HomeMy WebLinkAboutPermit Electrical 2000-3-9
Job# 00-00372-01
Page 1 of 2
TRANS#:01-0000870
DATE:MAR 09 2000
AMT RECD:2 $ 21.60
2 $ 21.60
1 $ 1. 00
CHANGE:$ 0.20
CASHIER: 059
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00372-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
, Inspection Line: 726-3769
location Of Propo~:ed Site:
Assessors Map#: ',17033513
lot: Block:
804 c St
Spr
Contractor Type
Electrical Contr
Contractor
Adt Security Services Inc
1501 Pearl St, Eugene, OR
~ Tax lot #: 09600
L..(OA4.d~l'lOFJ,; Subdivision:
#~L r 0' I. V'~lt
~~~~I~6bJ6'~541-741-3481
~~~~~6'O ~~eld, OR 97477
Alterati~~ //~Olftl) Q~~OIft~~~b- $0
~& -.7'<7~ ~~
-</MI' 0.(,. l:b
. 'Q~ -'-<1 Jp,
.~" O'~,y
Registration~OJV~iration Date
Phone
541-342-1313
Owner:
Address:
Mark Swanson
804 C Street
Scope Of Work: Electrical Only
Office Use
Quad Area: land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type:' !JO/I '(VPk, ':." Bedrooms: Heat Source:
fe:J/lfJ I.J ,,/:.,' , '
Water Heater: au'o .~.fON!rl1lllnRang~: .:J;,. _"'q Sq. Footage:
"d'" . f UOR ,iJ.uo;;V'
. "'1 'Sam'f ....!'J; ';4~ :'al .~-'G l:J1.1J J ,.
To request an inspectigl)_~if tWeI2~ '~JU~&bR!lUl~t~9'~~!,,6.91uAII inspections requested before 7:00
a,m, will be made th~"~~7W~~$~'1ri~~~~/~l:I~~after 7:00 a.m, will be made the following
working day, '!j"ll saJesa/n' fJ410tOO_lO UJno^ '060
,;I;.!!YOfJaJ{lA:.as04.L 'J~ q-~S ~
,- '3t:1Jlnb 'J/...."Jall"ll(~qgl ctlons
ajA.... ,.... fUO~. 11. .
"''''1 /Joo~~.:'tlUtCl!tocal ", I
. I\JILI\I~ 'lu;
, "::::Ill. 'rf
low Voltage
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
~Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Electrical
03/09/2000 870
03/09/2000 870
Value/Quantity
Fee Amount
Limited Energy - Residential
State Surcharge For Electrical Permit
1
$20,00
$1.40
Fee
Job# 00-00372-01 I
Paid On Receipt#
Electrical
03/09/2000 870
Electric Administrative Fee
Total Electrical
Grand Total
~/~ 2::;,~~
"Signature
,?/
- ?-'
Page 2 of 2
Value/Quantity Fee Amount
$.60
$22.00
$22.00
3- 7~ ~
Date
, .tted haS the following
, r: a" subml d se
The following prOle,,'.~ lirf specific Ian U
, 'oe< no\ reQL .
zoning ano 0 - /} -
approvai L. 0 , '::::.------:
225 FIFTH STREET 2.oni'19 .__0'-.- ELECTRICAL PERMIT APPLICATION
~~~~i~;;>REg~~~~9~~~~m~ ?-~_,5_:.~-=-= "'~ty J~b Number DO-003 7-dl-Ol
OFFICE: 726-3759 ",,j;\,:)rized Signature--
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
St?tf ;'C" 5-frt:)e~'
LEGAL DESCRIPTION nrQ 0
\ :]..o33? I~ .. OT~
JOB DESCRIPTION
fi-(fA ~ c:;:_ ~~
//
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
Electrical Con trac tor AOf'ieCCtr,'-f,?
Address r.56' J r&>.rl
~ iA-#-ri:z... /]
Ci ty fl~61-"'" ~ Phone jt/:JL-f 3/1
i/~ .
Supervi.sor License Number/6/'7 Ill, i:!'
Expiration Date~2~ IO(J
Cons tr Con tr. Number S 7'~ '/ '/
:U
..
Expiration Date
Signature of Supervising Electrician
~~/~.// '
./ - --=- L~
A5wners Name YYvvJ.<.. S I..v- ":-l'-~ Ch^-
Addres~ <i 0 l-f
Ci ty SD.-J.
r )
() 'S~
'74/ - '3 'f~1
Phone ::; 'ib - ~
OVNER INSTALLATION
The installation is being made on
property I .own whi~h is not intended
for sale,lease or rent.
Owners Signature:
----------------~----------------------
DATE:
RECEIPT #:
RECEIVED BY:
.;). '- 1'1 ~ ()l)
~'11Q
U)"}
A. New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft.or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home. or
Modular 'Dwelling , . $ 40.00
Service or Feeder
.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' Cor 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 not included)
-Each installation
,Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res I $ 20.00 1..-0'
Limited Energy/Comm -,. $ 39.00 ) ~ ~.i
5. ~TOTAL OF ABOVE
Q State Surcharge
% Administrative Fee
TOTAL
~ -
~J~