HomeMy WebLinkAboutPermit Electrical 1991-6-17
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225 FIPTU STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477
iNSPECTION REQUEST: 726-3769 City Job Number5?~d'~~~
OFFICE: .726-3759
1.
LOCA. TION OF IN;>tALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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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.
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Electrical Contractor L6..rl.('il) T:;(0riG
Address X'~trO t'N1.r~ ed.
Ci ty ~ . Phone ld-t, -4lIgY1
Supervisor License Number .326 J"
Expiration Date
Constr Contr. Number 1~-~07
Expiration Date
Signature.of Supervising. Electrician
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.. ;wner~me ~~ ()oJ1r;/UV--
Address ::,~
Ci ty Phone 7~ - 3ffll
OVNER INSTALLATION
The installation is being. made on
property. I own which is not intended
for sale, lease or rent.
Owners Signature:
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DATE: ~ -/ 7-9/
RECEIPT t: 2C?3'9/
RECEIVED BY: / L ..--,. ~
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3. COMPLETE FEE SCUEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1500 sq;ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Items Cost
Sum
$ 85.00
$ 15.00
$ 35.00
Services or Feeders (10 Branch.Circuits
included). Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
~ $ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
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C. Temporary Services or Feeders
Installation, Alteration or Relocation
$ 35.00
$ 40.00
$ 00.00
volts see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited energy panel
One Circuit
.Two .to ten Circuits
Each Addt'l ten or
portion thereof
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 50.00
$ 15.00
not included)
$ 36.00
$ 36.00
$ 36.00
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I JOB NO.
Zo"a:
SOLAR ACCESS
Occuooncll C.:
REQ.-
L-COC""
T.ype/Cor.8t: .
Bedrooms:
I I Ener(1lJ So:~rc(!n
1 !feat
I
II
II
II
Tl/ro
Lot Sq. Ftg.
~ of lot C"".rag.
Ii of StOM-So
TotaL H.ight
Topography
LOT TIPE: I Lot Faces -
Interior I S.tbacks
,,' ... , I P.L. ll/ouse Garaqe I Access.
Corndr '.' INorth I
l'anhandLe lEast I I
CUZ-de-sac ISouth I I
IWeot I I
I
I rTF-I(
I Main
I Gr-rl1r.e
I Caroort
I AcCe~SOrlJ
I
I
Is. D.C.
I S~.FTG
I
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I
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TOTAL VAWE:
(lJC.LuiJ
1.5",
:' Sui tding Permit
.Stat. Surcharg.
TotaL Chalog...
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IITEI(
I Fi.:z:tu.res
I R..id."tiaL (1 bath)
I Sanit:J.ry SetJer
I Water
PLumbing P.nr.i. t
State Szatc1-.a:roge
.J:EEz L Chair/..
rITEM .
I Res. Sa. (ta.
I N3UJ/Extend Cirocuits
I Temporary SeroicB
I
'NO. ,
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I I
FEE
Eleotrioal Permit
State Swochart1e
Total Charces
IIT511
I Fla'n:lce I!TU' S
I Ezhaus t Hood
I Vent FCl11
f Woods to:J8
NO. FEE:
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I I
I I
Permit IssuancB
lI.chaniaaL P.nr.i.t
Stato SUZOcJr.a:rcc
Total ~"ttfn'
I -- E:NCROACHHENT -.
I . I 't '
Secrolr1.tll D3oo31. . ,'1 "
I Stor~(le 1.", ~;v.."'''''''''' I ......fl....' ,.,.... ~ . ..,.. 1'''-,
I Main tena~e
I Pcmit
Total CharogOB
I Ourbcut
I Sid_lk
I Fcnoe
I Elsctrical Lab.t
I NoM l6 Homs
I TOTAL AMOUNT DUE;-
x
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I <.5CO,Lt1
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I (.::). 00
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Value
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C/lARGE:
CHARGE
CI/ARGE:
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.,
j '~Il."....' ".'! ,.:" ~
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(C),~01-
Water' Hl'!at('l'
Ra~Ir;(!
FircnZQca
Wood~ tor.:/J
Fee8
Building Value & Permit
Thin permit in (Jranted OIl the axproon condition that tho fhlid CO'ltlt,'Uc'Lioll
8hatL~ in all ronractn, conform to tho Ol'di,ulI;r:a :uiopt/?.j hy Lila City of
Springfield, including the Zoning C'rd~nallcf1, rcgu.Zr:tL11a tha c:cllatr:l.::tLell
and uce of buildings, and m.:1Y bo oucpended or l'ctJoked at G.I:!J t-:.m~ llpon uie-
lation of allY pralJiDiono of Daid 'Ordir.ancaa.
IPlan Chock Pec: J
IOatc Paid: j
IR~C.iPt H: j
St.(Jned:
I
Plumbing Permit
No parcon ahaH conotJ'uct, inata1.?, aZter 01' chan(Je any neW Cl' a:inting
. plwnbing 01' drainage systc:n in :Jhole or in part, w:lcn8 Bkch pSl'con io tho
legal poSOCSROl' of 'a vaUd plumber's licence, llXccpt tJ:at a parson may do
plW:'lbing work to p'l"opm'ty which io ownod, leaDed 0'1" opcl'atl1d by the appli-
cant.
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Electrical Perm it
Where StatB LaLJ requ.ircs tr.at tha electrical lJOt'i.: ba dona by all ELe~trical
Contractor, the' electrical portion of this pCr'mit shall root be valid until
the t.abeL has been Digned by the Electrical :':olltractol".
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I
Mechanical Permit
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P Um Examt.ltc'l"
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I HAVE CAREFULLY EXAMINED t.w completed application for permit, and do
h6reby certify that all ir:fo;wmation hereon io trua and correct, and I
fU~the~ ce~tify that any arn all work parforoned shall be do~e in accor-
dance with the Ordinances of tM City of Springfield, and t.h: Ur.JB of tho
State of Oreg"n p~rt.lining to tha work cescribad heroin, t::11d that NO OCCU-
PANCY wilL be made of any Dtructu.~a witho~t p3rmi03ion of the Su.ilding Di-
uision. I fUrthor certify that o~ly cont'l"actors and enpLaye68 who aro in
compliance with ORS 701,06E will bo used on this projsct
liotJ-tY 7~
St.gnsd
r -( ~ -19
Dat.