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HomeMy WebLinkAboutPermit Signage 2002-8-13 ~ Office: 726-3759 ~ ~~~ection Line: 726-3769 ~'\~,,\S~ Main St Spr ~~\~\~~~~ ~~~ . ~~"" '\:~S 'N~v.~ Tax Lot #: 00406 r''<.\~~7Vt:~ ~~n,",'Q~~ Subdivision: "';\~~~~~~~ ~;t~~e Number: 503-539-6024 ~~~~~;~~ ~~ City/StatelZip: Tualatin, O~J7062 ","\-1. New ValiJ"~ '~{$400 ....\" ~<(,- \)~ f:'." !:>.-V' o~ '10. \0 ~- 'l>ot\ ~0 0~0~~0 ~0~:W<::l<;j '0'\ ",-, , ..'\(\0 ,^t; rlg \f>f.> ,oOYJ_o'O'\ -0~\)' 0..... 0\V (\~.., Contractor Regi~triltion\#' oE,fpirati~n./,Date~O~ Phone ,Ov' ~ \' >1$". -:",~~ .0' :[i.\\J<> Meyer Sign Co Of Oregon Inc ," . J!~Of~(\,0 ~,<::l. c.Q13Q!?003,~0'" 503-620-8200 7340 Sw Landmark Ln, Tigard, OR\~\ ~o'''' ~ ~o~ G f.::j<::l"1S ~,1J;~ ~0'\.0\:>\~~,\ '?JP"V 97224-8029 ,0'1. .[i.\c.'l>~ rt~'/: 'l>'\ 0 'Io.e~' o~ '2>'/:"" \o'\.' ~-:> ,<:,(\ 0<<' ~0<:$ ".'5 Meyer Sign Co Of Oregon Inc ;-. 0~64!);14>1$'~Ci ~e,o ,11.30/2003 7340 Sw Landmark Ln, Tigard, OR \I'c<::lg\)' ~\~~ \O~~ "i\~ 97224-8029 v~-:::-'00\ (,r,~~ -.~ . I Job# 02-00861-01 I "..,,-' . Page 1 of2 r CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00861-01 225 Fifth Street Springfield, OR 97477 Location Of Proposed Site: 4020 Assessors Map#: 17023141 Lot: Block: Owner: Automobilia Inc Address: PO Box 1011 Scope Of Work: Sign Sign Sign Contractor Type Electrical Contr Sign Contr ,. Quad Area: # Of Units: Constr. Type: (VN) Wood Frame Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. All ins'pections 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 working day. Sign Electrical Required Inspections I Electrical I -After connection is made, but prior to energizing. ~ 503-620-8200 I Sign I Sign Footing/Attachment -Footing: After excavation and forms are in place, but prior to concrete. Final Sign -After all required inspections are conducted and approved and the sign installation is complete. :D :J:: -< -< 0::;0 :;0 :D D fT1 -< z C') rr1 (j) o..~ C"J .. D.. n f"..JCO co Ci11--'- :c ... I ~C") J-LC) rr1 ::c 0'''':.......1 C) ;::O:DI-....t. ..I-'- .. :z:o~-30 aG)o ON On1c)O~ c..nuC)r-.,)u .. . I Job# 02-00861-01 I . Page 2 of 2 ~- " Construction Types:(VN) Wood Frame Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Sign District: rSign Dimensionr I Vertical: 3' 6" Height (Above Grade): 15' Sqr. Footage: 12. Illumination? 0 Comments: A Community Comm Type of Sign: Wall Sign Face Type: Single Face Horizontal: 3' 6" Thickness: 5" From Grade To Bottom: 12' Sign Material: Sheet metal/lexan Fee Paid On Receipt# Value/Quantity Fee Amount I Electrical Minimum Electrical Permit Fee 08/13/2002 10273 $.00 Each Sign or Outline Lighting 08/13/2002 10273 1 $50.00 State Surcharge - Electrical 08/13/2002 10273 $3.50 8% Admin Fee - Electrical 08/13/2002 10273 $4.00 Total Electrical $57.50 Sign Sign Permit - 0 - 35 Square Feet 08/13/2002 10273 400 $80.00 Sign Application Plan Review 07/18/2002 9979 1 $40.00 Total Sign $120.00 Grand Total $177.50 Plan Check Type Checked By Date Completed Comment Sign David Bowlsby 08/01/2002 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, and the Laws of the State of Oregon pertaining to the work described herein. 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 are requested at the proper time, that project address is readable from the street, that the permit car is located at the front of the property, and the approved set of plans w~afnl~e at al :",:::uri~g the installation of the sign(s). (.A ~ l .J .