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Home My WebLink AboutPermit Electrical 1994-5-12 " - , " ri ~- J~I~i~~~O:,::I~r~:,;~r~~:;:~::' ',;'; .~~'<< :l:'. epprCiJ':.i.. a, 225 FIFTH STREET L{':~;..', l,D ELECTRICAL PERMIT APPLICATION . SPRINGFIELD, OREGON 97477"--'-" --. ,u' -'- q40~ ':l Q INSPECTION REQUEST: 726~316,9__~_~-'~~'f ' City Job Number 'V JJ OFFICE: 72'6-3759 :- ;','':'i::e;;IS,. 01,',.:'; ,"1.1\1\. ~ " - J~ . 3-. - "COHPLETE- FEE SCHEDULE BELOY 1. Jrlf~~ ~~~~. ) \eo~-sJr ~(11 ~J~~~~~o(l/'O /\~~-it' . . 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 INSTALIf~I~N ONLY Electrical Contrac~ ~ Address-.55f)5~ ~ ~ Ci ty _Yl Ll2ili2..- Phone J2=11 ~t Supervisor q,icen.se Numbe'r ~m,~ . ,\0 ' \ ,Q~ " I~.~ I cQ . If!' .q4 Expiration Date Constr ContI'. Number Expiration Date . ~~~ of pervising El ctrician ~ -<-: Owners NamJ\~ r\ J J)sen., ) Address A#k5 nAiWUS City f.. Joifto_ / Phone lPffi .AffS mINER I~TALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: DATE~==-----------~:~~~:f-------- l\t,\"r.H'l' I: 1\ ~ \' (\' () ,1 el, RECEIVED BY: t1\\f.D--J V~ 0- , A.. New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 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 l $ 85.00 PfS ~ $ 15.00 :3Cl $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40.00 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 ' E. Miscellaneous (Service/feeder -Each installaticin' Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) ;1' $ 40.00 $ 40.00 $ 20.00 $ 36,00 I (~po -f~ 'd: '1::; -r :!J 4S 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL , , ........ fi YY}n'!!!!t~!~!!! Job No. 9~O s 3 f3 SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: ~t#l ~_) ~~O AJ, ~s-t1-,3 eu4ZAJ~ PHONE:Jn~~ - 2,4 S9 - ,;.,.,; - ADDRESS: STATE:.M~ ZIP 9' ?e7dZ LOCATION OF JllROPOSED BUILDING SITE: 4~~ & ~ Platt Name: ~r Iu, 71ac1,r/~ax Lot Number: ,~.7P!?A- /~2- O~- 2-2 ~C'J ? Street Address if Known: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type definitions are on the back.) A. Sim!le Familv - Detached V;ingle Family home NO OF UNITS / B. Sim!le Familv - Attached NO OF UNITS C. Multi-Familv Aoartment NO OF UNITS D. Manufactured Home Park NO OF UNITS Manufactured home not in a park X $400 PER UNIT _= $ 4c;a , X $370 PER UNIT = '$ X $277 PER UNIT = $ X $280 PER UNIT = $ WPRD SDC $ 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. com~i~~es~~:~ City of Springfield t)/ Date $ $pcrD \ tJ~4 o' I~ .Cf4 ~*- ~ 'l Q?J 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit) , \3'l. B 6.3 ~ I ob SPRINGFIELD -sf? L/55' RESIDENTIAL PERMIT APPLICATION :OB NUMBER!1!!- 03~~ Inspections: 726-3769 Office: 726-3759 225 Fifth Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: LlI~?) -f6y<S~~ ASSESSORS MAP: \<K ozx:0ZL- lic, OWNER' ~ YOvQ...\ <;e.,~ ADDRESS: - 156b N Ma1J\.AS '~~ TAX LOT: 4-0 l SUBDIVISION:-tj()0V\ ~~ ./ ~?;-'61f61 BLOCK- LOT: PHONE: ZIP: Cf-:zl(o V r\e.- STATl=- CITY' S'- t:: ' Q...-,ec, t-~G.e..- DESCRIBE WORK: NEW 't-- REMODEL ADDITION DEMOLISH OTHER CONST, CONTRACTOR # CONTRACTOR'S NAME ADDRESS EXPIRES PHONE GENERAL: PLUMBING' MECHANICAL: ELECTRICAL: - OFFICE USE - LAND USE:~ II / :::;:'T~PE. 0 rJ HEAT SOURCE: 'f=S RANGE: CZ-J QUAD AREA~~C./ # OF BLDGS: l 6CCY GROUP: k\..~ # OF STORIES: \ WATER HEATER. . ~ FLOOD PLAIN: ZONING CODE: l D~/ # OF BDRMS: ~ SECONDARY HEAT:........... F'\J t'l'l \ SQUARE FOOTAGE: To request an inspection, you must call 726-3769, This Is a 24 hour recording, 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 work day, REQUIRED INSPECTIONS C"'-/'i' Rough Mechanical - Prior to ~ cover, ~ <:b(. T,", J><:f"'Final Plumbing - When all , ,.,Iumbing work is complete, D Temporary Electric rYi Rough Electrical - Prior to ~cover, D Site Inspection - To be made after excavation, but prior to setting forms, IYl Final Electrical - When all ~Iectrical work is complete, C rX(Final Mechanical _ When all ~echanical work Is complete, I)?'