HomeMy WebLinkAboutPermit Electrical 1991-11-25
SI"IIINGFII.:.LO
225 uun STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 City Job Number 9//:<~
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
? 34 C::;/"t>~ C;;c-c-.&-- /~
LEGAL DESCRIPTION
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,
JOB DESCRIPTION '
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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 Contractor&,V/A7 ~~?:""'h~
Address ~ 'Z. ~A/~LA/
Ci ty
&.fiiI{"E~
Phone -=?t./&/-2f!!:~/'
Supervisor License Number
"341'97 :5
Expiration Date
/6-/"-"'? ::.<..
Constr Contr. Number ~D~~"'7
Expiration Date
/~"'2 ?~r
Sign~ture of Supe~ising Electrician
A y,,~ v/<--'J.J--,-
/)~ "
Owners Name '//",,:#1'0/7.4 C~A-7~C:;-
Address 'ItYC>"/ 7b7> =-~ -5'........~
~~.
City _~~~~ Phone
OWER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: //- 25"-"'3 /"
RECEIPT II: &>6 '3 / k if
RECEIVED BY: /7' ~
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3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems 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 1!z:6
Service or Feeder "Z. $ 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 vol ts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
One Ci-rcui t
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 $ 20.00
Liinited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
8o.~
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.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office; 726.3759
.
SPRINGFIELD
'xc> fi'{-
.
JOB NUMBER2L/2.~5:
225 Fifth Street
Springfield. Oregon 97477
LOCATION OF PROPOSEjD~~; 5b,.-' -73,r/
~,ASSESSORS MAP: l luo~'ll~ '
~
4-1<2"77"-' 07'"/~ ~vr'H' vL
TAX~L~..
SUBDIVISI~J( J l.i!.lJ,J or-
CONST,
CONTRACTOR'S NAME ADDRESS ~CONTRACTOR # :!!.PIRES
. f!J~lltr - ~8I7'1~ 11.9(7'2-
GENERAL:.&::"-l:::.i:ZJ f2 ..4// d ar-d"____l5tL~ L" ~v-.<",.,'" /f:!'Uc/ - ~"'-:I '17" q :1 .;t'-?'I.J+
/7 D / /. " 7 --"
PLUMBING: (:,,, r< (, , I I '--L/.!/J.??'b/-h""__XM';Il ~Zd\"';~' ,;::> -;t~gl/<fG,
./ . yc-- -ez,t..iiN~ 'li'f'~1 - -
MECHANICAl :----:.z.
ELECTRICAL: _~ 1//'-"
LOT:
OWNER:
J7/ _-::I ""; -1-::> ..:r:
.1/&01 ron4-.,. ,<-I-
ADDRESS'
CITY: ~/~J ".., ....,.."r
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DESCRIBE WORK'
NEW
y
ADDITION
REMODEL
BLOCK'
(?,,-~ h <"
#4",,-,
STATE: .D~
DEMOLISH
OTHER
'\
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_C-/. =h.,.....
.E"/~~-/c....5"3~ U"7ClJ/'" "7~~
,~/ir;F ~ :~~/.I/
12/2.V9~.,tP.lr--79, r(
QUAD AREA:
l RQ) 1 ')
( .
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I
T.J
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
LAND USE: DFFICr(~()
# OF UNITS:_(
CONSTR TYPE:
HEAT SOURCE; f='9_
r~
RANGF'
PHONE:
/. ,t;?":?-~~ 7_'
ZIP' 7'?'~O -.s -
PHONE
FLOOD PLAIN:
ZONING CODE: .lJ)rz-.-,
# 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
made the same working day, Inspecttons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
fTZP'i, ,~",' , --,.,'I1~rlcal) "l 0 Electrical Service - Must be
~ 1\ ~.. ~ III - Pflo~'cover/ approved to obtain permanent
rf1 electrical power.
Footing - After trenches are
excavated. D Fireplace - Prior to facing
materials and framing Insp.
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
Underlloor Plumbing I Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
~ Sanitary Sewer - Prior to filling
~. trench.
~ Storm Sewer - Prior to filling
~ trench.
~ater Line - Prior to filling
t trench.
o Rough Plumbing - Prior to
cover.
D Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Slave - After Installation,
D Insert - After fireplace approval
and Installation of unit.
~urbcut & Approach - After
forms are erected but prior to
placement of concrete.
r.-7ffiidewalk & Driveway - After
'or :xcavation is complete, forms
and sub-base material in place.
D 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 atl
electrical work is complete.
o
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - When all
required inspections have been
approved and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
~IOCking and Set.Up - When all
T :Iocklng Is complete.
~umblng Connections - When
home has been connected to
water and sewer.
~Iectrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
~al - After all required
nspections are approved and
. porches, skirting, decks, and
venting have been Installed.
Lot faces
lot Type.
lot sq, ltg,
Interior
Lot coverage
Corner
Topography
Total hei ght
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
State Surcharge
Total Fee
(A)
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I PL HSE GAR ACC
IN
Is
Iw
IE
VALUE
P6p:D
ffiJ.cD
{5, OJ
IS
j~.1<,
SYSTEMS DEVELOPMENT CHARGE (SDC)
>>"""1(-'h",r..:.....,..d,.J.J. (B) (l;.110'\- ~ tw!>
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
n
n
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/ Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
/_.-, I
Sidewalk '".,
-",",,,,,-'
Curbcut 2.2
It
lte9teuf
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~~
as
&.5
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
opted by the City of Springfield, including the
Dev ment Code, regulating the con uctlon and use of
building and may be suspended revoked at any time
upon violati of any provision f said ordinances.
Plan Check Fee:
~
~
~
Date Paid:
-Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~ ~tx'I. t' ~r\ 0 u?J1 Qt."
'ANNf:'X A E .
r_cA~T : H
\ ~~~ ~$1~4~O
- t" ,_" - . ~
~\~o ILJ'
~\ J,n l5\.o~U l...t ti:)
~O~f\Qlt~ : )'d'tv~~.
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.
I 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 plans will remain
on the site at all ~i~dUring constructlo~) .#,
Signatur\~~Z4~4./~L
Date /c:> - 2. r-9...-----
VALIDATION: ~ lto our "J / -O^
RECEIPT NUMBER ., O. ( - 't~ ({} 70
DATE PAID 71 'de::::....r.,.z ( n- ~
AMOUNT RECEIVECJ)~ / q~a( . ct5
RECEIVED BY / /)C;l )
,v.- _ _
.
SPR.FIELD
DEVELOPMENT SERVICES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726,3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that with the approval ,of the attached
manufactured homes will be placed at
Springfield, Oregon, City Job Number
Development Code, I understand and
perm~ O~_;~l1h~ f9-l,lpwing
~'-.n ~J' (.:) U 11 )
cJ. \ \ri.5S .
agree
~
Class' A Manufactured Home. A manufactured home of not less than 24
feet in width and 16% (not less than 2:12) roof pitch, with exterior
dimensions enclosing a space of at least 960 square feet, with roofing
and siding materials that are commonly used or compatible wi,th site
built homes. ,
o
Class B Manufactured Home. A manufactured home of not less than 12
feet in width and 16% roof pitch, with exterior dimensions enclosing a
space of not less than 500 square feet, with roofing and siding
materials that are commonly used or compatible with site built homes.
"
I further state, by my signature below, that I have been provided with the
following information:
- Mobile home blocking
- Sanitary sewer' connection
- Vater line connection
- Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
'A"d:'.z--/40k' _
2.s- 6c~~-?;/
Date '
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