HomeMy WebLinkAboutPermit Miscellaneous 2001-11-26 (2)
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I Job# 01-01154-01 I
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Page 1 of 3
TRANS#:Ol-0007320
DA TE : NOV 26 2001
AMT RECD:2 $ 103.50
CHANGE:
CASHIER:061
.~
CITY OF SPRINGFIELD, OREGON
PUBLIC PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01154-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 205 Dorris St Spr
Assessors Map#: 18030200
Lot: Block: Addition:
Tax Lot #: 00802
Subdivision:
Owner:
Address:
Willamalane Park and Recreation
200 South Mill Street
Phone Number: 541-726-4335
City/State/Zip: Springfield, OR 97477
New Value: $1,610
Scope Of Work: Miscellaneous
Flag pole installation with exterior lighting
Contractor Type
Electrical Contr
Contractor
Wi llama lane Park and Recreation
200 South Mill Street, Springfield, OR
97477
Registration # Expiration Date
Phone
541-726-4335
Footing
Final Building
. ''(\
Office Use ~,; o~'" -0..
-E - t> '\. \ \'
~ ",.,. ~O~e#,Of BUilciings:
",,\"',' ;\ er:..~ r J" ""~
PLOS ".. ~- ,\ 'OJ, \,)~"pccupancy_G. roup:
'.., ....B.... ~~ ~-',~' ^'\#
.:JV ~(,,,> ~r.;, HeafSource:"\
. r. 'c;.\.- ....,. ",'to - -\-:.:,. r,S,
Water Heater: Range: ,,~~c",\vC'~\(:,. -\J' .~.q. F?otage:
,,"c,\-..-;;'_"'-:I"(':-';" ~\.c." :~- \\"\.) '.:.:
To request an inspection call the 24 hour recording at 726-3769.JAII.inspections requested before 7:00
,\,. " , ". '".. J_;;';"
a.m. will be made the same working day, inspections requested~after,\(j:OO a:ri1?wilhbe made the following
k. d ,. c\). "." ,_u-
wor 1n9 ay. -lJ- .,\~'" . .\'"
-' ~. j3' "r.\.~'
Required Inspection~" .-
'. . ~
I Buildin!l I ~o~ \\
-After trenches are excavated. . '((~((;:. \ro~o
- When all required inspections have been approved_~lh~~&fin~~ complete.
r-- ~ .- ~<()-:.v..\ro~ ~\)'(
I Electrica~l~~' -lcoy.~ ~\,. ~o~
- Prior to cover. ~O \ I ~~' \:s~,\)~ ~<o~~
-When all electrical work is cOr1]~,?~ ~1f;-\) O<r(o.\ro Ii).
, . &.0 ~v~\) ~~O
I*-l'~~~ ~~
c,o \~\)
~~-{
Quad Area:
# Of Units:
Constr. Type:
5PSW
Land Use:
Zoning Code:
Bedrooms:
Rough Electrical
Final Electrical
...
.
.........
-
~./
Zoning: PLOS
FloodPlain? 0 Wetlands? 0
Journal numbers
1: 2:
Comments:
I Job# 01-01154-01
Overlay District:
# of Street Trees:
.
3:
Additional Requirements:
Glenwood Area? 0 Required Attachments:
Source Locn:
Material:
Planner:
Urban Growth Boundary?D
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA:
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
iArea (Sq. Feet:
I Main: Accessory:
Fee
Public Plan Review
Total Plan Check
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Minimum Electrical Permit Fee
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Grand Total
Plan Check Type
Checked By
Initial Review-C/I/P
Engineering-C/I/P
Planning-C/I/P
Lisa Hopper
Pam Ownby
Liz Miller
Structural-C/I/P
Tom Marx
Flood Plain FEMA:
# Of Stories:
Current Units:
Census Code: Does not apply
Page 2 of 3
Land Use:
Pave Driveway? 0
Height (feet):
Proposed Units:
Total:
Paid On Receipt#
Plan Check
10/22/2001 7032
Building
11/26/2001 7320
11/26/2001 7320
11/26/2001 7320
Electrical
11/26/2001 7320
11/26/2001 7320
11/26/2001 7320
11/26/2001 7320
Date Completed
Comment
10/23/2001
11/05/2001
11/01/2001
Value/Quantity
1,610
1,610
1
Fee Amount
$29.25
$29.25
$45.00
$3.15
$3.60
$51.75
$2.00
$43.00
$3.15
$3.60
$51.75
$132.75
Reflect lighting away from less intensive use
and public rights of way.