- '? '13 Od---..- Signature .J Date , ;,- , SPRINGPIELD ~*' . . Page ~ I Job# 02-00861-02 I CITY OF SPRINGFIELD, OREGON _\\\0 .\~e"" '\\'i.\\\\" ....\" Registration~#' ,l:'xplratlon'Date '-0.'" '~0~0", _ <;,1(,0 ()y Meyer Sign, Co Of Oregon Inc 6.49JA I' ,\ \'(!.0 ~0~ 1130iff.9031 ",'0'1 7340 Sw Landmark Ln, Tigard, OR . ~ ~\06'f;J~",0\Vj 1(\01'o~ 0 ~\}\0 e 97224-8029 .' . \ ~'" l'O e~ .'\~ ."o\}g 0\ \~ ~'(!.0'fC'. o~ . .\ - .\"., .-"'11 . \Q~" ,,\0'" .r;>,\0 ..--o.'~ Meyer Sign Co Of Oregon Inc .,<- -< . :o~ '-640;1;1\ .~ cOy. \1'30/2003' ,~" \~ .,. "Q\ :1,-0.\\' :1,0. ~~ 7340 Sw Landmark Ln, Tigard:~.I3~::l~;;';'\O -0.'\ 0'0 ~.~o \)'i.~\''1 "!Jr}>'1' 97224-8029-.:".(', \l. ~ ~0f\\e ~"o~ ~':b'/:'j; v ......0 ~ v ~(....,~ ,,":."\ llU. 0 ,". Y\'c::o - ':Ov- Office'Use'i(\.,v~'" sV v..... 'f)€'" 'r'?J" Land Use: (\.:,~ C.' Zoning Code: Bedrooms: Range: 225 Fifth Street Springfield, OR 97477 Location Of Proposed Site: 4020 Assessors Map#: 17023141 Lot: Block: Owner: Automobilia Inc Address: PO Box 1011 Scope Of Work: Sign Sign Sign Contractor Type Electrical Contr Contractor Sign Contr Quad Area: # Of Units: Constr. Type: Water Heater: (VN) Wood Frame COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00861-02 Office: 726-3759 Inspection Line: 726-3769 ,'\\::J"''f.. Main St Spr '(.~ 'I' f;J\ ~,"'~ \~ ~,\Ta'1t ~ot #: 00406 ~. A~t!!t!.elt~u\S '\'~!\~\ifU~~ivision: \J\.' ,,~,. <-'1'" !i!.,u'v' ~c::,'\'\ "~,,,\;tI\ \)~\Ptio?ii.>N\imber: 503-539-6024 ,\\S ' \1.~\) "'~:o \" '(.\::JW x.~ \J i~/jtatelZip: Tualatin, OR 97062 t-\)\ .I.,~~\.j ~ '? c,\::J~\~''O\:) ~WlJew Value: $1,750 t-~'{ \ Phone 503-620-8200 503-620-8200 # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. 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 working day. Required Inspections I Electrical I -After connection is made, but prior to energizing. Sign Electrical I Siqn I Sign Footing/Attachment - Footing: After excavation and forms are in place, but prior to concrete. Final Sign -After all required inspections are conducted and approved and the sign installation is complete. :D ::;:: -< -< 0;;0 ;ODD rn -I :z: ("")f'T1(.Q O.M# c-J .. D.. X> r-.JC::O c.o Gl........ :c ... I 1"'--1('") ~C) rn ::c 0'- t.....t 0 ;.:o::I>I-...... 1-...1. .. Zol'-.JO OuJ" Of'...J OrrlOO-J (J1".QNt.N , , .. . f..-' I Job# 02-00861-02 I . Page 2 of2 Construction Types:(VN) Wood Frame Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Sign District: iSign Dimensions I Vertical: 3' 2" Height (Above Grade): 15' 6" Sqr. Footage: 27. Illumination? 0 Comments: Automobilia Quick Lube Community Comm Type of Sign: Wall Sign Face Type: Single Face Horizontal: 8' 9" Thickness: 5" From Grade To Bottom: 12' Sign Material: Sheet metal/lexan Fee Paid On Receipt# Electrical 08/13/2002 10273 08/13/2002 10273 08/13/2002 10273 08/13/2002 10273 Value/Quantity Fee Amount Minimum Electrical Permit Fee Each Sign or Outline Lighting State Surcharge - Electrical 8% Admin Fee - Electrical Total Electrical 1 $.00 $50.00 $3.50 $4.00 $57.50 Sign Permit - 0 - 35 Square Feet Sign Application Plan Review Total Sign Grand Total Sign 08/13/2002 07/18/2002 10273 9979 1,750 1 $80.00 $40.00 $120.00 $177.50 Plan Check Type Checked By Date Completed Comment Sign David Bowlsby 08/01/2002 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, and the Laws of the Slate of Oregon pertaining to the work described herein. 