Loading...
HomeMy WebLinkAboutPermit Electrical 1998-8-21 :. - ' . ZonInp , () 225 FIITH STREET o-X"J11/1^ SPRINGFIELD, OREGON 97477 f. f\ INSPECTION REQUEST: 726-3769AulholVad~-U..h1 OFFICE: 726-3759 ~ U "7 ' ::>P~ l"'\C~& COMPLETE FEE SCHEDULE BELOII 1. LOCATION OF INS ALLATION . ~~~~~) .-::}-:2,/')5 /v\kl.l0 S-tRt:-C! A. Ne" Residential-Single or Multi-Family per d"elling unit. Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion Permits are non-transferable and expire thereof if "ork is not started "ithin 180 days Each Manuf'd 'Home or of issuance or if "ork is suspended for Modular D"elling 180 days. NOTICE: Service or Feeder 2. CONTRACTOR INSTALLATION 0N\:J\6 PERMIT SHIlll E~HEiIESSifOWOOl€'ders ~~ ED UNDER "fl-I1~~'!Ir~SINotl terations Electrical Contractor ~~~ '~ or Relo~atlon: .'il j'':;''1J OR IS ABANDONED FOR Address ,l"Z-l0 QAd,c.'PA.TCtiNv . ~v PERIOD. 200 amps or less $ 50.00 4 ~- 201 amps to 400 amps $ 60.00 Ci ty /2..U&t::~ Phone BS~tbTI7 401 amps to, 600 amps $100.00 601 amps to 1000 amps $130.00 Supervisor License Number -ZO.;;255CLS Over 1000 amps/volts $300.00 ^ _ 1- n. Q. ATTOOR5\ll:t5r~91!>P,ta:w requiree l,n,"" $ 40.00 Expiration Date Iv -, () ~1I0.1esad~te~~theOrei~~~n Constr Contr. Number Ill'2g{o ~otific 'hme~~ \1'1 R.~~atl~ ~ '~elocation In OAR -Bo;- tl1 tnrou~F. u, tt::>~-6'ul- ;:2..( d- ( 0'1 0090. ~~nwprst>\5ljn ~~es of the rules bY$ 40.00 calli!!91h~m~!lt8(0(f'YRltr ~1~...I.v..v $ 55.00 numWei.lrItOOO~qro\:lti~~ ,;;;v",;;vn $ 80.00 o~en'61!l031nl!p!l-:m;!-:t . volts see "B" above , JOB QESCRIPTION~lA ",.n'ALOlf'l',/ tL.Lut14.l AJ A'rEJ') I-V IV lJ JVI.{...VL T ~ 1:::'1'.1 Expiration Date Signature ~perviSing Electrician f' .A.J/'o .:: ....:Jruf).J O"ners Name W~tJ ~rnomAL D. Address 'fo \3) x. '2-'3'2-~5 Ci ty tZ'U~ Phone '3+1.-- c:zs ~ I O\INER INSTALLATION The installation is being made on property I o"n "hich is not intended for sale, lease or rent. Owners Signature: --------------t---r.-------------------- DATE: X 2/1'i' r :..3 RECEIPT 11: I . () V 1(, / / ' RECEIVED BY: oJ t.J ELECTRICAL PERMI7\APPLICATION r.i tv Job Number "'\ ID \ G 0 Items Cost Sum $ 85.00 $ 15.00 $ 40.00 Branch Circuits Ne", Alteration or Extension Per Panel One Circuit Each Additional Circuit or "ith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 40- Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 'TO- 5% State Surcharge 2,- 3% Administrative Fee ~.~ TOTAL '-13. '2.0 SIGN 'PERMIT APPLlCATIO. 225 Fifth Street Springfield. OR 97477 SPRINGFIELD JOB.BER qXtXa?3 . Inspection Line: 726.3769 Office: 726.3759 CITY: STATE: q,-P/ZI f0&t==-L~D TAX LOT: /J."'l,CrJ _i4il IlJ [ PH9NE: ~l- 02 g I I 0YL. ZIP: C11401- fvUaU.0le.. Ikt.-- rdA ~ s SITE ADDRESS: ASSESSORS MAP: ADDRESS: BUSINESS NAME, FIRM nc,: DESCRIPTION OF PROPOSED SIGN(S): (please check and complete all appropriate information) Wall ~ Freestanding _ Projecting Roof _ Single Face __ Double Face _ Billboard Other Square Footage: ~ ~.~ Total Height above Grade: ~ ~ I 10 l\ _ Marquee List ALL eyisting signage and attach a photograph of oach sign: \Q ~ ~~ (aj Type C~btt..:& Sq. Ftg. ~Wm....y"b) Type ,,~ \. / Sq. Ftg, (cl Type Sq. Ftg. (d) Type Sq, Ftg. ADDRESS: v..s~ A ~ , 1.1~lO ()AKf'kTCl-\ \{.b, ~U~ 4rJ '" ,..,.. A I PHONE: V'GI ................1..0 CONTRACTOR/lNST ALLER: CITY: STATE: 0Y2- ZIP: 0(14OL- EXPIRES:~ EXPIRES: to f 30 I q 8 CONSTRUCTION CONTRACTORS REGISTRATION NUMBER: 4so3Q1- - \ A iD.~, Sign DistrictlliD~f'_, (\f\\\~J~~nd u~e: ~ill ') Ouad Area: ~\~./ Zoning: 9\ () Code Section: ~ . QJ rf)_ 4r\ ~ Approved BY; UlJ7\ \ ( rh\t~ ;eAATE: A, IR ~ _ - _;n. rr - ---;- '~ . '\ ' It L'Z-bltJ CITY BUSINESS LICENSE NUMBER: OFFICE USE Sign Permit Fee: REOUIRED INSPECTIONS: Site ~ting Attachment ~nal to be made prior prior to placement after fasteners are to sign placement of concrete installed/prior to cover , \ Addition.1 Comments and/or Conditions:! (), 'It \ ~ ~C\''t(f; : , By Signature, I 5tate and \gree. that I have carefully examined the completed ap ic ion and do hereby c~tifY that all inlormation hereir is true and correct. and I further certify that any and all work performed shan be one in accordance with the Ordinances of the City 0 Springfield. and the Laws of the State of Oregon pertaining to the work described herein, 1 further certify that only contractors an employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all reQuired inspections are reQuested at the proper time. that project address. is readable from the street, th. the permit card is located at the front of the property. and the approved set 01 plans will remain on the site at all times durinu the installatio of the sign(sl. ' Signature .i2hO.A~~Q1M-: / I2StA.;:WC.'Date ,--- l) U ~-,e('{'L C~2- Amount Received: ,l ?J . W Date Paid: Receipt Number: tJ '7/1 (p / shC\\q'2, '8/'2./ ir'l /J VtJ"J! Validation: Received By: