HomeMy WebLinkAboutPermit Electrical 2001-9-13 (2)
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I Job# 01-00991-01 I
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SPRINGFIELD
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CITY OF SPRINGFIELD, OREGON
PUBLIC PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00991-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1 Gateway St Spr
Assessors Map#: 00000000
Lot: Block: Addition:
Tax Lot #: 0000
Subdivision:
Owner:
CITY OF SPRINGFIELD
225 FIFTH ST
Phone Number: 541-726-3668
City/State/Zip: SPFlD, OR 97477
New Value: $0
Address:
Scope Of Work: Electrical Only
Traffic Signal at the Northwest Intersection of Gateway and GameFarm Road.
Contractor Type
Electrical Contr
Contractor
Lantz Electric Inc
4131 E Street, Springfield, OR 97478
Registration #
84679
Expiration Date
7/14/02
Phone
541-726-0659
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
Rough Electrical
Electrical Service
Final Electrical
- Prior to cover.
-Must be approved to obtain permanent power.
- When all electrical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
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Fee
Minimum Electrical Permit Fee
Permanent: 200 Amps or Less
Branch Circuits With Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Job# 01-00991-01
Paid On Receipt#
Electrical
09/13/2001 6684
09/13/2001 6684
09/13/2001 6684
09/13/2001 6684
09/13/2001 6684
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Value/Quantity Fee Amount
1
1
$.00
$63.00
$3.00
$4.62
$5.28
$75.90
~ ~ $75.90
9(3(')/
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Date
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ELECTRIC.ERMIT APPLICATION "Y.".,
City Job Number rll no Ct qR~N~01.-0006684
uHTE : SE~' 13 2001
3. COMPLETE FEE SCHEDULE BELOW AMT RECD: 2 $ 75.90
.1 L~ATION OF INSTALLATION CHANGE:
...0:\ H lJ,fll,1 ~lf2. EFi\ A. New Residential-Single or CASHIER: 001
I . Multi-Family per dwelling unit.
LEGAl< DESCRIPTION . Service Included:
/...1/.\ ('~LQb Ls'J.-'ihl_J,\AU, ~~FN2-I'^-,.GO
JOB DESCRIPTION , 1000 sq.ft. or less
---If f+. PF l e~ ~ \il, n Q Jl.. . Each additional 500
sq. ft or portion
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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Items Cost
Sum
$106.00
PermitS~.rrl;'I\on-transferable and expire
if work is not started,within 180 days
f'.." ,',.',..01 'f"I'<I::.,-I. t:xP,Qo; 'a' rHE WORK
o Issuance or I WOIK lS suspenue IvT
~8(joays:~:::ED UNDER THIS PERMIT IS NOT
em,in!. .. ,q'n ('\8'~ ^8^~'D""C[) F,l"D
2. cONTRACTOR INST;b;Lt'ATION oNLY
P~IY 1F ;' t,\, Q::RI"n
Electrical Contractor lA,,+z.EL~c...
thereof
$ 19.00
Each Manurd Home or
Modular Dwelling
Service or Feeder
$ 50.00
Address 1..\ \ ~ I E S Ttz...u.:::r
City ~n'1 ~elJphone I 'Z /" - ~S-~
Supervisor License Number 3 l..{q z.. <::.
Expiration Date I oLLI 0 I
B. Services qr..F~~er~IO \ :'.
Installation, Alterations or
Rei~c~ti~~.;')It.:;.':' c..u..)~."'~L' '.~' i '~.' l~'
"V.i ll...t.!''';~l C2'1~~I" "fila..:"" "o"~ .
2' oiro' OMi b"~I.-I:O !-0u"~' ,:,,~ '(ih (') :.', $ 63 00 id2 (S'()
amps or ess I _.'" . . _ ::::>.
II'JtiL y..,'J......~\1rh\!"".1...., . -
201 amjJsto.400'amps"" .':"::lE ~$,75.00'
401 r.f"""t" '6'0.0,.'n nr ""Q'. l~~ 'n'- '$12500'-
amp's 0 amps', L "' ~ '.....1..' .
60P!.'t\\p'11&ffOOO'iimpS'; -,' 1~,;1;" ''''i,$l(;~.OO =
Over 1000\;'mpslv'olts'-c" .' '," $375.00
Reconnect Only - $ 50.00-
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Constr ContL Number R4 &''7 9
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C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 40 I to 600 amps
Over 600 amps or 1000 volts see
"B" above
Owners Name ' \ OJ:' ~ . d
New, Alteration or Extension Per Panel
0T(L \
7/,(/ /07-
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$50.00
$69.00
$100.00
Expiration Date
Signature of Supervising Electrician
Addres~ 5 5'tt
Ci~~Oi't 1(tJtil0~one 7l.J 0-3753
o ERINSTALLATION
One Circuit
$43.00
Each Additional Circuit or with Service
or Feeder Permit --1. $ 3.00
3,CiU
Owners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $50.00
Sign/Outline Lightinl!
Limited EnergylRes
Limited Energy/Comm
The installation is being made on
property I own which is not intended
for sale, lease or rent.
TOTAL
$50.00
$25.00
$45.00
d, 0(p_OD
q.J....Y/
.LJ . (p'"l...
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J\:'S'1o
5. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
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