HomeMy WebLinkAboutPermit Electrical 1990-11-26
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225 FIPTH STREET
. SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1 ~ LOftTf/7 OF INSTALLATIO'i,
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LEGAL DESCRIPTION
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JOB DESCRIPTION
Permits are non-transferable and expire
if work is not star.ted within 180 days
of issuance or if work is, suspended for
180 days.
2. CONTRACTOR INSTALLAT}fN ONLY .
Electrical Contractor f....f./uno Ids
~
Address
City
Phone
License Number &.fJ/ J-{S
Supervisor
Expiration Da'te In'/, <1 2-
Co~str Contr. Number ltJ{i ~q4
. , ,
Expiration Date G, 2--3. q /
Signature of Supervising Electrician
.- ~- A lllh"-t .
owners<;Jame V
Address
City Phone
OWER INSTALLATION.
The installation is being made on
property ,I own which is not intended
for. sale, lease or rent.
Ovners Signature:
---------------------- ---------
DATE: II, '::?€-~i!?
RECEIPT,: ' /k$'~ '3
RECEIVED BY:~_ ~ _,--
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ELECTRICAL PEiu!rr APPLICATION
City Job Number q () I ~ J' 0
3.
COHPLETE FEE ScnEDULE BELOV.
A.
New Residential-Single or.
Multi-Family per dwelling unit.
Service Included:
.~
1500 sq.ft. or less
Each additional 500
sq. ft or port~on
thereof ' . ,
Each Manuf'd Home or
Modular Dwelling
Service.or Feeder
Items
Cost
'Sum
$ 85.00
$ 15.00
$ 35.00
B. Services or Feeders (iO Branch Circuits
included). Installation, Alterations
or.Relocation:
100. amps or less
101 amps to 400 amps,
401 amps to 600 amps
. 601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
$ 60.00 /." ""
. $ 90.00.'~
$130.00.
. $300.00
, $ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to' 600 amps. $ 80.00
Over 600 amps or:l000 volts see "B" abov~
D. Branch Circuits
New; ~;teration or Extension Per Panel
One Circuit '
Two to ten Circuits
Each Addt'l ten or
portion thereof
$35.00
$.50.00
$ 15.00
E. Miscellaneous (Service/feeder not included)
-Each installation .
Pump or irrigation $ 36.00
Sign/Outline Lighting' $ 36.00
Signal Circuit or
limited energy panel_____ $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
,TOTAL
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IINSEcCTION LINE
726-3769
INFORllATION UNl
726-]75]
~~: ~;~: ~~~~S~: ~
Sq, Ftg. Other :r:')~ '-../
Ilew Add.(A1r.r Rep. _
t Ranqe -- --Fence Oemo__Change/Use ~ I'
' ~ Val'f)of-j;o~ I"Y'\ ~~ ...y
owner~~\lli\'UCl.f'\ \ ~\\\i)]'i'li1' .C'Y\)(,t ~:-V , /" - 4: ~. ~
Addro_55 . '^ '-I~f\ ~. .",l.I..ono BullGlnQ P~n1l1t Info: Descrlbe Work(1-e., BUlld Single lL\j
\-MYf~(\D~ '~ ~~\': F~\lV neSid\\\rlittached Garaoel \ On ill _ 10
Construction Lender \ '\\ 0fR"i''Q ~r~lfuh iiltfWJJt.
Address Phone ~I.
DESIGN nAr~ (name) (address) (lies. no.) (pxo;res) (I)hone no. \
Job Address I Lj' ~-)4 1'0 Qj) ,rYJ I O-;J!cU
Legal Description \1 DfJ,.q.CVd.6 CDI cO I
. CITY OF SPRINGFI ELD
COMBIIIATION APPLICATION/PERMIT
ElIERGY SOURCES:
Heat
Hater Heater
.
Primary
Structural
~
Electrical
Mechanical
:::::LT~~r\\\\~\\ 04- ?'-S~3h ~N (~\~~S~ Tj~M~ 'T~~;~
Plumbk, -fblHh\--5Lu\N\~\~ . '\ \.J IOIPiOI 01)4)
Electric~ 0 '\.. f~\n\r\ c::z I ,
,'Iechanick '~W W\ct~ ~~
PLUIIBI~
ELECTRICAL
MECHANICAL
....illh
FEE CHARr,F Nn
~rr r"ARGL NO
r'I- .c.HARliE.
