HomeMy WebLinkAboutPermit Electrical 2001-01-08Job# 01-00021-01
INDUSTRIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
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SPRINGFIELD
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 720 00035th St Spr
AssessorsMap#: 17023121
Lot: Block: Addition:
Job Number: 01-00021-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot #: 02600
Subdivision:
crrY oF SPRTNGFIELD, OREGON
Owner: Roger Hunter
Address: 2555 Hayden Bridge Rd
Scope Of Work: Electrical Only
Fire Alarm for sprinkler
Phone Number:
City/State/Zip:
Alteration
541-747-6178
Springfield, OR
Value: $O
Contractor Type
Electrical Contr
Contractor
RFI Communications & Securit
1010 Tyinn Street, Unit 6, Eugene, OR
97402
Registration # Expiration Date Phone
541 -345-681 6
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 call the 24 hour 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.
Required lnspections
Electrical
Low Voltage
Construction Types
Height (feet):
Proposed Units
Area (Sq.
Main:Tota!
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
# Of Stories:
Current Units:
Census Code: Does not apply
Restricted Energy
Accessory:
0110812001 4197 1 $36.00
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
Job# 01-00021-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
0110812001
01t08t2001
4197
4197
$2.52
$1.08
$39.60
Grand Tota!$3e.60
Signature Date
CITY OF SPR'A'GFIELD, OREGO'V
SPI ..iFIELE,
DEVELOPMENT senwce$no"{effi [,{$fi ftGct as submitted has the tollowing
eonlrrg and does not require sPecilic land use
approval 4,Zoning
225 FIFTH STBEET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-s689
225 FTTTE SI3.EET
SPRTNGFTELD, OREGoN
INSPECTTON REQTIBST:
OFPICE: 726-3759
725r''3d69rgnature
1 OF ON
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q
JOB
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. COIiITRACTOR INSTALI,A:TION ONLY
Co zr.rtrvatc
PERHIT APPLICATION
ty Job Nunber CLCA aFc I
3. COHPI,ETE FBE SCEEDUI,E BBLOS
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
s 8s.00L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Eome or
Hodular Dvelling
Service or Feeder
$ 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amps _401 amps to 600 amps _
601. amps to 1000 amps_
Over l-000 amps/volts
Reconnect 0n1y
c.Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 anps to 400 amps _
Over 401 to 500 amps
Over 600 amps or 1000
Branch Circuits
vorfs see rrB, aEove-
--o
Sum
Electr
Addres
Ci ty
ical Contractor
s ()
c-ra ln t
u
#'r
1 LE
tr Yn,".7t {-Lf/ b
$ s0.00
$ 60.00
$100.00
$130. 00
s300.00
$ 40.00Supervisor License Number
Expiration Date
constr contr. Number b
Expiration Date 0
Signature of Supervising Electrician
0vners Name Pt-
Address 29s{ru Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.00
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utline Lighting_
Limited Energy/Res
Limited Energy/Comm -V-
SUBTOTAL OF ABOVE
7%, State Surcharge
32 Administrative Fee
TOTAL
$ 40.00
$ ss.00
$ 80.00
D
L
Ci ty Phone
OITNER INSTALLATION il,.7q7- b/
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Signa
q
$ 40.00
$ 40.00
$ 20.00
$ 36.00
05
DATE:
RECEIVED EY:
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