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 are requested at the proper time, that project address is readable from the street, that the permit car . ocated at the front of the property, and the approved set of plans (:Z;:7n t(~ at ,al~::;:g the installation of the sign(s). Signature Date <;? ,/C{ . OJ- ~' I " . ;yv Page 1 of 2 . I Job# 02-00861-03 I CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00861-03 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 4020 Assessors Map#: 17023141 Lot: Block: Owner: Main St Spr ~ ~ll~t #: 00406 .... Addit~\~t. \i ;~'t \13L\tldivision: \\Q't\~~~~\" ~~~~ifi~~~~~O~03-539-6024 "~~~~Q~\t.t.Q : Q~ \~~~tate/ZiP: Tualatin, OR 97062 ~Q~~t.~~~ ?~\9 . Value: $1,750 f>,~'( '\?lQ Automobilia Inc Address: PO Box 1011 Scope Of Work: Sign Sign Sign Contractor Type Electrical Contr Contractor Registration'#J\IEEx'lfi~aWon Date -:\\a'l-J \V"-\ ~(lt\ U\"~-.. Meyer Sign Co Of Oregon Inc \OI'l'.1.6401'4b" \ne Ole ;lJ~ogo031\~_ 7340 Sw Landmark Ln, Tigagl., ORi' \as adO'\lte~nose luleS p..B 95'2.-00 'e)'oj 97224-8029 \ \IO'/'lIU ce(\\el. :nrOUg'" 0 :ne lilieS o . 13.\10(\ ~,,~ot.. SO\\ . -::\e Meyer Sign Co Of Oregon \~C;\I\~C 95'2.-0()6401~1(\ cO'\l\~ ",~(~91~~3\10(\ 7340 Sw Landmark Ln, TigardCGJR- Il \'CIa~ 0'0 ~~o\e. t. ~o\\\\ca 97224-8029 '009()_',~~a \",e ce~~~~QO(\ ~~~:~_~). v- .~!'O\ '''-._~.'Ou\rV- Off\~~:\:Jse ce(\\"" ',- Land Use: Zoning Code: Bedrooms: Range: Sign Contr Quad Area: # Of Units: Constr. Type: Water Heater: (VN) Wood Frame # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. 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 working day. Sign Electrical Required Inspections I Electrical I -After connection is made, but prior to energizing. I Siqn I Sign Footing/Attachment - Footing: After excavation and forms are in place, but prior to concrete. Final Sign Phone 503-620-8200 503-620-8200 -After all required inspections are conducted and approved and the sign instailation is complete. :D ~ -< ""':;0 ::0 :D :D rn -I :z C"J l'1 co 0.-# ("") .. ::I>.. :D r-.JC=O (I') G1~ :::c ... I ......0 !-LO m::I:G".GJO ;.o:D1--'- t-'- n ZOf"-..:JO QQ- at-..) omOQ-.J (J"l-.Ot...,)LoJ . " " . I Job# 02-00861-03 I . " Construction Types:(VN) Wood Frame Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Community Comm Sign District: iSign Dimensionr I Vertical: 3' 2" Height (Above Grade): 15' Sqr. Footage: 27. Illumination? 0 Comments: Automobilia Quick Lube Horizontal: 8' 9" Fee Minimum Electrical Permit Fee Each Sign or Outline Lighting State Surcharge - Electrical 8% Admin Fee - Electrical Total Electrical Sign Permit - 0 - 35 Square Feet Sign Application Plan Review Total Sign Grand Total Plan Check Type Checked By Signature , Height (feet): Proposed Units: Total: Type of Sign: Wall Sign Thickness: Page 2 of 2 Face Type: Single Face 5" From Grade To Bottom: 12' Sign Material: Sheet metal/lexan Paid On Receipt# Electrical 08/13/2002 10273 08/13/2002 10273 08/13/2002 10273 08/13/2002 10273 Value/Quantity Sign 08/13/2002 07/18/2002 10273 9979 Sign David Bowlsby 08/01/2002 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, and the Laws of the State of Oregon pertaining to the work described herein. 