HomeMy WebLinkAboutPermit Electrical 1999-12-15C;|TY OF OREGO'V
0
225 FIFTE STREET
SPRINGFTELD, oREGoN 9
INSPECTION REQI.IEST:
oFPICE: 726-3759 Authorized
1. LOCATI
a1 Pl
SPFrINGFIELO
PERHIT APPLICATION
City Job Nunber
FEE SCEEDT'LE BELOV
A. Nev sidential-Single orMulti-Family per dvelling unit.
Service Included:
Itens Cost
1"000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
$ 8s.00
$ 1s.00
$ 40.00
s300.s 40.
u -4s iJ
I.,EGAL DESCRTPTION
o,
JOB DESCRTPTION
Constr Contr. Number
Expiration Date O
Signature of Supervising Electrician
'<* ^)
Ovners Name ab
Address )')B I N a5lvo ) t
ciry €ZO-^1,*t Phone v>G'olI7u/'
OVNER TNSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vners Signature:
DATE:9
RECETVED
flffiffi:?"rjrur#,:;:,T:
E:,';,|,2:'W*CTRICAL471 Zoning
Srgnature
5
ON OF INSTALLATTON
Sum
t-
Permits are non-transferable and expireif vork is not started vithin 180 days Each Manuf,d Home,or
-of issuance or if vork is suspended for Modular Dvelling
180 davs. sertice or Feeder
2. cONTRAcr0R rNSTALLarr0N ONLY B. services or Feeders
1,.2-Ins ta11at ion, Alterations
Elec t r i ca 1 Con tr ac tor L 5 L ltCfZ,z_ *,_rt t".*llflfrhr ReI oca t i on :
Address P o Bo. &-.{9a'q 200 amps or less
20L amps to 400 amps
-401 amps to 600 amps
-
601 amps to 1000 amps-
over 1000 amps/volts
-
Reconnect 0n1y
Ci ty Phone ("PA */6 , q
Supervi-sor License Number aLl qZ S
Expiration Date -o
C
00
00
00
00
00
00
S so.
$ oo.
$100.
s130.
Temporary Services or FeedersInstalIation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Panel
200 amps"or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 voT[s see I'Brr a6m-
E
One Circuit IEach Addi tionalCircuit or vith Serviceor Feeder Permi t
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/Out1ine Lighting- $Limited Energy/Res
-
S
Limi ted Energy/Comm $
SUBTOTAL OF ABOVE
72 State Surcharge
32 Admini.strative Fee
TOTAT
$ 3s.00
$ 2.00
not
40.
40.
20.
36.
do
included )
00
00
00
00
5
Undcrlloor plurnbln g/ M cclr:rnical
- Prior to lnsulatlon or dccking,
Post and Bcanr - prlor to floorlnsulation or cJccklng.
Floor llrsulation - prior todccl<lng.
Sanitary Scvrcr - prior to Illlin0lrcnch.
|_l Storrrr Scwcr - l)rior Io Iiilin9.J trcnclt.
Watcr LInc - ptlor to lilling
lrench.
Rouglr Plurrrbirrg - prior to
covcr.
Curbcrrt & A;.1;.rro:rclr - nltcr(orms arc crccled bUt prior tol)laccrnclit O( concrclr:.
Sidcwalk & Drivov;ry - nlrcrcxcavatiorr is cornplc.tc, Iorrrrsan(l sul).basc lnalcriill irt plilco.
Fencc - Whcn con.lplotcd
Elcctrical Corrrrcctiorr - Wlrcnblockirrql, scl.up, anc/ pluntbing
lrt...;pcclion:; lrnvc bccn approvcdirnd tlrc ltorrrc is conncctecj totlrc scrvicc lrancl.
/,O
I--l woocJ Stovc - n f tcr lnstall;rlion.
3g-<o
MOBILE I.IOME INSPESTIONS
lnscrt - Aftcr flrcl.rlacc approvclano tnstallaIlon oI unll.
[l O]octring ancl Scr.Up - Wtrcn all
-
blocl(ln/.I is cornplctc.
Plrrnrbinp Conrrcctions - Whonlrotnc llrts bccn conrrcctcc, tow;tlcr iul(l scvr(,.r.
{itroot Trccs - Wl.lcn all rcqulrccllrccs arc plantcd.
Final - Altcr all rcquircdlltspcctions arc approvcd andporc.lrcs, $l(lrling, c,leclrs, andvcntlng havc bccn lnstailcc,.
