HomeMy WebLinkAboutPermit Electrical 1998-9-4
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Dale NOTICE:
225 n~~uraJlM ~t:HMIT'SHALL EXPIR .ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 AUTHORIZED UN E IF tHE WORK .
INSPECTION REQUEST: 726-37690MMENCItD OER THIS PERAfJtP.r~tif> Number t:t f It /2-
OFFICE: 726-3759 ORISABANOONt=n - . )f
- ANY jail f)Il,y PEAl&; CO!fPI:ETfOREE SCHEDULE BELOIl .
1. LOCJl.TION OF INSTALI4TION' .
b ~ (, /J1/.J-/ /....../ S-fL- . A. New Residential-Single or .-
Multi-Family per dwelling unit. .
LEGAL DESCRIPTION Service Included:
/1b'l,?- 2 13 N'J-OiJ Items Cost Sum
JOB DESCRIPTION
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~S... f::'1~t
Address --;5'22-3. ~ ~
City ~E71e Phone fMif'tAR5"
,
Supervisor License Number ,_'\Xb3S
Expiration Date /C>Jt:?-1i"
Constr Contr. Number ;?Jt7/0Sc(I?
Expiration Date
/2../98
Owner~signature:
"
--------------1-1----------------------
DATE: <j I.( 7Y II
RECEIPT 1I:, 0.3./ y "[, I..L.-
RECEIVED BY: tN~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular. 'Dwelling'
Service or Feeder
.B.
Services or Feeders
Installation, Alterations
or Relocation:
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
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
200 amps' 'OT less
201 amps to 400 amps
Signa.tu ./?re.:~uper~i~~~ Electrician Over 401 to 600 amps
~.~~ Over 600 amps or 1000 volts
lI/1n 1I;/....JL)rf\otn~ D. Branch Circuits
owne~s NameJ:JJ::jf..dJ) ~
Address~ 1-~ ~() New, ~lte~ation or Exten;ion
.J - ("' ^'\ ~ One CHCUlt -L $ 35.00
Ci ty ~ '\l1\ ~ 'S~~~~ION:Oregon law requiresant!oAddi tional
/..F1eoo I '.?W I.u,"'" <tUUfJl"U uy lJle Oregon<I:iitit;ui t or wi th Service
01lNER iNSTALt..AT~'rcallon Center. Those rules are Slltl~~der Permi t
tnvtlAR 952-001-0010 through OAR 952-001- . ,
The installation isoBg~ngoh\B.'\!W elltain copies <fl4hett~rt.'6waneous (Service! feeder not included)
property I own which fs"If/Gih'iliefllatelNote: theieleptfumP installation
for sale. lease or rt!1lrll1ber for the Oregon Utility Notifl1!Mllll?or irrigation
Center is 1-800-332-2344). Sign Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$ 40.00
$ 55.00
$ 80.00
see "B" above
.'
Per Panel
p"c..
$ 2.00
$ 40.00
$ 40.00
$ 20.00
$ 36,00
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ADDRESS: 2 2 '2. ~/~
k /4 #1 A. -T'..p
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SPRINGFIELD
WiL~
/I1.4/I/hLtJ
BLOCK:
/./-J ofp bit ^ tvA'
EJL/.:t? 1<:, I V
t:4/lr .
DESCRIBE WORK: b~tI ~Nl-;"( ~ {) """
REMODEL' I ADDITION
OWNER'
CITY:
NEW
CONTRACTOR'S NAME
IJ IJ N-f' PI-,
r
I
/
/
/
GENERA' .
PLUMBING'
MECHANICA' '
ELECTRICA' .
STATF' .
D/L
tp
JOB NUMBER tfg. / / J 7_
DEMOLISH
, ,. OTHER
'225 Fifth Street
Springfield, Oregon 97477'
TAX LOT: ---'-4' LOo
SUBDIVISION'
~- ~~ .
.~
PHONE: _
ZIP:
4'7;;' 0)
,
. CONST.
ADDRESS ' CONTRACTOR'
o Rough Mechanical - Prior to
cover. .'
D Rough Electrical - PrIor to
cover. , "
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Flrepl~ce - Prior to facing
materials and framing Insp.
Framing - Prior to cover.
, .0 waIl/C~lnSUlatlOn' - Prior to ' '
--.:: c~ver. :~ ." .
~t'1I - PrIor to taping.
o .wood.Stovo-- After Installation.
[j Insert - After fireplace approv~1
and Installation of unit.
D Curbcut & Approach - After
forms are crectedbllt prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base ,material In place.
o Fence.- When COiYlpleted.
D Street Trees - When all required
i trees are planted.
