HomeMy WebLinkAboutPermit Electrical 1997-5-20
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225 FIFTH ;'Ul.r.l:oJ. z~.owlng prCjoct as subm!tte"'~^^ ,,_ ELECTRI~ PERHrr APPLICATION
~:=RE~~~~ 9;;~3~69"rnddC.S nLClrC/~u(2irc '?"oi:c.:: :,.; ~d ~'3Jo~~ber {Cr 70 71c (
OFFICE: 726-3759 Zonlr.1 . ./ ~, ' a-JO '71:
De:!o c; -diJ-it7 3. CtlKPLETE FEE SCHEDULE BELdv' 0'
1. LOCATION OF INSTATT ~nONI_ .' '^
1004 'NANCY AVENUE ""0. .OOSI9nct""-11-~NelLlteside.!!.tial_Single or :;::.. L
. ..J..~ ' Multi-Family per dwelling unit. /-11'
LEGAL DESCRIPTION Servi ce Included:
1((') ~ ;{, 'J.Q..tJSff1m
Items
JOB DESCRIPTION
INSTm HEAT PUMP
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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 B. Services or Feeders
Installation, Alterations or
Electrical Contractor S'''"H'.n Fl,1"(~'lHC Relocation:
Address
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
PO BOX 2765
Ci ty EUGENE.OR
Phone
686.8612
Supervisor License Number
3240-$
Expiration Date
10-1-98
~
Cost
Sum
S 85.00
S 15.00
S 40.00
S 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
038702
C. Temporary 'Services or Feeders
Installation, Alteration or Relocation
Expiration Date
200 amps or less
201 amps to 400, amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
12-21-97
Signature of Supervising Electrician
~ Jr.'1'~,1
D.
Branch Circuits
Owners Name
MnRT()N HT'T'l'
New, Alteration or Extension Per Panel
Address
1004 NANCY AVENUE
One Ci,rcui t J
Each Additional
Circuit or with Service
or Feeder Permi t Ol.
City
Phone 746-2034
.C::PDTNf:l;'T'RT .n
OllNER INSTALLATION
$ 40.00
$ 55.00
$ 80.00
see "B" above
$ 35.00 3SCO
$ 2.00 4, (J()
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $,40.00
. Limited Energy/Res S 20.00
Limited Energy/Comm $ 36.00
The installation is being made on
property I Olfn which is not intended
for sale, lease or rent.
Ovners Signature:
DATE~ 5'-;,(0 -q 7
RECBIPT t: ;.<"?" '?V7
"'-l"Uv..... BY: W . '
5. SUBTOTAL OF ABOVE
54 State' Surcharge
37. City
TOTAL
,..., ~ ....,
39.00
j. q.>
I, 17
/oj;;:!. j:1
OWNER' \"fIn II())V)
ADDRI""',' \<'A'i-\ L ~o t"I (\ \ I
CITY: ~~~,\~Q \A . "
DESCRIBE WORK: \Ii\~~' \1
Y\QDj~Lt VIA ~ . (.l) rrI
ADDITION DEMOLISH
RESIDENTIAL
PERMIT APPLICATION
.specllons: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/ TCJ ~
ASSESSORS MAP'
LOT'
\A'M-
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: ~ J'W 0.1\
ELECTRICAl'
.
.
'.
BLOCt<'
,At 1" '-
STAT'"
()9
.
97f)1~9
JOB NUMBER
225 Fillh SIreel
Springfield, Oregon 97477
'SV\{\~SRt~~
TAX LOT' C> S,g cS-i)
SUBDIVISION'
PHONE:
'4 '-I!o - 'd-{104
ZIP:~
Air He ncC.kA
OTHER
"
CONST,
CONTRACTOR'
EXPIRES .. PHONE
ADDRESS
~~h,~
,
QUAD AREA:
. OF BLDGS:
OCC'f GROUP'
. OF STORIES:
WATER HEATER'
\['In ~\.rur,
Lf.r!f)L,
LIt'/-{)" /O(
- OFFICE USE -
LAND w,,,.
. OF, UNITS'
'.
CONSTR. TYPE:
i
HEAT SOURCE: ..
RANG'"
.'
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, Alllnspecllons requested belore 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be mado
after excavation, 'but prior to
setting 'orms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
o Footing - After trenches are
excavated. . .
.0 Masonry - Steel location, bond
beam., grouting,
o Foundation - After form. 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 Bnd 8eam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking. (J
.0 Sanllary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench,
o Rough Plumbing - Prior to
cover.