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 are requested at the proper time, that project 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 remnn the site at al~ifii?s during the installation of the sign(s). { !a. (~.f/--.._ / Date Completed Comment 1 1,750 1 Fee Amount $.00 $50.00 $3.50 $4.00 $57.50 $80.00 $40.00 $120.00 $177.50 Date jff3'O~ , " , I Job# 02-00861-04 I I' cV '- , --- Page 1 of2 SPRINGPIELD ~ CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00861-04 225 Fifth Street Springfield, OR 97477 Address: PO Box 1011 Office: 726-3759 Inspection Line: 726-3769 ~\J~'t. Main St Spr \'i \~'t. \S ~\J\ 't.i-'?\~\'t.~~\\ ~TJl. Lot #: 00406 ~\('~. ,,~ ~!@Wflt\\~"\~\J~'t.1i) Subdivision: \\\\)': W';: '\:i'l'-V' ~~". \,~\S '?~~\1.'i:.~ Ii) \J~ 'P.h~..e Number: 503-539-6024 l>-'\:i\~ ~'t.~c,~ ~ ,?'t'ClW/StatelZiP: Tualatin, OR 97062 c,~~ \~r;} Ii) New Value: $2,250 Location Of Proposed Site: 4020 Assessors Map#: 17023141 Lot: Block: Owner: Automobilia Inc Scope Of Work: Sign Sign Sign (VN) Wood Frame ou ..- Registratio'i\l'tf ~ EXPi~ation Date ?-"ro.: \U~ '(e~O -" \O'''\' Meyer Sign Co Of Oregon Inc _~640!,4.\\eO s'3-le1/30!3903 7340 Sw Landmark Ln, Tigard, qR ' 09\eo '0 ~s0IU,e Ol'o~ 9'6Z,es 'O'! 97224-8029 :. , '" 0-' \\\ 10UQ,\\ ~ \\\e \U (\e " . ,. ..' .,(\\\;\, 'esO . .~no ;\ Meyer Sign Co Of Oregon Inc ' ,. <, .-~640t.4c09\ "'0\el/~0/20.o3 - .j\J :l,\l.\\' . \\, \\,\V~ 7340 Sw Landmark Ln, Tigard, QRJ" ..,' ')'0 ,~o\e. .~\\'!~O 97224-8029 . . 'Iv'} 0'''c0(\\0t. 0(\ \j\\ n':J'.b,). , . ",r _...P.G: ,..nf).." Offi~~"ljse" t(\" - . _':>)J''-- ,.,.J.... ','- Land Use:' I' Zoning Code: Bedrooms: Range: Phone 503-620-8200 Contractor Type Electrical Contr Contractor Sign Contr 503-620-8200 Quad Area: # Of Units: Constr. Type: Water Heater: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. 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 working day. ' Required Inspections I Electrical , I -After connection is made, but prior to energizing. Sign Electrical I Sign I Sign Footing/Attachment -Footing: After excavation and forms are in place, but prior to concrete. Final Sign -After all required inspections are conducted and approved and the sign installation is complete. :D :J:: -< -< 0:;0 ;:0 :D :D m-<z orncl') 0..:;::;: o -. D-. ::0 /'.,) c:: 0 1:'') Ci1 ~ :c ... I ~CJ ~o n1 ::c 0" 0J 0 :;:;f.JD,...... ........... ..:Z:ONQ om- 01'-.:1 OfTlOC)-J tTlHOr--..)(....J .--' , '^ , I I Job# 02-00861-04 I I Page 2 of 2 ,,- Construction Types:(VN) Wood Frame Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Sign District: rSign Di , ~i. ~ Vertical: 6' 6" Height (Above Grade): 25' Sqr. Footage: 70. Illumination? 0 Comments: A Automobilia Quick Lube Community Comm Type of Sign: Free Standing Face Type: Double Face Horizontal: 5' 6" Thickness: l' From Grade To Bottom: 18' 6" Sign Material: sheet metal/lexan Fee Paid On Receipt# Value/Quantity Fee Amount r-- Electrical Minimum Electrical Permit Fee 08/13/2002 10273 $.00 Each Sign or Outline Lighting 08/13/2002 10273 1 $50.00 State Surcharge - Electrical 08/13/2002 10273 $3.50 8% Admin Fee - Electrical 08/13/2002 10273 $4.00 Total Electrical $57.50 Sign Sign Permit- 61 - 100 Square Feet 08/13/2002 10273 2,250 $140.00 Sign Application Plan Review 07/18/2002 9979 1 $40.00 Total Sign $180.00 Grand Total $237.50 Plan Check Type Checked By Date Completed Comment Sign David Bowlsby 08/01/2002 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, and the Laws of the State of Oregon pertaining to the work described herein. 