(Electrlcal Service - Must be ~approved to obtain permanent electrical power, D Underslab Plumbing/Electrical/ Mechanical - Prior to cover, r--.....;(Footing - After trenches are ~ excavated, I)(f Final Building - When all ~equired Inspections have been approved and building is completed, D Fireplace - Prior to facing materials and framing Insp, D Masonry - Steel location, bond beams, grouting, ~ Framing - Prior to cover, D Other T;xf'Foundation - After forms are " - erected but prior to concrete placement. ~'Wall/Ceiling Insulation - Prior to . 'cover, /[] Underground Plumbing - Prior M Drywall _ Prior to taping, to filling trench, ~ ~ Underfl~lumbing~hanica!) ~ _ Prior~insttl.:.~;v~ecKlng, 0 Wood Stove - After installation, MOBILE HOME INSPECTIONS D Blocking and Set-Up - When all blocking is complete, K7r Post and Beam - Prior to floor ~Insulation or decking, D Insert - After fireplace approval and Installation of unit. I\/f Floor Insulation - Prior to ~ decking, D Plumbing Connections - When home has been connected to wateroand sewer, . - , IYf Curbcut & Approach - After ~orms are erected but prior to placement of concrete, 1>21 Sanitary Sewer - Prior to filling , , trench, d Storm Sewer - Prior to filling J2S...!. trench, ' / I fVI Water Line - Prior to filling ~ trench, - I~ Rough Plumbing - Prior to ~over, D Electrical Connection - When blocking, set-up. and plumbing inspections have been approved and the home is connected to the service panel. "Kr1 Sidewalk & Driveway - After ~excavation Is complete, forms and sub-base material in place, D Fence - When completed, D Final - After all required inspections are approved and porches, ski rti ng, decks, and venting have been installed, ~ Street Trees - When all required ~ trees are planted, " , Lot faces # Lot Type Setbacks - i \..._- IS THE PROPOSED WORK IN THE Lot sq, ftg, 95fi,S X Interior I P.L HSE GAR Accl HISTORICAL DISTRICT, OR ON Lot coverage /~ IN /fo zt) THE HISTORICAL REGISTER? Corner Is 51 If yes, this application must be signed L-Z?o and approved by the Historical Topography Panhandle Iw I~ Coordinator prior to permit issuance. Total height \..L!L. Cul-de-sac (M') IE ~ I APPROVED: BUILDING PERMIT : sa. FT. \ ~S\.o ~~ \ l 0 ITEM fi.{~ "~Etb Main Garage Carport Total Val ue '7'7J3(}~ -::?y" .,..:-;7. tJ;O - - r I t!J.!S 3/b~J~ Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) ~ (B) t'2.0&-\-B\::!' PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) NO 2... /~.c-.P Sanitary Sewer FT. Water FT, FT, Storm Sewer Mobile Home Plumbing Permit State Surcharge $~ L09:J~O Total Charge (C) MECHANICAL PERMIT ~~ ;""/ f 1) " # ~.G-o 1~,8-0 -3 0,0 Furnace Exhaust Hood Vent Fan NO ? Wood Stove/lnser~irePlac~ Dryer Vent Mechanical Permit ~4,S;() - I /~~O :~/,'73 ~ c-:z... 3 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge L4~~(J / 3.'1/ Sidewalk 9(, 2-(, ft ft Curbcut Demolition \:~~:.::~ clliOlli (E) , , TOTAL AMOUNT DUE (excluding electrical) ;z,?_Q..~~O (A, B, C, D, and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of anY) Rrovisions of said ordinances, Plan Check Fee: C>l3 8 ,CCJ~ Date Paid: Receipt Number: Recei~ ~ Pla~~viewed By Li /t2-/J~ ~ ;atk ~ Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, ADDITIONAL COMMENTS ~~N-~o.~' \ cA.-\-\ ~ c 9\f\\f\ Q ~. ..... /~J \d \Y~l) f)~T~: \ C\ loC) 5Ot1~ _/~~-/.J ~~.. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information hereon 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 ~aws 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 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 each 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 slte{\ all times;~n~nstructlon, ~gnature ~ ~ ---.. Date (/ '-'" VALIDATION: RECEIPT NUMBER 122?j ~//J/~ ( , 2')";2..'1, ~D ~7~ '-'\, DATE PAID AMOUNT RECEIVED RECEIVED BY