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Home My WebLink AboutPermit Electrical 1996-05-08B Pr lnspectlonst 726.3769 Oflloel 720.3759 JoF DESCRI tri,yt{- &OC ESIDENTIAL ERMIT APPLICATION SPRI ,IELD JoBNuMBEa fuW' 225 Flfrh stro€t Sprlnglleld, Oregon 97 471 225 FIFTH STREET SPRINGFTELD, OREGON 97477 fNSPECTION REQUESTz 726- OFPICE: 726-3759 5+la 3769 :i .-\]GFIELO /vo1 ts in LsCL 1. LOCATION OF TNSTATLATTON ELE TRTCAI PERHTT APPLICATTON Ci ty Job Nrrmber 3. COHPLETE FEE SCEEDTILE BELOS Nev Residential-Single or Hulti-Family per dvell-ing unit Service Included: I tems 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Modular Dvelling Service or Feeder Cos t s 8s.00 's 1s.00 s 40.00 A Sum PlION - -Lrn-m 0r{*r Permits are non-transferable and expire if vork is not started vithin L80 days of issuance or if uork is suspended for 180 days. 2. CONTRACTOR INSTALI^ATTON ONLY El-ectrical Contractor Address Ci ty Phone r/41 -,.31^ Supervisor cense Number l(.8bS Expiration Date t0 -l*q9 Constr Contr. number 03849 ExpirationDate 1-l-Qb Signature of Supervising Electrician Services or Feeders Installation, Alterations or Relocation: B C 200 amps or 201 amps to 40L amps to 601 amps to Over 1000 Reconnec t less 600 amps L000 amps amps 0n1y s s0.00. s 60.00 $100.00 s130. 00 $300.00 s 40.00 ovners ll"n" POI r 0 ,rUl aaaress X443 Yl , 35-Ll,u't Temporary Services or Feeders Instal-Iation, Alteration or Relocation 200 amps''or less $ 40.00 201 amps to 400 amps - $ 55.00 over 40L to 600 amps - S 80.00 Over 600 amps or 1000-tolTs see rrBrr ame D. Branch Circui ts Nev, Alteration or Extension Per Panel c Ci ty Phonerl4b-31OS OVNER ALLATTON The instal-lation is being made on property I ovn vhich is not intended for sale, lease or rent. 0rrners Signature: DATE: RECETVED oneCircuit I $35.00 35=qoEach Addi tional Circuit or vith Serviceor Feeder Permit S 2.00 a E. MiscelLaneous (Service/feeder not included) -Each i.nstallation Pump or irrigation Sign/Outline Lighting- Limited Energy/Res Limited Energy/Comm s 40.00 s 40.00 s 20.00 s 36.00 5 SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.strative Fee TOTAL 35"oo , .45i,o5 3rl, t o |J trench.- Slorm Sewer - Prlor lo lllllng trench. Water Llne - Prlor to fllllng lrench, Rough Plumblng - Prlor to cover, l-l Sldewalk & Drlveway - AfterH excavallon ls complolo, lorms and eub.base materlal ln place, Eleclrlcal Connecllon - When blocklng, sel.up, and plurpblng lnspecllons havo boon approvod and the homo ls connecled to the servlce panel, Fence - When completed Slreet Trees - When all requlred treeE aro planted. I t., tl l--l ftnal - After atl requlred.J lnspecllons are approved and porchos, sklrtlng, decks, and ventlng have been lnstalled,E Lot Typo - lnterlor - Corner - Panhandle - Cul-de-sac ,.',, i.Fr,,.l. Lot faceg Lot sq. ftg. Lot coverage Topography Total [elght ks ( ts rxr PFroPosED woBK tN THE - ' " HrsroBlcAL DlsTRlgr, oF oN,.THE HISTORICAL REGISTER? lf yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordlnalor prlor lo pormlt lssuance, APPBOVED: P.L.HSE GAR ACC: N S W E VALUE (A) x $/so. FT, Tolal Value Bulldlng Permlt Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. fv.l aln Galage Carporl BUILDING VALUE, PLAN CHECK,AND BUILDING PERMIT Thls permlt ls granted on the express condltlon that the sald constructlon shall, ln all respects, conform to the Ordlnance adopted by the Clty . of Sprlngf leld, lncludlng the Development Code, regulatlng the constructlon and use ol bulldlngs, and may be suspended or revoked at any llmo upon vlolatlon of any provlslons of sald ordlnances. Flecelpt Number:- Plans Date Plan Gheck Fee Date Pald: Recelved By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls due on all undeveloped propertles wlthln tho Clly llmlts whlch are belng lmproved. ITEM Flxturest Resldenttai Bath(s) Sanliary Sewer Water Slorm Sewer Moblle Home No FEE FT. (c) PLUMBING PERMIT Plumblng Permll Stale. Surcharge Total Charge ADDITIONAL COMMENTS MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan No Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent l-- ---/2-:.'rj )7r 76.2e(D) Ba_ Mechanlcal Permlt lssuahce State Surcharge Total Permll By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby certlly that all lnformatlon hereon ls true and correct, and I f urther cerilly that any and all work performed shall be done ln accordance wlth the Ordlnances of tho Clty of Sprlngfleld, and the Laws of lhe State of Oregon pertalnlng lo tho work descrlbed hereln, and that NO OCCUPANCy wlll be made of any structure wlthout permlsslon of the Bulldlng Safety Dlvlslon. I further certlfy that only contractors and employees who are ln compllance wlth ORS 7O1.OSS wlll be used on thlsprolect. I further agreo to ensurs thal all requlred lnspecilons are requested at the proper ilme, that each address ls readable from lhe street, that the permlt card ls located al lhe front ol the property, and the approved set of plans wlll remaln Slgnature .( Date on the slte at all tlm durlng constructlon. MISCELLANEOUS PERMITS Mobllo Home Slate lssuance Slale Surcharge Sldewalk -_- lt Curbcut "__- ft Demollllon Slate Surcharge Total Mlecollaneous pernrlts (E) TOTAL AMOUNT DUE (exctudtng etectrtcat) (A, B, C, Q and E Comblned) VALIDATION: RECEIPTNUMBER 2 -28 . ?.o ?DATE PAID AMOUNT RECEIVED RECEIVED BY /. FT. FT.