HomeMy WebLinkAboutPermit Electrical 1998-8-19
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'1
Q~e NO'fl : '
2Z:l HIS PERM ELECTRICAL PERMIT APPLICATION
S"~....,i./ ,0 ON 97477 IT SHALL EXPIRE IFTH
INSPECfION REQUEST: 726-3#mHORIZED UNDER THIS ~~ljob Number qf/o'] K
OFFICE: . 726-3759 COMMENCE PERMIT IS NOT .
, 0 OR IS .AJlAN~ FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATIOtfY 1P..9lDJ\'( ,;l1lA/OO
q LI" j..}r.O+J.. I!!!{~ HtJ f'-- . "A, New Residential-Sillile or
'too
Hulti-Family per dwelling unit.
LEGAL DESCRIPTION . Service Included:
(ft())(dli_./n') /1012(,/7- {Jt(3'lJ Items Cost
"-
J9" DBSCRIrrION
~, ~Ul-p
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
l80 days,
lOOO sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home, or
Hodular.Dwelling
Service or Feeder
2, w.....ACTOR INSTALLATION ONLY B, Services or Feeders
Installation, Alterations
Electrical Con trac tor J::'5.."1 Lc.TI2.c.. ~..HItdo or Relocation:
I~c..
Address .p. ~ ~o OJ" "-" C' ~ ~ ,200 amps or less
" 201 amps to 400 amps
City (....5...~.1 Phone "'Yb~b).-~ <.... 40l amps to, 600 amps
601 amps to l~O amps
Supervisor License Number .:;L 0 -:i.!ftL. Over 1000 amps/vol ts
Reconnect Only
C, Tem&f~i'1llhte!!~oe$Oor Feeders
ATIENTION:ormJd~ ~n\1o~iJtiiu;ation or Relocation
follOW rules adople re set forth
Expiration Date /2. -1. o-<:.Y NO'ificationcentl!OO~JUJFig2-o01- $ 40,00
inOAR952-00Hl)10ll1ll~~g~~ OrW!iy $ 55,00 -
Signature of Supervisilli Blectric~o. You may @l@if\(l{~et8~!!\ 'h8~Bs' $ 80,00 -
.-V calling the ce~~Nroll: \\W'N( e<<rft~RO vo.1t s see "B" above
" ~ ---1~ _..rn'nerfortheOregonUtilily Olllcal
, cRnler~-:a:raM.'~s
Owners NameJ;q~ <\"Ie'- l ..........
I
Address!iu, 10,::,'(( ./.-( _If' :'" t .1l.
CitY~A Phone -~ 7-h '1,37
.o1INER INSTALLATION
,
'-,
Expiration Date j/J_/~q;>
Constr Contr. Number ? 0 t? "'.,
The installation is being made on
property I own vhich is not intended
for sale, lease or rent.
"--'
OWners Signature:
-.
DATB;---------------R-fT~Jff1r----~-~
llBCEJ....l' II.' 0-111 2..9".f _ "y
RECEIVED .11: ~
'.
Sum
$ 85,00
$ 15,00
$ 40,00
$ 50.00
$ 60,00
$100,00
$130.00
$300.00
$ 40.00
"
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
E, Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Li~ited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35,00
3\"'""
/
$ 2.00
not included)
::,s;a>
$ 40.00
$ 40,00
S 20,00
$ 36,00
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Q4s No(+nnd(u}
S~0.}:'-eJd '
~n.cAfd I
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oltice: 726.3759
LOT'
OWNER:
ADDRESS'
CITY:
DESCRIBE WORI<'
NEW
REMODa
ADDITION
e
SPRINCr-IELP
-
.JOB NUMBER ~/.:?::? ~
225 Fifth Street
Sprlngllllld. Oregon 97477
TAX LOT' ~ y~.:?~
SUBDIVISION'
PHONE: __
/4-7-03>17
BLOCI<:
STATE:
fJR
ZIP:
0,,471
H61...t 1JUJYlp
DEMOLISH
OHIEn
ADDRESS
CON ST.
