HomeMy WebLinkAboutPermit Electrical 2000-10-5 (2)
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Job# 00-01498-01
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Page 1 of 2
TRANS#:01-0003403
DATE:DCT 05 2000
AMT RECD:2 $ 55.00
CHANGE:
CASHIER:059
I'-
SPRINQFIELD
~~
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01498-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4795 Franklin Blvd Spr
Assessors Map#: 18030220
Lot: Block: Addition:
Tax Lot #: 02S'00
, Subdivision:
Owner:
Riverside Mobile Home Park
Phone Number:
Address:
4795 Franklin Blvd
City/State/Zip: Springfield, OFt
Scope Of Work: Electrical Only
New Service
Alteration
Value: $0
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
"il b\ I iUI,;l;r.,()( r a" .
f II . .;J~' l;:1"'f"":' b: rL'
o Olll' nd,'=ll;,: ::>i10W..............' 00- ~
Contractor ""Reglstratlon'# ExplratlonlDateOI' Ut",Phone
UlI"(;clllOn (jenre, 1 h,,~c rule< a' . ,
Builders Electric Inc ,r.4296i952-001 0(J1~/,10/03 'O~ 1651541'485-0922
. 0." - 'v [IIrUU911 AR952-00'
195 Madison St, Eugene, OR 97402-5030) ~~;..You.may ootain copies of thp 111"'< I..
-_..:"" "'C V"",,,I. \Ivore: me telephon6
Office Use .:r fOI th 0
"u" 'u . 6. regon Urilir'V Notificatio
(;pnte.' '. '.># Of,Buildm~s: 11
Occupancy Group:
Heat Source:
Sq. Footage:
Land Use:
Zoning Code:
Bedrooms:
Range:
Contractor Type
Electrical Contr
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. wiil be made the same working day, inspections requested\after.7:00 a.m. will be made!he following
working day. r '\J , ICE:
R . d I THt.lSPERMITC:W^" 'OVn,~_.__.
eqUlre nspec Ions - . '-'" " H:: vVU""'1\
P.,fU9IilIZED . .
I Electrical,~... ._1 UNDER THIS PERMIT IS NO'r
Electrical Service - Must be approved to obtain permanerii'pow'i9.ED OR IS ABANDONED FOR
I., \ 182 JAYPER!OD.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
[Ar~a (Sq. Feet)
_ Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Electrical
10/05/2000 3403
Value/Quantity
Fee Amount
Permanent: 200 Amps or Less
1
$50.00
,
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Job# 00-01498-01
Paid On Receipt#
Electrical
10/05/2000 3403
10/05/2000 3403
..:.r
Fee
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
Grand Total
Signature
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Page 2 of 2
Value/Quantity
Date
Fee Amount
$3.50
$1.50
$55.00
$55.00
s submitted has the to 0
'f"'~ followmg prOject at require specific land use
, dOO ooes nO
c";.~~",,Mjl),z, _
Zoning. I D _ c:,-0lJ,
pete _ pW) El;ECTRICAL PERMIT APPLICATION
97477"_0 Signature - - I /.II
72'6"'-'3169 City Job Number ()(3~Ojl- qf?-u .
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LOCATJ.PNSOF INSULLAT~Otf R ( J Jl
l-j -:r '1 +-rr.,^.k\;\" l..Li.l,t:e.,
'=#-C5
()-;:;)'106
LEGAL DESCRIPTION
j(:l()<. 0 :->=',0
JOB DESCRIPTION
~)"J ~o,,^':"AQ
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
City
Phone
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
3. COMPLETE FEE SCHEDULE BELOY
A.
Nev Residential-Single or
Hulti-Family per dyelling unit.
Service Included:
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
Modular 'Dyelling
Service or Feeder
One Circuit
Each Additional
Circuit or yith Service
or Feeder Permit
Items Cost
Sum
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
Installation, Alterations
Electrical Contractor Bui Idees Eec.:Trit or Relocation:
Address ,<is MOc\l'S()() c:uC\enf' oe. qT~'OC 200 amps or less
J . 201 amps to 400 amps
Ci ty E.uC\("n-P Phone 4'6S-CAzz.. 401 amps to 600 amps
J- 601 amps to 1000 amps
Supervisor License Number '~'2 qO -'5, Over 1000 amps/vol ts
. Reconnect Only
Expiration DateIO~J.-{) J
C. Temporary Services or Feeders
Constr Contr. Number 4-Zq(p Installation, Alteration or Relocation
Expiration Date 12-(O-O~ 200 amps"or less $ 40.00
201 amps to 400 amps $ 55.00
':{jigna re f Supervising Electrician Over 401 to 600 amps $ 80.00
'1 / / / / Over 600 amps or 1000--VC>Its see "B" above
I ~~ 1. / L._
- m I _ n If D. Branch Circui ts
Oyners Name R',,~Q.. I" IOlffJ9-:t\\W'{;fbA,h.
Ll ~r 1 I. Ney, Alteration or Extension Per Panel
Address ,1'<t Jn~
~o~ I rJ.
OYNER INSTALLATION
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
60
,"
$ 35.00
$
2.00
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
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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