HomeMy WebLinkAboutPermit Building 2000-02-25Job# 99-00704-01 Paoe 1 ol2- TRANSS:01-0000?21
DATE:FEE 25 2OOCI
At{T RE[D:2 $ ?6.?5
EHANGE:
CASHIER:059
lsPFIiI(iFIELD
GOMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1345 00011th St Spr
AssessorsMap#: 17032644
Lot: Block: Addition
Job Number: 99-00704-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 05100
Subdivision:
ctrY oF SPR|NGF|ELD, OREGON
Owner: Nick Roehl
Address: 3205 Western Drive
Scope Of Work: Apartment
Phone Number:
City/State/Zip:
Remodel
541-344-0183
Eugene, OR
Value: $O
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
1 RNW
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 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 lnspections
Transfered Records
Rough Electrical
Progressive
Final Electrical
Gonstruction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(sq.
Main:
-Prior to cover,
-\A/hen all electrical work is complete.
# Of Stories: Height (feet):
Gurrent Units: Proposed Units:
Census Code: Does not apply
Accessory Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical Permit
Total Transfered Records
$53.00
$53.00
05t24t1999 34159 53
Job# 99-00704-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Electrical
Renew Permit - Electrical
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
02t25t200a
02t25t2000
42t25t2004
721
721
721
27 $26.75
$.00
$.00
$26.75
Grand Total $79"75
rAu
Date
a -t IC'TY OF SPR
SPFUTDIGFIELE
tile
lanO use
r less
One Circuit
Each Additional
-Each installation
Pump or irrigation
-
Sign/Outline Lighting-
Limited EnergY/Res
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAI
q q 0?0LlDate
225 FIFTE STREET
SPRINGFTELD, oREGoN 97 4',lythorized
INSPECf,I0N REQUESTz 726-3769
OFPfCE: 726-3759
1.ON OF
*",fi #',:'JJTj itift ,:#;:
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. CONTRACTOR INSTALI..ATTON ONLY
Ovners Name
Address 0
Ci
(,rcnt-
P hone 34y''o/F3T-
INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
0rners Signature:
DATE:
qq PERI{IT APPLICATION
Ci ty Job Number
3. COI{PI,ETE PEE SCMDTILE BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost Sum
$ 8s.00
lou
Servi
Services or Feed
in"t.tt"tion, A1
or Relocation:
terat ions
Zoning fl,
signature
ffiwve
B
Electrical Contractor
Address E
Ci ty Pnone b
Supervisor License Number (.7 3-s 0ver
Expiration Date l0-/-Dl
C
constr contr. Number I O..1 (t
lo Ll
Expiration Date
rvices or F
A1 terat ion t ion
D. Branch Circuits
Nev, Alteration or Extension Per Panel
00
00
50
60
200
20
40
$
s
s/ru
$ 3s.oo
'LA)g 2.oo lfua
SigpEture of Supervising Electrician
II
d)-..h'^,n-' f, --/'r^--='-Li
200 amps"or ]ess $ 40.00
over 4b1 to 600 amps
-
$ 80.00
0ver 600 amps or fbOO vofts see uBu a6ive-
OVNER
72- 39b/Circuit or vith Servicq
or Feeder Permi t Ll
E. Miscellaneous (Service/feeder not included)
$ 40.00
s 40.00
$ 20.00
$ 36.00
5
RBCBTVED
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