CONTRACTOR'
PHONE
- OFFICE USE -
LAND USE: _'_____
H OF UNITS:
CONSTR. TYPE:
HEAT SOURCE: ______
RANGE: ___
REQUIRED INSPECTIONS
o Rough Mcchnnicnl - Prior (0
cover.
o Sito Inspection - To bc m.:ldc 0 nough Elcctricnl - Priof...,'G'f(..'f...
aHer excavation, but prior to cover. \~~..... cf'
settln~"'15, 'j..,?\'?-~\'i' ~'0\S~
o Underslnb Plumbing/Electricnl/ .r~"EICs;,l!if'.,,'I-~crYl~,?.s;.'?'M.Jt'i~1if'
Mcchnnlcnl - Prior to cover. tl..'O'\~ a'no'fOvC(ld'(\c;Stnil,l..~"6\t.lllcnl
''" ,?~'?-~cct~~'POW~"'~\)
.<.:0(-.\'0 ~\t~~ ~ \'0 ~
~~F.i,\<;et.hi) -fW,lor to Inclng
l'I ~ll1'erla\s,frid Imming Insp,
O Masonry - Steel locntlon, bond rQ\N \-..1\"
b 1 v n~
cams, grout ng. 1~\-\'4rFrDm'ng _ Prior to cover.
o Wnll/C'cilinn Insllllllion - Prlor to
cover.
o
DrywlllI - Prior to lJ.ping.
CONTRACTOR'S NAME
GENERAl'
PLUMBING: '\
MECHANICAL: (lJ)m.\1)(-k EJ~I /--l-ej))m4~Dl2t{S+'1 ~D COil:{) tfZ7-qQ 7Zb-D/(t
ELECTRICAL: ;f}J7J-;"'/"":~A'C //-'.....-c7. ~4'/7".~~""'"~l').
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES: ____
WATER ~IEATER:
EXPlliES
FLOOD PLAIN'
ZONING CODE: ____
" or- BOnMS:
SECONOArtY HEAT: __'_..
SOUARE FOOTAGE: .'n,_,,_
To request an Inspection, you must c~ll 725-37G9. Tills Is Cl 24 hour recording. AI/Inspections rcqlJcsted before 7;00 ::un. will be
made the S.::lnlQ workIng dflY, Im;pcctlons requested afler 7:00 a.m. will be made lhe followIng worl< dllY.
o Tempornry Electric
o
Footing - After Irenches arc
excavated.
D
Foundation - After forms arc
erected bul prior to concrele
placement.
o
Underground Plumbing - Prior
to fllllng trench.
o
Underlloor Plumblno/Mechanicnl
- Prior to Insul.Hlon or dccldng.
o
Post nnd Ocam - PrIor to floor
InsulatIon or dccl<lng.
o Floor Insulation - Prior 10
deckIng.
o
Sanitary Sewer - r>rior 10 (llling
lrench.
o
Storm Sewcr - Prior 10 filling
trench.
O WOller Line - Prior to filling
Irench.
o Rough Plumbing - Prior to
cover.
o Wood Stove - After lnslallilllon.
o Inscrl - After (Jreplacc npprovlll
and Installation of unit.
o
Curbcut & Appro~ch - Arter
forms ore erected bul prior 10
plnccmcnl I)f concrele!.
o
Sidewalk & DriVCW:I\' - After
cxc<:Ivntion is complete. rorllls
<:IntJ SU\).b.1se mat~rjill In place.
o Fence - WIlen completed.
o ~ltroot Tree:; - When <:Ill required
trees arc planted.
o
Final Plulllbing - When all
plumbing W9rl( is complot,e.
ILl
r:in.nl EleCI~c"l - vVl1en all
electrical worl( is complctc.
(
I (I Final Mcchanicnl - When all
. mecllarllcal worl( Is complele.
