HomeMy WebLinkAboutPermit Electrical 2000-4-24
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The following project as submi<<ed has the following
zoning, and does not require specific land use
approval. C--c...-
Zoning
Date _ 'q-;"'f ~ \
OW.J ELECTRICAL PERKIT APPLICATION
97411i]lhorizad Signature
726-3769 City Job NumberOO~0060~ -01
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. ~CATIqN) OF INSTA,L1.ATION
7(')0<' Irione'er 'ft,(fl.t);,lI I//t"-ST
LEGAL DESCRIPTION
J70--z,~'l-'2 o7q~
~OB DESCRIPTION
Pltoc. ,r) Ck/ l.0M IL
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. ~NTRACTOR INSTALLATION ONLY
Electric~ Contractor
Address ~
~
City
Phone
License ~b~
Da te ""
""
\
Supervi.sor
Expiration
Constr Contr, Number
Expiration Date
Signature of Supervising Electrician
Owners Name M_lJr-.ae I 1-leJ,) s hClt..Ld
Address Q5cJ. 9J/)nee V' ~h.A::,l_.w::-sr
Ci ty Srf cfl Phone 7 </'1- ()()() <.,
OVNER INSTALLATION
The installation is being made on
property I own which is not,intended
for sale, lease or rent,
~YYo iL-
--------------------~~----------------
DATE:
RECEIPT 11:
RECEIVED BY:
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit,
Service Included:
Sum
Items Cost
1000 sq,ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
.B.
~ervices 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
$ 85.00
$ 15,00
.$ 40,00
$ 50,00.
$ 60,00
$100,00
$130.00
$300,00
$ 40,00
IOO~
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40,00
$ 55,00.
$ 80.00
see "B" above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ~
$ 35,00
$ 2,00
q,
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 40,00
-$ 40,00
$ 20,00
$ 36,00
~ \ O~ ,OQ
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I Job# 00-00605.01 I
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Page 1 of 2
TRANSB:01-0001329 I
DATE:APR 24 2000
AMT RECD:2 $ 135,30
CHANGE:
CASHIER: 059
l
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00605-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 452 W Pioneer Pkwy Spr
Assessors Map#: 17033523
Lot: Block: Addition:
Tax Lot #: 07900
Subdivision:
Owner:
Address:
Michael Henshaw
452 Pioneer Pkwy West
Phone Number: 541-744-0003
Scope Of Work: Miscellaneous
City/State/Zip:
Alteration
Springfield, OR 97477
Value: $0
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq, Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day,
Required Inspections
\- - Electrical ~-I
Rough Electrical
Electrical Service
Final Electrical
- Prior to cover.
-Must be approved to obtain permanent power.
- When all electrical work is complete.
r --- - Plumbinq
- When all plumbing work is complete.
Final Plumbing
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
iArea (Sq, Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Electrical
04/24/2000 1329
Value/Quantity
I
Fee Amount
Permanent: 200 Amps or Less
2
$100.00
;'
.
Job# 00-00605.01 I
Paid On Receipt#
Electrical
04/24/2000 1329
04/24/2000 1329
04/24/2000 1329
04/24/2000 1329
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Page 2 of2
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Fee
Value/Quantity
I
Fee Amount
Branch Circuits W/O Feeder or Service
Branch Circuits With Feeder or Service
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
4
$.00
$8,00
$7,56
$3.24
$118,80
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Plumbing Administrative Fee
Total Plumbing
Grand Total
Plumbinq
04/24/2000 1329
04/24/2000 1329
04/24/2000 1329
1
$15.00
$1.05
$.45
$16,50
$135.30
By signature, I 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. I further state that only contractors and employees who are in compliance with
ORS 701,055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time, that the project address is readable from the street, that the permit card
is located at the front of the pro~ell' andA the approved set of plans will remain on the site at all times
during const/j~ a 1.J..v.dev-J ~ e:J t( -CJ()
Signature
Date