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HomeMy WebLinkAboutPermit Electrical 2001-3-22 , . .~ DEVELOPMENT SERVICES DEPARTMENT The following project as submitted has the following zoning, and does nol require specific land use approval. Zoning 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 ELECTRICAL PERMIT APPLICATION 225 FIFTH STREET SPRINGFIELD, OREGON 97qvg INSPECTION REQUEST: 7.29.mJ,l~Signature OFFICE: 726-3759 Q..C!....--" 3,,,l;l.-Ol "1<-.....) 1. LOCATION OF INSTALLATION J:; 3~ ~..,., ST ~i3 fle. LEGAL DESCRIPTION /10)... >/ <...1)...0 7L..1UI,o ("'Hy Job Number 3. COMPLETE FEE SCHEDULE BELOII (] / ()()d-7l 0/ Items Sum A. New Residential-Single or Multi-Family per dwelling unit. Service Included: JOB DESCRIPTION 'S'S'... .'........ /J_ t) t../ s;/c- .--.. , 1 ~lOTICE: f bl d . PermIts are non-trans era e an exp.Ire if worHB fi,isR;"c\t Ss:t'ar-fe'fPIOf:tiirlii[1'801Fd~ys of i~e,l!ll,l(,q!!,Z!:D tJ:;Dl::'.?.r,lHlt~'~u.$,p:e.Q.c1eQoTfor 180 t~vtMENCED OR IS ABANDONED FOR 2. CONTRACTOR PINSTALLATION ONLY Electrical Contractor .4,)'T' Sfr,~:-+y_ , ",' Address-#t::o ?7J..!<:l."" sr. '#A-/~ Ci ty 5"".f"lLJ Phone :}-36 -""3>')-3 Supervisor License Number :?.26a Jt...z Expiration Date Ire" . Constr Contr. Number 2<: /0<; (" t. ~ Expiration Date /?~ Signature of Supervising Electrician _~,/ ')' Af4~.,,- Owners Name ML ,'r. /AN,., a /)!:.t/. Address Ci ty Phone :J 11'1- 5S00 O\INER INSTALLATION The installation is being made on property I ovn which is not intended for sale, lease or rent. Owners Signature: -------~------------------------------ DATE: (J..J- ;})-- Qj , RECEIPT JI: 47?f{ RECEIVED BY;l7 'Iyr;lt tLJ--<'J Al I:':;',.,J ,."" ~ I" 1qQqo~oq, fJ. .or; ,l.es$, _. , .._~~ $;85.00 Each addi tional'''500 . - ...-..Ot, u!l ,'y '''ulIIltf'tqu. V~'l;' ," .: I L ,',:' 'Ul'-..l.loo, ...aroa. ';;::Ql "1' .sq.. ,..or portIon' - u. ~ '-~.. , '0' 'tth~1!EiO'fc:-lJ(}H)U IV ulrougn vAA !$5rl'5'Goo E'M.~i{J'M~nuf';?d''''H~m~ or:Jk:~:)1 wE rulas b) Mo~d\mra:r .iDwEd'ling,,~u,_' :0" talephone Sef,v,i'ce',or"FeedeIJ . ',1:' ,I,'0111$;<.4Q;.:00 (>~~ 0 ' . - " ..4) Services or Feeders' . Installation, Alterations or Relocation: B. 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 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 D, Branch Circuits $ 40.00 $ 55.00 $ 80.00 see "B" above Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ..... ::E ':5D Ail '.m5 iJ"S~..... (""'J 0:3:.. .,/ D ..:00 -'0 . c.v CI) OJ :;IJ I--' ;;J. ~ ~C"Jf:41'..j6 / . d( ;0 D G/....:l g --;=,,,,_, ( -- ~ '" OJ "" \.. '")7 'J' ()C)m. O-.J U"rO"O~ ..........O........co .- . I Job# 01-00282-01 I . Page 1 of2 ~ CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00282-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3738 Main St Spr Assessors Map#: 17023142 Lot: Block: Addition: Tax Lot #: 02406 Subdivision: Owner: Address: ARLIE LAND DEVELOPMENT X Phone Number: 541-344-5500 City/State/Zip: X, X Scope Of Work: Electrical Only New Value: $0 Contractor Type Electrical Contr Contractor Adt Security Services Inc 4660 Main St, Springfield, OR 97478 Registration # Expiration Date Phone 541-736-4973 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 -I Low Voltage Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. r, ,I) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Electrical 03/22/2001 4748 Value/Quantity Fee Amount Restricted Energy $.00 . .~. Fee Restricted Energy - Multi Family State Surcharge - Electrical Administrative Fee - Electrical Total Electrical Grand Total Signature . Job# 01-00282-01 Paid On Receipt# I Electrical 03/22/2001 4748 03/22/2001 4748 03/22/2001 4748 . Page 2 of:! Value/Quantity Fee Amount 1 $36.00 $2.52 $1.08 $39.60 $39.60 Date