EXPIRES
PHONE
- OFFICE USE -
':":'
QUAD.t'llEA' LAND USE: FL~Jims'~1tt
NU.....IC/:: ^JTENTION:Oregon law req r ~.J lt~a.y
· OF BLDGS' . OF UNITS' t'\ d bythe<lThlagQ'~DlO
, THIS PERMIT SHALL EXPIRE IF TH follow rUlel; auv.....l I re set fortn-
OCCY GROUP' E WQ8\(iSTR. TYPE:Net"'M.;nn r,p.nter. Those r.v 881w~c^'
AUTHORIZED UNDER THIS PERMIT IS NnT 'n OAR 952-001-0010 through I",,~bv
. OF .sro.F.lJE~: I'Ie.AT SOURCE: I , r.iin copi5!tOOllr.€lAi:\'f'l'1EAT:
vUMMI:I~0I:U OR IS ABANDONED FOR ' 0090. YOU llIay v~. (Note' ~e telephone
WATEFl,HIfATER: - - RANGE: '- :;al\inl:' th.. can ar. S ].!Go.R!ti1f66~bWE:-
'IIH ,~\,) 1,"\ r I"QR'UU, I_..~-.fnrlhp., Ore!lon UtllY NO
... . 1, 80o-~;j"-"""""
To request an Inspection, you must call 726.3769. This Is a 24 hour recol<illl1:l!3Al~ih-spec\lonsrequested before 7:00 a.m, will be
made the same ~orklng day, I.nspec~ions requested after 7:.00 a.m. wll,1 be made the following work .day. .
REQUIRED INSPECTIONS
o Tempor8~ Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
.0' Underslab Plumbing I Electricall
Mechanical - Prior to cover.
.0 Footing - After trenches are.
excavated.
o Masonry - Steel, locatIon, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete'
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation 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 flllJng
trench.
o Water line - Prior to filling
trench.
D .Rough.Plu":1b1ng - Prior to
cover. " .
I
o Final Plumbing - When all
. plumbing w<;>rl< is complet.e.
D FI.nal Electrical - When all
electrical work is complete..
o Final Mechanical:"" When all
mechanical work Is complete.
o Final Building - When II '
required Inspections h e. been
approved and buil is
...".......:--'Q.t.bc.
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.
D Electrical Connection - When
. blocking, set.up, and plumbing
Jnspectlons have been approved
and the home is connected to
the servIce panel.
o Final - After all required
. Inspections are approved and
porches, skirtlng, decks, and
venting have been Installed.
Jf[) :J;
!5:dO
lfr. /lr
-Lb. ]..u
SYSTEMS DEVELOPMENT CHARGE (SDC)
Lot faces
lot ~ype .
lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle ','
Topography
Total height
Cul.de.sac.
,I '.'1
BUILDING PERMIT
t
ITEM
sa. FT.
X $/SO. FT.
"Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
(B)
PLUMBING PERMIT
. ITEM
Fixtures
Residential Bath(s)
N'
. Sanitary S~wer
Water
FT.
FT. ....
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan.
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit'
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
"
TOTAL AMOUNT DUE (excluding electrical)
(A,' B, C, 0, and E Combined)
, ;"
I PL.
IN
Is
V\,/ ;
----
E
VALUE
"
FEE
',';" i.! ',I ~::i';~~?!~:ir:~i'
i' THE PROPOSED WORK IN THE _
'''HISTORICAL DISTRICT, OR ON
TH'E HISTORICAL REGISTER?
II yes, this application must be signed
alld approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I HSE" GAR I Acdl
I
I
I
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APPROVED:
'. '.... '!
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City 01 Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties wIthin the' City limits which are being Improved.
ADDITIONAL COMMENTS
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I
iNote: ..
-, Building Inspector may reqUire
I additional plans information,
-\ and/or fees for the completion of
I this project. -
I
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By' slgnatur~, I sta~e and ag'ree, that;' have carefully examined
the completed application and' do hereby certify that all
Information hereon is true and correct, and I further certify
, that any and all work performed shall be <;ione in accordance
with the Ordinances of Ihe City 01 Springfield, and the laws
of the State of Oregon pertaining to tho work described'
herein, and thaI NO OCCUPANCY will be made 01. any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
arc In compliance with OAS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address 15 readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans. will remain
on the SI~y~S during c,o~ructlon. ,
Signature. #/_~~~&'.---1J
Date l' --,~ ~ ,~ s17
VALIDATION:
RECEIPT NUMBER ,~. 5/3 / u
DATE PAIr> '1 (y! C; f
AMOUNT ~ECEIVED --.i,?, 24J /l .
RECEIVED BY (# UJ ~