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HomeMy WebLinkAboutPermit Electrical 2001-2-23 ~_. " '. . J~.' ;_Il::"V[;'~...)f~t.IC-f.' 1" ::.i.r.i viCi-:) ULj;~.{ I t f.Jc/\ ( 3. 225 FIFTH STREE r SPRINGFIELD, OR 97477 (541) 726-3753 FAX(541) 726-3689 ELECTRICAL PERMIT APPLICATION City Job NUlDber-{j-1-uL,j:t-:~- I[) I (X}/5r. Of COMPLETE FEE SCBEOULE BELOV Tile folloWing project as suomitted has the following .wnlng. and does not require specific land use approval. .n /1 225 FIITH STREET Zoning ~ SPRINGFIELD, OREGON 97477 ? -2'3 -01 INSPECTION REQUEST: f''1'26-)7';7 . 1<0 OFFICE: 726-3759 ""'''U''L~O Signature_ 1. LOCATION OF UlSTALLATION ( . Il) 02.( ~- r ~"-:~ ')'1 /JAUtT... LEGAL DESCRIPTION /,O-:d- g::l;",'::2 O/9GO JOB DESCRIPTI.9N >('(cJ /-;-~v 5'7 ,.L:-. Permits are non-transferable and expire if worl(,lti'sTliof:.:started wi thin 180 days of i ssuanceJCorlVlilfs\work Eisl[sUspeh'd-ea'Cfor I nhJ I [.,1 I I .. ,-- .. 180 daytLlTHORIZED UNDER THIS PERMIT IS NOT 2. CONTRACTORCINSTAIiliATIONJONCfJ FOR B. .................~ ,A"'V 1~n (lAY PI:RIOf). Electncal Contractor ADT Security Services Address 4660 Main Street. BIde A. #100 City Sorinefield Phone 736-4973 Supervisor License Number 853 JLE Expiration Date 10/01/02 Constr Contr. Number 26209CLE Expiration Date 10/01/01 Signat~ri of Supervising Electric!.an pr~ C~ Owners NameQ.lUJ0 (7fujlG/ I Address City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -----------------,y-------------------- DATE:.:.2 ~;}"5 --01 RECEfPT #: 00_0 453-~ RECEIVED BY ://. iYJaCJ7c:ea: () A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service_or Feeder $ 40.00 t';l!o'.'\: ~' '," '_: '\ \," . I' . ServA~!!~",<?.r, ~,eeders ". , ., ." " -.', Ins t,~'U!l,t.i<?!l1)1,4IJ_e,x:a.~J9.!1J~ I 01-1r' ~:5,,-1 Ii or Relocalion:"....",tPir ...o",:.:.'--.....~ :-h'- flJI":'o';. , UV;:IV. I' J;' . '0 , . ,.. . L ".....1 200 r.:,\lIinc. r'f ;dn'~, ,1~rJ' 'I]. tf's't:iso,"b, '0" 201 ~~E'~O~~L4b6s amp~;l:, "$";60~ci'6r 401 amps to '600 amps $ioo.oo 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 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 volts $ 40.00 S 55.00 $ 80.00 see "B" above D. Branch Circuits 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 -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 ~ -I S 40.00 'DD $ 20.00 i"iirriu.; I $ 36.0~ &e- '=2 / (5V ~ N to '1 uf.o. !:::lq~NO '2 ..,..t- Etix;(.,JLoo.Ig .::!""Ol'\)~ I .O'i> Q9J. 001 39. ~ 0 .=-..'G;Sf;3 SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL .- . Page 1 of 1 . "'- SPRINGFIELD ~ I Job# 01-00156-01 I CITY OF SPRINGFIELD~ OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00156-01 225 North Fifth Street Springfield. OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 4215 CSt Spr Assessors Map#: 17023232 Lot: Block: Addition: Tax Lot #: 1900 Subdivision: Owner: Quick Check 4215 C Streel Phone Number: 541- - City/State/Zip: Springfield, OR 97478 New Value: $0 Address: Scope Of Work: Electrical Only Quick Check Quad Area: # Of Units: Constr. Type: 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 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 Electrical Low Voltage Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D rArea (Sq. Feet) Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# I Electrical 02/23/2001 0004532 02/23/2001 0004532 02/23/2001 0004532 Value/Quantity Restricted Energy State Surcharge - Electrical Adminislrative Fee - Electrical Total Electrical Grand Total 1 Fee Amount $36,00 $2,52 $1,08 $39.60 $39.60