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HomeMy WebLinkAboutPermit Electrical 1997-11-21 . DEvaOPMENTSERWCESDE~RTMENT 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION 3..:>..:>Cj ('~-,WI~~ S+ LEGAL DESCRIPTION 1702..31 Z-I o1.o-oe JOB DE~CRIPTION / . . (z ') 2eo IJw.f '> e- 26 c..., rc..V\.-;:4-s -- I Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor 't)"tttlf ~lP~ Address LlO '54 sr~ ld. 'SOD....... ~tl-4iJ--" Phone '7tl1-l77.tt. LIlliS Lo .. 0 , -0 I "f...D -lj lfU City Supervisor License Number ~,. Expiration Date ConstrContr. Number Expiration Date I 0 ~t'}l -0 I . . . Si~~ture of Supe~ing Ele rician ,( [) VJJl..J \ => \ - - ers . Name k-t /~ C-Ie-t; L Address J 7 SS-l> J-I,'-//5 Cret:f ~. Ci ty spr';71 '~tJ Phone 7l1b' S~ZO , ) OWER INSTALLATION D. The installation is being made on, pioperty I own which is pot intended for sale, lease or rent; E. Owners Signature: --------------------------------------- 5~ DATE: ' RECEIPT #: RECEIVED BY: . SPRINGFIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 ELECTRICAL PERKIT APPLICATION, Ci ty Job Number 01-:00373.- 0 ( 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq. ft. or less. Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 t B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less , .:, 2.- 201 amps to 400 amps ,; 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 ICSO $ 60.00 . $100.00 $130.00 $300.00. $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 .amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000. $ 40.00 $ 55.00 '$ 80.00 volts see"B" above Branch Circuits New, Alteration or Extension Per Panel. One Circuit $ 35.00 Each Additional Circuit or with Service or Feeder Permit 2,-0 $ 2.00 L/D ," Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE . 7% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ /'10, ~5'f~ 40 . 00 ' 40.00 20.00 36.00 , PLAN REVIEW COMMENTS I SPECIAL INSTRUCTIONS:. '. . 'RESTORATlON WORK SHALL BE IN CO"'MANCE WITH EXISTING CITY CODES AN.dbMPUANCE WITH CURRENT STANDARD SPECIFIOATIONS, EXOEPT~OTED BELOW. ,'" C 001 Backfill With ." mlnul rock. _ 002 Compact .v.ry ~ S" 100.. d.pth. __ 003 Raqulr.. comp.ctlon with a Itltl rolllar. _ 004 A.C. to match the greatar of .xlltlng d.pth or 4". .. 006 AU cutl ..al.d for f1nallnap.oilon. _ 008. T.mporary p.tch m.y b. u..d .t the .nd of the day. 007 Signing and Zoni protection to comply with MUTCO 008 Cut concrete only on scora IIn.. or. cold Joints. 009 Sldaw.lks .nd drlvaWaYI mln. 3.000psl. 010 Curbing mln 3.600pall No patchwork lass than 3'. 011 Me'at min. r.qulrem.ntl on curb cutl. Spfd. cod.. 012 Rlltor. plant.d,areas, Spfd. cod. 208.3.05 013 Sp.c. to Bor. I Jack I No A.C. cuts. 014 Mechanical compacting r.qulrad. 016 No patchwork allow.d. 018 Lat.ral cut. to have control d.nllty fill. 017 Cuta to b. polym.rlzed crack ..alad for final Inspection. .018 Mlnlnum 2" cruahed rock ." mlnua. - 018 020 021 022, 023 024 026 028 027 028 029 030 031 032 933 343 Comments: , ,-'-;". ~ ~_: ,'t~. ,. Mlnumum 4' clllranca at any point. Iwlng.away. Concr.t. minimum 4" d.pth, 3,OOOpal. Trench to b. "T" cut. Neada Stata I County parmlt. No .bov. ground .ncloalng. In sldawalk or handicap ramps. Dlemond cut A.C./Concrete value box.. to grade. Frllh 011 slgnl I Gradad. Comply with Americans with Olaebllltlll Act. Concrate slab.. 72hra. curing time, 4600psl. Concrete slab. require Joint seal m.tarlal. Driveway require. dow.ls .very 1 S". Submit traffic control plan prior to excavation. Notify Tr.fflc Division bafore .xcavatipn. Cor. drill main I1n.. Inllrt tee, 2% min. grade. Must comply with the provisions of ORS 767.641 to 767.671. 6" Circular hole/H2().Vac. . . t, . ' YOU ARE REQUIRED TO CALL THE lANE UTiliTIES COORDINATING COUNCil'S "ONE CAll NUMBER" 1-800-332-2344 48 HOURS BEFORE DIGGING I INSPECTIONS: '0 CURB CUT AND SIDEWALK INSPECTIONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB NUMBER/PERMIT NUMBER. JOB ADDRESS, TYPE OF INSPECTION REQUESTED, AND WHEN YOU WILL BE READY FOR INSPECTION, CONTRACTOR'S OR OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A.M. WILL BE MADE THE SAME DAY, REQUESTS AFTER 7:00 A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED IN AFTER EXCAVATIONS ARE MADE AND FORM WO~K IS IN PLACE BUT PRIOR TO POURING CONCRETE. o SANITARY SEWER, STORM SEWER, ENCROACHMENT PERMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT 726-3761. SIGNATURE: .' AMOUNT RECEIVED: ~ ~/. ~ RECEIPT NO: -:z &"'~& 55 . " DATE PAID: RECEIVED BY: ,.. /r7/"~'? /z~~_j~~ /~- r By signature, I. state and agree( that I have carefully examined the completed application and do hereby certify that all information herein Is true and correct, and I further certify that any and all work performed shall be done In accordance With the Ordinances of the City of Springfield, applicable City Standard specifications and Drawings hand the laws Qf the State of OrejJon pertaining to the work described herein. I further certify that only contractors and employees w 0 are In compliance with ORS 7U1.055 will be used on this , project. The City may InsJ:)ect the work site described In this J:!ermlt at :any time during a one year period following the receipt QY the City of notice of, completion of the described work and ,pe~fy, at th$ City's sole delloresslon, any additional restoration work re~uired to , return the ,Ite to a standard acceptable to the City. Tlie p,rmltte, will be notified In writing of any work required and will have thirty , days (30) from the d~tQ ofbthe notice to cOfTlplete the work. Work not completed at the anet of the thirty days will be performed by the . ' City and the costs will be l\Iled to the permittee, ' I furthor agree to ensure that all required Inspections are requ&ted at the proper time, that project address Is readable from the street. and the approved set of plans will remain on the site at all times during construction. , Slg:a~ ~" oat.' Itl2.d'!7 . ~ VALIDATION: 0 TRAFFIC REVIEWED BY: DATE: 0 ENGINEERING ,REVIEWED BY: I, DATE: 0 MAINTENANCE: DATE: 0 PERMIT ISSUED BY; DATE: " : FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER. INSPECTION: t :, INSPECTION: , WORK IN PROGRESS . . AT TIME OF COMPLETION: ELEVENTH MONTH: DEPOSIT RETURNED: DATE: DATE: DATE: DATE: . DATE: DATE: .' i