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 are requested at the proper time, that project address is readable from the street, that the permit is located at the front of the property, and the approved set of plans rr7main on the site a allti es during the installation of the sign(s). ( la fJ . <t '15 -oJ-. Signature ./ Date .con :)o(J5: Oz.-oog6/-6 I 02-ooZ6f-04 I~<-- 0 'Z. -00 'i56f -.0 2. . 0'2-00 'Be' '8 ~ . .s GFIELO~ AL,~-.;= b It d has the following /A~ The followmg prOlset as su ml e. d ."' .. '?~.1 > and does not require specIfic Ian use '&fJJ/I zOning, approval., Cf' ..-/ zonm9l{.,/ I~~O'~, ~vJ 1. LOCATION OF INSTALLATION- ~. I [ _4D 20 lfJa iirJ 5-7'. 4Mmj ((, A. New Residen tial-Single or ( - , "if /' Mult i-Family per dwelling uni t. . L1tGAL D~~WPTION ..!.o//O/1l t::IVService Included: ~n 170Z3I'-I1 OO'l.Of-::ffic. .tli!e~V/V ~I. Items ~ ~.. UA,1y CitIO/) <JOb ,'~ v,- _ JOB DE~CRIPTION -I- /1 V J / 090 l/S.?_Q~oqQ.:OSq~' ~ t~""O!; less ~tPrc.. <:;,rn fw1b:UIJ I I" "-f o-"/i: Ou 111 'Eacli1':a~ddVtii'.on'a<;J,!tI!iOO - ,-' YUmA//}!] II} Ciy ,J,,~?'lf,>;U8r t~M't~g.f{ You ~ Perffilts ate non-transferable and expHeE>tfo eOentlieri'>.of,:)UOf1 E>,s<1t, 'lJUti/'O if work is not started within 180 days C. ttl}~ E';rch'^M'anuf'd),Ho~eS'(or."Y \9 ..-.u 'lIt \.'"'~ ")(0 t '0 of issuance or if work is suspended for 'lJteri 'M~,';!,']la~'tRwE!Ming~_Q ttf; 180 days. ,s '.ServIce. o-rt€Fe~de~ 0,. -vO'J. . "'Ify II;. 'E>PI} . "',s 6 . J.?_., o~:<: o/}", ~ ,B. Servlces',J'qr,) Fe'~dlrs Installati6n, Af?erations Electdcd Contractor ,J/)eYl3fL ~/6'N 0;. t{; Dt.., or Relocation: Address 2?>-'JD 1CV ~ 117tJ.A /c. ~(j~ 200 amps or less $ 50.00 7122.> J'f;~- ~~. 201 amps to 400 amps $ 60.00 City flG-A-IL-'D,bR. Phone~i)i~ 401 amI's to. 600 amps $100.00 1 '% ~ 'I/, 601 amps to 1000 amps $130.00 Supervisor License Number -5/t.""'J> ~~ ~to St9..lver 1000 amps/vol ts $300.00 'e/> PC't/' lI/fI/'~f'2[:nec t Only $ 40.00 Expiration Date ID-D/-o7-- v/).. ~~<.It..Qa~ ir.o~,ISt~ Services or Feeders Constr ContL Number 2.0 -(90 c..L5 J9tOO1i'~<2 ~~t Alteration or Relocation Expiration Date 10-01-D"2-- '200 a~g?/,$l-t@~ $ 40.00 201 amps ~~~~ mps $ 55.00 Sign~e~ ~~r~iSing Electr~ Over 401 to 60 amps $ 80.00 ~~I ~ ~ Over 600 amps or 1000 volts see "B" above {-I II V D. Branch Circui ts Own~s Warne 'fSfLF:7r 1~ Address fD f!JdIf., IOlf _ \' 1706 L , / Ci ty / /,(It 1.11- frAL" DR. Phone (1"1)::) /,39-to2V OVNER INSTALLATION .- . l!:) O~C\J ..c:r: .. ** '.0 CiJWc..J Zl--W CI: CI: a:: Q,:<::> >- >- ::c 225crIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 Date 9,z fu7Jized Signaturo , t;1'6-3769 2. CONTRACTOR INSTALLATION ONLY ~ The installation is being made on property I own which is not intended for sale, lease or rent. ul\c}l\r."" $;,""",,, ~~~~:-:~----------------------------- "'\ RECEIVED BY: ELECTRICAL PERMIT APPLICATION ~ity Job Number o'z-oo'6bI-O I 3. COMPLETE FEE SCHEDULE BELO~ Cost Sum $ 85.00 $ 15.00 . $ 40.00 New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting 4 $__!iO~ 7-00- Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE ~()' 5% State Surcharge /7 3% Administrative Fee lb TOTAL ~ '2.3("""" I