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Home My WebLink AboutPermit Electrical 1995-6-27 ~~:'j~~~~~~~~~~j~~ ~~S~~:slttp~if7:S'atnhde following" approval. use , Zoning-L- /) tZ- D~k-~-l1\ NM 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 974i]!jiorized Signature 726-3769 1. ~~l!]N ~l\rli~ON \ 10!$ ~crPTION (Jj22IL ~Fr~O~~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. CONTRACTOR INSTALLATION ONLY ~ rical Cont~actor ~ / Ci ty ~ Ph~e ~ / Supervisor Licen~~mber Expiration Date/"" Constr con~~umber'" Expiration Date '" S. //.f S .. El."'" 19n~~ure 0 upervlSlng ectrlclan ;/ ,- ~ , , , Owners Nam / Address ~..; City ~~ ~ Phone 14\- \C' (~. , O~ \1STALLATION The installation is being made on property I own which is not intended for sale, lease or rent. e Signat~ n ~-~-~--7'~~---~------- RECEIPTlf: W:ii . \<j,~ RECEIVED BY: --(:f-) JU _) - ELECTRICAL PERMIT APPLICATION ti~7 Job Number q~~\ 0 '-' 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost 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 ro $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amp~.or less $ 40.00 20J amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits New, Alteration.or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or with Service or Feeder Permit ~ $ 2.00 -L- 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 .~~ ,clJ 5% State Surcharge 3% Administrative Fee \~~ TOTAL ~~ RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726-3759 SPRINGFIELD LOCATION OF PROPOSED WORK: --.!/-B 77 ~2:A-Vb-/"" ASSESSORS MAP: //~::<'-':3:< - Y / OWNER' };I~6E"4<' ADDRESS: '4/~ 7"/ ~~ y~' ?~~~.. DESCRIBE WORK: ,&L"~~"'~"- _~ ~~ ,~?r ~:;.t:-/~~~ LOT: CITY: NEW REMODEL CONTRACTOR'S NAME BLOCK: STATE: ~.. r ,JOB NUMBER Q5c> ~56 ADDITION DEMOLISH 225 Fifth Street Springfield, Oregon 97477 TAX LOT: ~~ ? .' SUBDIVISION: PHONE: ?Y'~~/~, ,., _ ZIP: q?V~ OTHER ADDRESS CONST, CONTRACTOR It PHONE 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 Wail/Ceiling Insulation - Prior to cover. , 0 Drywall - Prior to taping. o Wood Stovo - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete, o Sidewalk & Driveway - After excavation I.s complete, forms and sub.bas~ material in place. o Fence - When completed. o Street'Trees - When al/ required trees are planted. EXPIRES GENERAL: ~ . L'. ~ 2;;? =<~~~";" ~ PLUMBING:?~r-r~.b~97~~_ /<'-'~ ~/.,4-<V"'~ MECHANICAL: / ~- y~/ - OFFICE USE - QUAD AREA: LAND USE: FLOOD PLAIN: It OF BLDGS: It OF UNITS: ZONING CODE: . OCCY GROUP: CONSTR. TYPE: It OF BDRMS: It OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANG E: 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, inspections requested after 7:00 a,m, will be made the following work day, REQUIRED INSPECTIONS [Z] Final Plumbing - When all plumbing work Is complete. ELECTRICAL: o Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/ Electricall Mechanical - Prior to cover. o Footing - After trenches are excavated. D Masonry - Steel location, bond beams,groutl ng, D Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to flllln!;! trench. o Underlloor Plumbing/ Mechanical - Prior to Insulation or decking, D Post and Beam - Prior to floor insulation or decking, o Floor Insulation - Prior to decki ng. o Sanitary Sewer - Prior to filling trench, o Storm Sewer - Prior to filling trench. o Water Line - Prior to filling trench, , r!J Rough Plumbing .- Prior. to cover. D Final Electrical - When all 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, D Other MOBILE HOME INSPECTIONS o Blocking and Set. Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water arid sewer, o Electrical Connection - When . blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. D Final - After all required inspections are approved and porches, skirting, decks, and venting have been Installed, Setbacks HSE GAR ACC! I Lot faces Lot Lot sq. ftg. Interior I P,L. IN Lot coverage Corner Is Topography Panhandle Iw Total height Cul-de-sac \:E BUILDING PERMIT ITEM SO. FT, X $ISO. FT, VALUE Main Garage . Carport , Total Value Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) NO Sanitary Sewer FT. Water FT, Storm Sewer FT. Mobile Home Plumbing Permit State. Surcharge /1;///. ~ /~~' r v ~?~ 7 .~~ /6.?~ Total Charge (C) , MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) A5.~ ..: ~~. ~.~~,~' ,1 . ,'. ,','; .. !S 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. '. I . . 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 adopted by the City, of Springfield, including the Development Code, regulating the cOf)struction and use of buildings, and may be suspended or 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 tile 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 maeJe of any structure without permission of the Building Safety Division, I further certi fy 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 ti mes du ri ng construction. Signatur~~ Date 7- :?C)'"7 os- VALIDATION: /? SY3 ~~,9~ AMOUNT RECEIVED ~, <~ 4::Z'SlW .. ; "/' .. RECEIPT NUMBER DATE PAID RECEIVED BY