3
Each single fixture
Residence of
~-~-
SQ. FT.
furnace/burner to
BTU's
Relocated building
(new fix. additional)
S.F. Residence
(1 bathl
Duplex (1 bath) each
New circuits alts.
or 'extensions
Floor furnace
and vent
SERVICES
Recessed wall
C;r');a,..". h",;,ot".. ;,on,.! ,....nto
I
I
I
I
I
I
Of .mps. I ~ ~4'9'##/~t ~;~ ":R,
&p<-"I,d~ ':::;;;~~5./.~,- ~/7/A( ~~~:
~ ~.!.' ~./A/~Af"~ ~ ~/.r. ~-"""5 /_~~ '/A~ :>
~ 7?h?/7" - 1/ I ISSUANCf OF PFR!llT
TOTAL CHARGES ;?~ ~ TOTAL CHARGES I TOTAL CHARGES
WHERE STATE LAW REQUIRES that ti,e Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division
Storm Sewer
Of
limps.
Appliance vent
seoaratp
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hood ilnd rJUl".t
Additional bath
Sewer
Temporary Construction
Change in existing
rpsjdenr:p,
multifamily, comm. or
Industri;tl
Water service
COMl,I. fIND. FEEDERS
Install/alter/relocate
rlic;.trih_ fppr:!pr"
Wood stove/heater
'.. :.
...... .
I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true
and correct, and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon pertaining to the work described herein. and that. fm OCCUPAIlCY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subco~tractors and employees who are in compliance with ORS 7nl.055 will be used on this project.
IlAI-lE(please print)~)/ i"'"". e.",/IIA.-C-:1~,
SIGII^TUR~2efL,t?~ --
DATE ;t)/~
BUILDING PERfIIT
Charges anC::
Surcharges
FOr. OFFICE USE OHLY
TYOe/const~ ~Ai'Ilnits Sq. Ftg. 11ain x Value
Bedrooms Occy load...LI~ Sq. FtlJ. Access x Value_
Stories , Occy Group 9- '2.... Sq, Ftg. Other~.C~F ~ Value ~,-~
\<613~ f\~1 AO TOTAL VALUATION
j""?fi L'"-. Plan Ck. ConmfInd \I() ~:2"::2.. Systems Development ~-'_. e>o
_ LK._~~____~/BlrloP,prrpp \ .rJ,) CharQe(J.5~)' '?/'-=:>.
~ Plan Ck. Res .
0. ~ 30%/BldQ Per Fee
':;:>~ ~e;:> Fence
___..dl__-_____
/. S-c::> Demo
:Sidewalk
Zone -'" /"
Fire Zone
Flood Plain
PLW1BING PERMIT
Cha rges and
Surcharges
ELECTRICAL PERI~IT
Cha rges and
Surcharge~ . : .......
IIECHAIIICAL PERMIT
Cha rges and
Su rc ha rge s
TOTAL
'2/P. 5"~
~B55"3'
. .......
'A/C Paving..,.....
..... . Tqt!.l :'Comb. - Perm; t
Curb Cut
'.........
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Applicant to furnish
. A. .... Job...Address ,
B,' .C.goLDescription
.' '1. 'example- 'Tax Lot 100, Lane County Map Reference
II 03 43
2. examele- Lot I. Block 3, 2nd Addition to
sprlngtie1d Estates
C. Name. etc. of owner and construction lender
D. Energy Sources . .
1. examEle- heat/electrical ceilinq/or forced air Qas
2. example- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. -
1. examo1e- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project. check-nfw - if addition.
check add, etc.
F. Building permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room
3. exa~]e - convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the.
Structural Specialty Code
H. DESIGN TEA/ol AND CONTRACTORS'
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules
have been abbreviated
2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL' FEES AND
CHARGES ON THE SCHEDULES
O. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is .not authorized.
to sign the electrical label. ---
Ill. Applicant to sign and.date
Whenever possible, the initial application will be used as
a worksheet only. Where possible. Building Division Staff
will prepare a type written copy and return it to the
applicant at the time 'the actual permit is issued for his
signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
~fees are paid. All other fees and charges are due and
~:.... ~ ~',R~y'able when the permit 'is issued.
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
):.
P~r~it applicant-e~empt from registration with the Buil~er's. ~oard because:
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. -Add.i:ti,onal ~roject.I~formi!,tjon:
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PLANS REVIEWED BY:
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signature ~~..-9 date //-2&>-51::=>
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