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HomeMy WebLinkAboutPermit Electrical 1991-6-17 ~1 225 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 .J4~ V~~. LEGAL DESCRIPTION /7-t:>~'7.5"'~2 O::;>-=;:-~C> " JOB DESCRIPTION _~~lJ <::,pnl,'t.lL (i1~o- .I 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. ;xc, - d8'=> v 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 -~~ p&~ .. ;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: ---------------------------------- DATE: ~ -/ 7-9/ RECEIPT t: 2C?3'9/ RECEIVED BY: / L ..--,. ~ r.i' 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 <-- 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 tf;e>. or t> ~-z::. Ccl?, rr--o 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 I I I TOTAL VAWE: (lJC.LuiJ 1.5", :' Sui tding Permit .Stat. Surcharg. TotaL Chalog... ~ I I I I 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. , I I 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: I I 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 I I I I I J I <.5CO,Lt1 I I (.::). 00 I .' r~ I I (() ,'is I- I I I I I I I Value " C/lARGE: CHARGE CI/ARGE: I I I I I ., j '~Il."....' ".'! ,.:" ~ I (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. - 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". I , - I I Mechanical Permit - ---..... ~ ~<--- \ . ~_." P Um Examt.ltc'l" '--' [e:- I I I I. I- I I I I b-- \~ ~ \a['11 . \ 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.