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Home My WebLink AboutPermit Electrical 1991-9-12 SI.rlINGt:I~LD 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 Ci ty Job Number q / /c!!>? L./ OFFICE: 726-3759 1. LOCATION OF lli~TALLATION ;3o~ ~ tlWnJ IklJti.UtJ \ -1<t5~~~~ON() \ ~Deu JOB DESCRIPTION I ntJU I ..110 fl t: ~ ulYY\ KU \ I 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 ContractorQ..ts PfuIit,u~ Address P,O, L:r{, /481-. 1 City~jcl. Supervisor License Number l~' Phone 14/- ~,:'J- '30 Ilog",S Expiration Date 10 -I - q 'J-.-. Constr Contr. Number o,~.a4.q Expiration Date q - 1- q '.J-. SO~"~7~'dd~ Owners Name .1lQ rno I POI\JYY\IIY',U tL> Address Eo~ ~ tH.1Jl'U ~H') CitY~l\lin~~'OOJ ,Phone 747-1..I.1It2. OlINER INS ALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: "'7-/2-"'7/' RECEIPT #: - '2 -?-;;r',,*,> RECEIVED BY: /Z_d~ . . 'l'- 3. COMPLETE FEE SCHEDULE BELOl1 A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cos t Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 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 "Bn above D. Branch Circuits New, Alteration or Extension Per Panel One Ci,rcui t Each Additional Circuit or with Service or Feeder Permit $ 35.00 05.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge. TOTAL ~q,oq ) .'15 .":fb.75 I RESIDENTIAL PERMIT APPLICATION .- Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT' SPRINGFIELD BLOCK' b~~\l_ \)(\\f\\Q n10 Y ADDRESS' ~r')f) _ S\.'t,tts ~\ 0 l\. CITY: - ~f\l.. D - ~ --'-"\--0-- DESCRIBE WORK' ~~\nJl ~- OWNER: NEW REMODEL CONTRACTOR'S NAME GENERAl' ,PLUMBING: MECHANICAL: ELECTRICAL' .. ,I JOB NUMBER q It rr7'1 '225 Fifth Street Springfield, Oregon 97477 (;\0(\ TAX LOT SUBDIVISION' PHONE:~&-' STATE: (l)AO~8Yl J P{ JLCl-r- ADDITION DEMOLISH OTHER ZIP: l.{'l.1.J.] ADDRESS CONST. CONTRACTOR' PHONE EXPiRES \.' ,tlY'f\\~t) ~\Oi ') py;SCS L0 \~; L 4({(!6 W3~/ql 3i?/3}OI QUAD AREA: \ ~ N\0 . OF BLDGS: OCCY GROUP' . OF STORIES: WATER HEATER: - OFFICE USE - \ \ eso LAND USE: . OF UNITS' CONSTA. TYPI" HEAT SOURCE: RANGE: FLOOD PLAIN: ZONING CODE: . OF BDRMS: SECONDARY HEAT' 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 mad~ the same working day, Inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. D Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench, o Underfloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. D Floor Insulation - Prior to decking, D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. o Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. o Rough Mechanical - Prior to cover. o Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. o Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After installation. D Insert - After fireplace approval and installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms and sub.base material In place. o Fence - When completed. o Street Trees - When' all required .,. trees are planted. o Final Plumbing - When all plumbing work is complete. D Final Electrical - When all electrical work Js complete. o Final Mechanical - When all mechanical work Is complete. o Final Building - When all required inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set. Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. o Final - After all required inspections are approved and porches, skirting, decks, and venting have been Installed. Lot faces Lot TY,-, Setbacks . IS. PROPOSED WORK IN THE Lot sq, ftg, Interior I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Panhandle Is I and a p proved by the Historical Topography lw I Coordinator prior to permit issuance. Total height Cul.de.sac IE I APPROVED: BUILDING PERMIT ITEM SQ, FT, X $/SQ, n VALUE Main Garage Carport Total Val ue Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer n FT. Water Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit { C}, 6D IO_tJ) I.m 1)R -V) Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut ft Demolition Stl~UJ1Wrge i- IlJ.6l) Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) J:/ .7{7 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the expre'ss pondition that the said construction shall, in all respects', conform to the Ordinance adopted by the City of Spri(l~leld, InclUding the Development Code, regulating the construction and use of buildings, and may be suspended br revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Date Paid: Receipt Number' Received By: Plans Reviewed By Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS 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 Laws 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. J 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 pia s will remain on the site a";p:all Im~s d? constructio. SlgnaturD U- Date _/J 9- / J -'J/ VALIDATION: RECEIPT NUMBE" Zrz/Cj.c" DATE PAID VJ. -13 ~I AMOUNT RECEIVED..!:t1 .zF RECEIVED BY I j ~