HomeMy WebLinkAboutPermit Electrical 1993-2-1
T\"w, following ?roject ;;\3 Sl!,bmilIO!\~:" H,~ \':.1:1-..,\..:1 ~,A".
zomng, and does not requITe $P~C.1IC ICfld uca ~...w
225 FIFTH ~TREET approval. D ELECTRICAL PERMIT APPLICATION
Sl'lUtlGFIELIJ, OItF.GON 97/,77 Zcnino L.D IL f)
INSPECTION REQUI~ST: 726-3769 ~_ \ -43' City Job Number ~5G /-f-bt
OFPICF.: 726-3759 DaleS" a flO\lO
Aull1olizod Signature-=-a.. COMPLETE I'lm' SCnEDULE BELOV ~ 10
1. LOCApON OF INSTALLATION ~
~4- YY\(+A..ll..LS..h (1+ A. Ne" Residential-Single or b-
Hulti-Family per dwelling ~
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JOB DESCRIPTION
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Permits are non-transferable and expire
if "ork is not started "ithin 180 days
of issuance or if "ork is suspended for
180 days.
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2. COm'RACTOR INSTALLATION ONLY
Electrical Contractor(lJ::: ~~nll-r,u{ll~'
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Add ress )\1-->
Ci ty Phone 14, -1-.J..Bfo
Supervisor Number _li?Z 10::;
Expiration Date
Constr Contr. Number D8'2Jq
Expiration Date q -I-q S
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Signature of Supervising F.lectrician
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, ~ne;s Name 4')1)(1.1\000 '~J.\mJ
A(ldress Iq8~ rnr.fllt,{i1h J C't.
Ci ty",JptU ~~Od l Phone 146 -1-.'6$0
OVNF.R INS'YALLATION
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The installation is being made on
property I o"n "hich is not intended
for sale, lease or rent.
O"ners Signature:
-~-------------------------------------
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DATE:
RECEII'l' ft:
HECEIVEll ny:
SI.I'IN(,;t:I~LU
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular D"elling
Service or Feeder
$ 65.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
n.
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201' amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
$ 60.00
volts see "B" above
Ne". Alteration or Extension Per Panel
One Ci,rcui t
Each Additional
Circuit or "ith Service
or Feeder Permit
$ 35.00~:1flO
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
P~mp or irrigation $ 40.00
Sign/Outline Lighting- $ 40.00
Limited Energy/Res $,20.00
Limi ted Energy/Comm' $ 36.00
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAl.
3'5,00
I. '1,5
~1.C;
Lot faccs
Lot Typo .
Lot sq. ftg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cui-dc-sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT,
Main
Garage
Carport
Total Value
Building Permil Fcc
Stale Surcharge
Total Fcc
(A)
Setb,cks
I P.L. I HSE GAR I ACC
IN
Is
ATHE PROPOSED WORK IN'THE
~STORICAl DISTRICT, OR ON . .
THE HISTORICAL REGISTER?
II yes, Ihis application must be signed
and approved by Ihe Historical
Coordinator prior to permit issuance.
W
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APPROVED'
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Stale Surcharge
Tolal Chmge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood SlovellnsertlFireplace Unit
Dryer Venl
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuancc
Stale Surcharge
Sidewalk
It
CurbcuI
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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/(') .0 C>
./5
~ C, {S;'
~C;jc:::7
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
constructlon shall,.in all respects, conform to the Ordinance
adopted by tho' Cify of Springfield. including tho
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any provisions of said ordinances.
Plan Check Fcc'
Date Paid:
Receipt Number'
Receivcd By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the Cily limits which arc being improved.
ADDITIONAL COMMENTS
rrhr'./. '~'/W\;-L r~c;CJ.LAA.Pr~
By signature, I state and agrce. that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I furl her certify
that any and all work performed shall be done in accordance
with the Ordi':lanccs of the City of Springfield. and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections arc
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will rcmaln
on the site at all jJcS;rlng cons uclion.
SlgnatUJ ~7
Datp I Jf~."
VALIDATION:
RECEIPT NUMBER
DATE PAID
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IJa.,,/0i3
;),<;. jS
,gp.,
AMOUNT RECEIVE!'
REeEIVED BY
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RESIDEf'JTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ofiice: 726.3759
lOCATION OF PROPOSED WORI"
ASSESSORS MAP'
LOT'
OWNER:
ADDRESS:
CITY'
.
SPRINGFIELD
,q 8~
BLOCK'
STATf'
DR-
DESCRIBE WORK: \ liST' A \...\... \~6-A- y
NEW REMODEL 0/ ADDITtON
CONTRACTOR'S NAME
CENERAI'
fl ~ \{\\l
DEMOLISH
OTHER
-fg.;{ CJO
.
0301/()
JOB NUMBER
225 Fifth Slreet
Springfleld,Oregon 97477
O~ I()(')
TAX lOT'
SUBDIVISION: 1 tJcJ.,\",.I~
PHONF'
'7 tf/.p - ;U? 5 {J
ZIP:
Q1t.J17
A
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ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
I'LUMBINC: _,."_
MECIIANICAL:0,D\f\\'.{)'c'\ \:-\'\)\0 \\~\-'\\\Cj ~S5 W. \s,+-.c::u.q<i?/.)71c;l. 'DOl./-t.oD
ELECTRICAL:
IQt--;,7q--;-iw- -Ii' 10 I
- OFFICE USE -
~UAD AREA' lAND USF' FLOOD PLAIN'
. OF I3LDCS: . OF UNITS' ZONING CODE:
oecyenoul': eONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SOUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. 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 work day.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Undcrslab Plumblngl Electrical/
Mechanical - Prior to cover.
o Footing - After trenches arc
excavated.
o
Masonry - St.eel location, bond
beams, grouting.
1--' Foundation - After forms arc
erected but .prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/ Mechanical
_ PrIor to i.nsulatlon or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking,
o
Sanitary Sewer - Prior to filling
trench,
o
Storm Sewer - Prior to filling
trench.
O Water Line - Prior to fl/llng
trcncll.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSP,ECTIONS
o Rough Mechanical - Prior to
cover. i
[2SfROUgh Electrical - Prior to
cover. I
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - PrIor to facing
materials and traml~g Insp.
o Framing - Prior to. cover.
o Wall/Ceiling Insulat,ion - Prior to
cover. I .
o Drywall'- Prior to taping.
o Wood Stove - After Installation.
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o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Aller
forms are erected but prior to
placement of concrete.
I
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Fenco - When complctccL
o
Stroot Trees - When all required
trees are planted. '
o Final Plumbing - When all
plumbing work Is complete.
~inal Electrical - When all
electrical work is complete.
~ Final Mechanical - When all
mechanical work Is complete.
o Final Building......;. When all
required inspections have !Jeen
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set:Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.