HomeMy WebLinkAboutPermit Electrical 1994-2-8
225 FIFTH STREET
SPRINGFIELD, OREGON 97417
INSPEctION REQUEST: 726-3769
OFFICE: 726-3759
l~lfItJ;orflR EfPT~ON
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Permits are non-transferable and expire
if work is not started within l80 days
of issuance or if work is suspended for
180 days.
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2. CONTRACTOR INSTALLATION ONLY B.
Electrical contractor~"..?~A ~#/C.
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Address
City ~~.u/ Phone ?~-.?2??
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Supervisor Licen.se Number .;1.5 :2tJ-5
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Expiration Date
Constr Contr. Number
Expiration Date
ELECTRICAL PERHIT APPUCATION
'Ci ty Job Number ,CH-fYJ <2\~
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
lOOO sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ l5.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
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
Signature of Supervising Electrician
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Owners N~\L-!fNJj ,t ~-o1w' D.
Address rO()fl~ ((Jj~))n f}Jt )
City .::::JJJJ rl ~ P ne U .
OwJl1STALLATION
The. installation is beirig made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
;))Q)0l..f
DATE:
RECEIPT I:
RECEIVED BY:
II c.., J <))
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200 amps or less
20l amps to, 400 amps
Over 40l to 600 amps
Over 600 amps or lOOO
Branch Circuits
New, Alteration or
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
One Circui~
Each Additional'
Circuit or with Service
or Feeder Permi t l.... ~.
Extension Per Panel
-I- $ 35.00 ,P5,ceJ
$ 2.00 (.0.0:)
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
E. Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20,00
$ 36.00
q/.-
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~~~
· JOB NUMBER-.94CX)OL'
.
COMMERCIAL/lNDUSTRIAL SP~'NaF'ELD
PERMIT APPLICATION l~
225 Fifth Street, Springfield, Oregon 97477 ... ,.
LOCATION OF PROPOSED ~RK' 0Vl'?-J (Q (J,fYl Dlf'I )
ASSESSORS MAP \ '7(\,) ,q~4 I d-.. . () 1-
OWNER: f\ '( ..: f'J \ C':\f\\o n 0n )
CITY:~ ~ \
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DESCRIPTION OF WORtt }! .Q..ffiOO ~
NEW REMODEL yJ ADDiTION
-I NAME
INSPECTION LINE: 726,3769
OFFICE: 726,3759
TAX LO'C
OllrY)
PHON'"
-""
S:AT,E: ~ \))U>~,()Q
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OMO:S~ OT~ER
ADDRESS
ZIP:
ct.f,\ 'VI' J
VALUE: t or;ffi ,CCJ
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/
PHONE
ARCHITECT:
CONST,
CONTRAqof's~ III ADDRESS CONTRACTOR'
GENERAL:Ut:: n '" G 0 J\clL~~) \\ "101'.;'(000 rA- Q'?)5.<)
PLUMBING'
;:E::~~::,\t~~ ,.,.. - u____ ~~~~
, ~-
I PLUMBING
I NO,
I
EXPIRES
1[).~'l4,
PHONE
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\ - 5-C{j/j 49A.~?)1\
8-,cJ41 ~~'ll17
MECHANICAL
FEE
...n
CHARGE
Single Fixture
Relocated Bldg,
Inew fix. addtll
Water Service
Furnacel burner & vent
< 100,000 BTUs
Furnace/burner & vent
> 100.000 BTUs
It.
Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct
,4 ,'.....J"f2f..,.... ._".~'
;/ '
Permit Issuance
Sanitary Sewer
It.
Storm Sewer
It.
Backflow Device
TOTAL PERMIT
TOTAL PERMIT
aUAD AREA:~C'W
- OFFICE USE -
n-2:C(~
HANDICAP ACCESS:
LAN D USE:
FLOOD PLAIN'
. OF BLDGS:
(\.c' )
. OF UNITS'
CONSTR. TYPE: "2.. -/ #/Z?'
lONING'
~-~
~
OCCY GROUP'
LIGHTING POWER BUDGET:
WATER HEATER'
. OF STORIES:
HEAT SOURCE:
sa, FT,
$/sa. FT.
VALUE
sa, FTG MAIN
sa, FTG ACCESS ___
sa, FTG OTHER~/C/')/'~
X
X
~.;..e-,-
~~~
-------
TOTAL VALUE OF PROJECT
PLAN CHECK Fe; 4\)'\ o...~
RCPTW \ r~u.'J
DATE-1.:j~q%-By~LQa )
I BUILDING PERMIT I ~:?. ~ I PLUMBING
15% State ~. /-.:1 5% State
Surcharge Surcharoe
'I MEC~ICAL/?> /V~ FENCE
,~--- I~ a-e:> VALUE $
15% State . .75" I SIDEWALK
Surcharae FT,
I PAVING I CURBCUT FT,
DEMOLITION
~~~
I SUBTOTAL
PERMITS
I SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES I
EXCLUDING ELECTRICAl
'W~
C""
i
('HARGi
I
I
I
I
/~ - - -
$10,00
.8. _ca
9/.~
W-o
.
REQUIRED INSPECTIONS
.
It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call
726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready
for Inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION: To be
made after excavatlon, but
prior to setup of forms.
y
ROUGH ~'-UI'iIDII\llJi,
ELECTRICAL &
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
PAVING: After gravel is In
place but prior to placing
asphalt or concrete.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
FIREPLACE: Prior to piacing
facing materials and before
framing Inspection.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Owner! Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
ATTIC DRAFT STOPS &
CURTAIN WALLS
y
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneys
and vents are complete and
the rough electrical, piumbing
and mechanical are approved.
STRUCTURAL CONCRETE: In
excess of 2500 P.S,I, (306 a.1)
CONCRETE SLAB: To be
made after all lnslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
STRUCTURAL WELDS:
Perlormed on the job, (2722 f)
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
INSULATION & VAPOR
BARRfER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board Interior wall covering is
applied,
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
a,6)
SPRAYED ON
FIREPROOFING: UB.c,
Standards 43,S,
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
FIRE & SEPARATION WALL:
located and constructed
according to plans.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork, (306 a,11 &
Chapter 29)
v
,
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterior, Is in
place but before any
plastering Is applied or before
gypsum board joints and
fasteners are taped and
finished,
GLU.LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed, (2501 U,B,C,
STDS, 25,10.11),
POST & BEAM: To be made
prior to installation of floor
Insulation, decking or floor
sheathing,
STRUCTURAL MASONRY: (306
a,7)
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathin9.
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
*In addition to the inspec-
tions specified, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
ROOF SHEATHING AND
NAfLING: Prior to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
A'
y
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking lot striping, etc. must be completed before
reQuestfng this inspection.
FINAL BUilDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
FINAL PLUMBING
v
FINAL ELECTRICAL
FINAL MECHANICAL
y
FINAL FIRE DEPARTMENT
,
ADDITIONAL COMMENTS'
PLANS REVIEWED B/_r~;~-"""..5} OAT" ~>-~ Y
By signature,l 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, and that NO OCCUPANCY
will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees
who are in compliance with GRS 701.055 will be used on this project.
I further agree to ensure that all required Inspecttons 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 remain on the site at all
times duri~~str.uctlon.
Slgnat.s;::f ZJ..di~ #~ Date .2/8~
!
VALIDATION:
AMOUNT RECEIVED:
RECEIPT #:
1~'23~
liS/X'
DATE PAID:
RECEIVED BY: ~
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