I 1 Fin.11 Ouildi/ltl - When all
required In::>pectlons hilve been
approved ilnd builcling is
completed.
o Ot,her
MOBILE HOME INSPECTIONS
o Olocking llnd Set.Up - When all
blocl<lnU is complete.
o PlumbilltJ Connections - When
Ilome IHI:; been connected 10
Willer tlntl sower.
o
ElcctriGtll Connection - Wi,en
blocldnu, SCI.uP. and plumbing
ln~;pcclion:; have been approved
ilnd tile home is connected to
lhe service pallel.
I I Finnl - After all required
Inspections arc <lpprovcd and
porches, $Idrtlng, decl<s, and
venting have been lnslnlled.
LOI faces
LOI sq, fig,
"
LOI coverage
Topography
To(alllclgllt
BUILDING PERMIT
ITEM
SO, FT
Main
Garage
Carport
Total Value
Qui/ding Permit Fcc
St~lc SurclHlfgc
Tolnl Fcc
Lot TYPC,-
Interior:
SClb.1C.]C; .
, , , I
PL, HSE GAR ACC
_.:; THE PI,OI'OSED WORI< iN THE,
".HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Corner
l'l.-___
~---
Panllandlc
II yes, tills application must be sIgned
and approved by the Historical
Coordinator prior to permit issuance.
E
_"Y._.._ ___ ____
APPROVED:
Cul.(Jc.~<<c
X $/SO, FT, VALUE
"
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(0)
PLUMBING PERMIT'
ITEM
Fixtures
Residential Oalh(s)
N'
Sanllary S~:wcr
Waler
1'1:
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permll
StO,to SUrCIHIr(Jc
Tolal Cl1<Jrgc
MECHANICAL PERMIT
FurniJco
EXh.aUGt Hood
Vent F;)n
N'
Wood Stove/Insert f FI replace 'Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharnc
TOlill PermIt
FEE
(C)
Mobile HOlllo
MISCELLANEOUS PERMITS
(D)
/~dOb
tt?-
}):L~-~f5
:2'.?:".-:2.""
Slale lssunncc
State Surcharge
Sidewalk
II
Curbcut
fl
Domollllon
;5tatc Surch.ugc
Total Miscellaneous Pcrmil~ (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, O. C. D. ond E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
T11i::; permit is grJntcd on the express condition that the said
con5truction sllall, in all respects, conform to the OrdInance
adopted by the City 01 Springfield, including Ihe
Development Code, regulating lhe construction and use of
buildings, and m3Y be suspended or revoked at any lime
upon violation of .my provisions of s<lid ordln<lnccs.
Plan Checl< Fcc:
D<1te Paid:
Receipt Number:
Received By:
rl3ns Revlcwed.-.Oy-.---"'----
Dale
Systems Development Charge Is due on all undeveloped
propertics witt1in t11e City Jlmits which arc being improved.
ADDITIONAL COMMENTS
\
(
By slgnature,l 5tate and agree, tJ1at I haye carefully eX<lmlned
tho completed appllcD(ion and do hereby certify thDI 311
Information 11ereQl1 i:; true nncl correct, and llurther certify
that nny and all work performed Ghat! be done in accordance
with tile Ordinancu:.: of the City of Springfield, and the Laws
of Ihe SliJte of Oregon perlainlng 10 lhe worl< described
her~in. Llnd .Ihol NO OCCUPANCY will be made or <lny
structure wl1l1oul permission of the Building Safety DivisIon.
I furtlwr certify tllat only contractors and employees who
arc in cornplinncc'with ORS 701.055 will be used on thIs
projcct.
I furtllor auree IQ ensure Ih<:ll all required inspections <:lrc
reQuc:.:tcd althe proper time, thaI each address Is rea.dable
from tl1C slree (' I the permit card Is located at the fronl
of the prop y,:1/ 110 .:lpproved set or plans will remaIn
on the sit nt a t mes during construction.
Slgnalu
D<lle
8-1L/-.q~ d
VALIDATION:
RECEIPT NUMOEfl "?/<:J9&r:.
9-/Y' "?$
AMOUNT flECEIVf.D :::?~- ?.::>
~,~?:.,-
#" /,-- -
DATE PAiD
F1ECEIVED BY