:REQUIRED INSPECTIONS
'.
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Mu.t be
approved to oblaln permanent
electrical power.
o Fireplace - Prior to facing
material. and framing Insp,
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood StOVQ - After Installallon.
o Insert - After fireplace approval
and "Installation of unit.
o Curbcut & Approach - After
. forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed,
o Street Trees - Whan all required
trees are planted.
o Final Plumbing - When all
plumbing worl( Is complete.
, ,
o Flnol Elcctrlcnl - When all
electrical work 15 complete.
IXl Final Mcchnnlcal - When all
~ mechanical worl( Is complete.
o Final Building - When all
required Inspections have been
approved and building I.
compleled,
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o PlumbIng Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspecllons have been approved
and the home Is connected to
the service panel.
o Final - Aller all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
..
Lol (aces
".'
. .: ' :. -,' :,': ...:~-;t :~.: '
.
Lot T\'po
Lot sq, ltg,
Interior
Setbacks
I :L fSE GA;I ACC
1 S I I
W I =i
~---I- -- --
-~..l .--.J
i IS THE PROPOSED WORK IN T,.--
""HISTORICAL DISTRICT, OR ON
THE HISTORiCAL REGiSTER?
II yes, Ihls appllcallon musl be signed ,
and approved by the Historical
Coordinator prior 10 permit Issuance.
LOI coverage
Corner
Panhandle'
Topography
Total heigh I
CuI-de-sac
"i 'f
BUILDING PERMIT
ITEM SO, FT, X $/so, FT. ~ VALUE
APPROVED:
MaIn
., . 'I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
"
ThIs perm/lIs granted on the express condlllon that the said
construel/on shall, In all respects, conform to the OrdInance
ado pled by the City, 01 Springfield, InClUding Ihe
Development Code, regulating the construcl/on and Use of
buJ/dlngs, and may be sUspended or revoked at any time
upon vIolation or any provisions of saId ordinances.
Pian Check Fee:
Total Value
Date Paid:
Building Perml I Fee
Receipt Number:
Stale SurCharge
Total t=cc
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
(A)
Plans RcvlcWQ'(J8y~-
Date
PLUMBING PERMIT
ITEM
Systems Development Charge Is due on all undeveloP.
properties wllhln the City limits which arc being Iniprove
Fixtures
FEE
ADDITIONAL COMMENTS
Resldontlai Bath(s)
N'
Sanitary S~wer
Water
FT,
FT.
Storm Sower
FT,
MObile Home
Plumbing Permit
Slatc Surcharge
Total Charge
MECHANICAL PERMIT
(C)
Furnace
I?~
Exhaust HOOd
Total Permit
(D)
J<;.~
/D,DC
1,'2.0
~3-D
By signature, I ~talo and agroo, thall have carofully examined
the comploted appllcallon and do horeby certify thai oil
Information horeon 13 true and corrocl, and I further cortlfy
that any and all Work performed shall bo done In accordanc~~
with the Ordinances of Ihe City of Springfield, and the Lew...,
of the Statc of Oregon pertainIng to tho work described
haroln, and thai NO OCCUPANCY will be mede of ony
structure wllhout permission of lhe Building Sofety Dlvlalon,
I furlhor certify that only contractors and employees who
aro In compliance wllh ORS 701,055 will be used on this
prolecl.
,I
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
MechanIcal Permit
~/#O,
Issuance
Stalo Surcharge
,1') r- ,'7'.r
I furthor agree 10. ensure that all required In8poc~lon9 Q:O
roquestod at tho propor limo, that 080h oddreDs la roadoblo
from tho 6lroal, thottha permit eord Is loeolad atlho front
of tho property, and the approved sol of plans will remaIn
on the site .0.1 all limes during construction.
Slgnature_L_ ~ ~ r' \.
~
Date 5\2..0 J '7~
.
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
Slate Surcharge
Sidewalk
It
Curbcul
It
Dcmollllon
TOTAL AMOUNT DUE (excluding olectrlcal)
(A, B, C, D, and E CombIned)
'/ /- 2A)
- ~,
VAll DATI~N: 2-::r tJ3 <f! y::
RECEIPT ~UMBER Ll~
DATE PAID .~/ ~ {1Cl
AMOUNT RECEIVED /'~
:, #-///1_
FlECEIVED BY -lP .... _ ---.
Slate Surcharge
Tolal MIscellaneous PermHs
(E)
,
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