, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and2, and either box 3,{ or 38 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A'. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 7-1-7Y (Signature of permit applicant) (Whrte copy to issuing agency peftnitfile, pink copy to applicant) (Date) Arn//n/ F