4
)oft'q _
aq/
", t
-I
E
tl
t]
Lot (accs
Lot sq. ltg.
Lot coveraoo
Topography
Total lrolOht
Lol 'lypc
-
lntcrior''
___ Qgrncr
-
Panlrandlc
-
Cul-<lc-sac
S)c tl:acl<s
P.L.HSE GNR Acc
N
e
E
IS TI-IE PFIOI'OSE,D WORI( iN TI{E .
I.IISTORICAL DISTRICT. OR ON
TI{E I-IISTORICAL REGISTER?
-
It yes, this application must be slgncd
arrd approvcd by the Hlstorlcal
Coordinator prior lo pcrrnil issuancc.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrrlit is grarrlecJ on thc cxprcss concJitiorl tliat llre said
construction slrall, in all respects, conform to tlrc Ordinancc
adoptcd by thc City, oI Springticld, including thc
Dcvclopnrcnt Coclc, rcqyulating tl're construction and usc of
buildings, and mny l>c suspcrrdcd or rcvol<cd at any tlrne
upon violation oI lny provisions ol said ordinanccs.
Plan Checl< Fcc:
Datc l)aicJ
I-lcccipt Nurnbc
Rcccivcd By:
Plans RcvicwccJ uy Datc
Systerns Dcvclopmcnt Clrargc is duc on all undeveloped
propertics wi tlrin tlre City lirrrits wl'riclr are bclng lmprove<J.
ADDITIONAL COMMENTS
<, a.-6t- 7Qoo6,--t+-!
kwy;;;r )v-
0
By slgnature, I statc ancJ agrce, tlrat I lravS caretully examlnerJ
tltc complctcd application and do hcreby certl,y lhat all
lrtformatlon lrcrcorr is truc ancl correct, and I f urthcr ccrtify
that any and all v,,orl< pcrforn'rccl sl'rall be done in accordancc
with tlrc Ordinancr.ls ol'thr: City otSprirrgtlcld, arrcJ thc Laws
<lt tlre Statc ol OrcAon pcrlairring to tlrc worlr descrlbccJ
hcrcin, arrd Ilrat NO OCCUPT\l{CY will bc rrra<!e of any
struclurc r.villroul Jtcrrrrissiorr of llrc Buildlrrg Satcty Division.
I [urlhor certily tlrat ortly contractors and cnrployecs who
aro in cornpliancc.with OnS 701.055 wlll bo used on thls
pro jcc t.
I (ur'ther a0rec to cnsuic that :tll rccluirccl inspections arc
requcstcd lt thc prol)cr Iin]e, tltat caclr addrcss ls reacJablc
frorn thc strect, tltal tlre pcrntlt carcJ ls locatccJ at thc fronl
of llrc llropcrty,cl tlro a1:ltrovcd sct ol plans will remaln
o,l tlrc sitc ilt al
Slgnaturc
during corrstructlon'\
E//-u,teg
/ d-q .qq
Lv-^
Da tc
VALIDATION:
RECEIPT NUMBEI.'I
DA]'E PN ID 1
NfulOUNT RECEIVI..D
-4
-f,\t" <<f)
BUILDING PERMIT
ITEM SO. ':T. X S/SO. t:T.VALUE
(^)
Main
Carport
Garage
Total Valuc
Building Pcrnrit Fcc
Slale Surclrargc
Total Fcc
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fix tures
Rcsldcntial B0th(s)
Sanltary Scvrer
Water
Stofln Sowcr
Mobllc Hornc
FEE
Nr
!:I-__
(c)
PLUMBING PERMIT
Plurnblng Pcrmit
State Surcharoc
Total Clrargc
Wood Stovc/ lnscrt / [:lreplace'Urri I
Drycr Vcnt
MISCELLANEOUS PERMITS
Mobilc Honrc
Statc lssuancc
Statc Surcharoc
Sldcwall< --- tt
Curbcut
--
,t
Ocmolltlon
Stalo Surcharge
Total Mlscellaneous ['errnits (E)
6re
$.1"0
NoVcn t Farr
(D)
JS-r-{S
#ec--$
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
Mcclranical Portnit
lssuanco
Statc S(trclt:.trgc
Total Pcrrnll
TOTAL AMOUNT OUE (cxcluclin0 cleclricill)
(4, B, C, 0, and E Cottlt:incc!)RECEIVED BY _-..._-qM)
APPROVED:
l:'l:
FL__