HomeMy WebLinkAboutPermit Electrical 2000-04-05SPRIhIGFTELD
Job# 00-00521-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Buitding Safety
Page 1 of 1
1P911$S:01-0001i.44
DATE:APR 05 ?OOO
AHT RECD:Z $ 68.20
IHANEE:
EASHIEft:003
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2050 00002nd St Spr
AssessorsMap#: 17032623
Lot: Block: Addition
Job Number: 00-00521-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 01002
Subdivision:
ctTY oF SPRfiNGFfiELq OREGOfiI
Owner: Beverly Duvall
Address: 2050 2nd Street
Scope Of Work: Electrical Only
Phone Number:
City/State/Zip:
Alteration
Service change & circuits for kitchen and bath (future remodel)
541-747-5707
Springfield, OR97477
Value: $0
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 callthe 24hour 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.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
04105t2000
0410512000
0410512000
04t05t2000
1144
1144
1144
1144
1
b
$s0.00
$12.00
$4.34
$1.86
$68.20
Signature Date
$68.20Tota!
Permanent: 200 Amps or Less
Branch Circuits With Feeder or Service
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
u5-00
Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not
registered with the Construction Contractors Board to sign the following statement before a building
permit can be issued. This statement is requiredfor 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 fited with the permit.
Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38:
Construction Contract- - s Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www.ccb.state.or.us
Permit #
Address:
Issued by:Date
(Date)
trr
F-2
I own, reside in, or will reside in the completed structure
I understand that I must register as a construction contractor if the structure is sold or offered for
sale before or on completion.
3,A.. My general contractor is
(Name)(ccB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
F-38. I will be my owrr 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 certi& that the 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.
'/ - s-oo
of permit applicant)
prop-own/f/ 3-99
(si
(White copy to issuing agency permit file, pink copy to applicant.)
CTTY OF OFEGO'U
SPFlI'{GFIELt,
The following project as submittec, haszonrng, and doesapproval
225 FIFTE STREET
SPRTNGFTELD, ORE&F
Zoning
INsPEcf, I oN REQUEETT h ". &Ak-, AZfr 2 ^OFPICE: 726-3759
1. LOCATION OP2-aso
LEGAI DESCRIPTION
EI^ECTRICAL PERHIT APPLICATION
city Job n*u". M- bfL/-Cl
3. COHPIJTB FEE SCffiDTII,E BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service fncluded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less L/w201 amps
401 amps
601 amps
Over 1000 amps/volts
Reconnect 0n1y
c Temporary Services or Feeders
Installation, Alteration or Relocation
40.00
55.00
80.00
ee rrBrr aEove
not require specific
the following
tand use
D>rz-
A
2_Sum
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days.
2. C0IITRAC,T0R INST/ILL,ATION ONLY
Electrical Contractor
Address
ci Phone
Supervi.sor License Number
Expiration Drt"
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name
Address bso N--lt Zpv 3I
Ci ty Phone 1'11-51O7
O9NER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
0vners igna
DATE:
to 400 amps _to 600 amps _to 1000 amps_
B.
$so .00
.00
.00
.00
.00
.00
s60
$100
$130
s300
s40
200 amps"o-r Iess
201 amps to 400 amps _0ver 40L to 600 amps
Over 600 amps or 1000-6fEs
s
$
$
s
$
s
$
s
D. Branch Circuits
SUBTOTAL OF ABOVB
7% State Surcharge
3Z Administrative Fee
TOTAI
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Serviceor Feeder Permi t _4_ S 2.00 / L
Miscellaneous (Service/feeder not included)E
-Each installation
Pump or i.rrigation
Sign/OutIine Lighting-
Limited Energy/Res
-
40
40
20
36
.00
.00
.00
.00
&5
RECETVED B
ure:
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