11/20/2001
,I , · I Job# 01-01154-01 I . Page 3 of 3
By signature, I state and agree that J 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 property, and the approved set of plans will remain on the site at all times
during construction.
(>1\. '1lr "J .f'~. )
Signature
O.n
l
O~
It(d-.G(6t
i
Date
"0
225.FIFTH STREET e\
SPRINGFIELD, OREGON 97477 .
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759" ,
.1', I
i
ELACAL PERMIT APPLICATION
'City Joh Number .1:2/- 0 U S4 :.. 0 I
"
I'
3. C01vlPLETE FEE SCHEDULE BELOW
,
,
L LOCATION OF INSTALLATION
205 ~RRi" sr-
i
1"...
- "'.A.
; .
New Rcsidenti,.I-Singlc or ' .'
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRll'TlON
r F303 Oz...o-o
o080Z.
Items Cost
Sum
Permits are non-transferable and expire
if work is not 'started within 180 days
of issuance or if work is suspended for
180 days.
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each ManuI'd Home or
Modular Dwelling
Service or Feeder
$106.00
JOB DESCRll'TlON r
I Cf (2..c:.lAl"-
$ 19.00
$ 50.00
2. CONTRACTOR INSTALLATION ONLY
Electrical. Contr'lcto~ ;I//;r
B, Sen'iccs or Feeders
Installation, Alterations nr
Relocation:
-
/' ~,
/ '
/
-------
200 amps or less
20 I amps to 400 amps
40 I amps to..600 anips
60 I amps to 1000 amps
. Over 10QO amps/volts
,..;.,..... .."......<
" .Reconnect,Only., ,'" .'
. '. :,;_{:.}Jf:~~,:;~_:'~:';"~1~;~':~~';_' ---,'};~i~~C;'f_
. .: t, Temporary S'ervicesor Feeders
'-'~-~;_.,~,:y~~' '. ;-rin';tallatio~,-AItcJ~ation(6rR~loc;ition
"-';j'~',~.., ,~:";~;~;.~' '~~ ._:.:~,:, ~ :":;\//:: ~~ ;;;-;',~: '-- ~ :\:-- ;,:>, -' "
'::::'~;f;" 200 I
' .., amps or ess . " ..
'_, 201 amps to 400 amps
. - .':"'Over 401 to 600 amps
Ov~r'600 ~mps or .1000 'volts
"BI! above -.~. '--(
1'-
! \.
Branch <;:il"cui~s f
New'Alteration or Extension Per Panel
/,f~;
O~7: Circuit'
.'.
Address .
City
;~
Phone
SupervisofLiceIlse Number
I -',' .
i ,,>c', ", ,', ~<,
Expiration Date ' fi)- /
/r'
. .,:'::~4r:; ~"
. /II'itf ' .
L..Constr Contr. Number.
--:.,
.~.
"- "'Expiration Date
: Sign:iturcof Supervising Electrician
.,.,.~,.,'".~~, 'D'~,/,) j 4;1
". /Yi//V'\.. K'LMtd"d"{
.., ' ,'.. . , . D
: Own~rs N~me t)11i4JVlA~ PAtk- Dlrr- .
Address :2dO. $h1/I/'-Si-. \
City '5f'RlN6 At:t6 Phone '73'- -'-10 yl
/ : '$43.00 . ij.;;'.:rV
OWNER INSTALLATION
The instaIlation is being made on
property I o\vn which is not intended
for sale, fease ot rent.":< .
Each Additional Circnit or with Service'
or.F eeder Permit
,
$ 3.00
Owners Signature:
, . .. \
E. MisccIlaneous (Service/feeder not included)
. -Each installation . .
it. .". .... ";', ,:
Pump of'lmgatlOn
Sign/Outline Lighting
Limited EnergylRes
Liinited Energy/Comm
$50.00
$50.00
$25.00
$45.00
I\linimum Electric Permit Inspection Fee is S45.00 + Surcharges
i ~ '
4. SUBTOTAL OF ABOVE 'i ~..-c
7% State Surcharge ~
8% Administrative Fcc .3~
~
<:;, 7;
3/}
,?6J
TOTAL