HomeMy WebLinkAboutPermit Electrical 2002-11-14
n;:::225 FIFTH STREET' .~ , .
,;, :;:rtSPRINGFIELD, OREGON 97477; . : ,',
f~HJN~P,~~tJON~q~~T: 72~~~?6,~.? ,,~:::,;;;,,' .;L.~
f:'::DFFICE: ;;.726-3759;:<'u .' >, ::. "::", ., 1
11:, _', ,_ _... ~'('" . ;;"" . . > "c.,, "'. _" ~...'" , " ",'" ' .
k,',( - .'..,<' " ?'-.' ,;, .;,. ::;':, ;'.' _ J; COMPLETE FEE SCHEDULE BELOW
.}. :(,('\ ~'" ,.. . ", u '" ' _ _: ,'i '" < ;., '~."" ...
t~t 1. 4:JsnO~ ~bN~~{1(bN ;:;, LL! 'di:;~ !l~~~01t~~denti;ll~S:i'ngl~'d~' :,.
, - .tte "as d use " "
. eel as subrn\ necilic lal'l MultI-FamIly pel' dwellIng umt.
, nfO\' uire s,..
LEGAL DESCRIP~~~O\ feQ Service Included:
~'lffl~~-L ?~ 1 ---------==
a? '1'10---
JOB DESCRIPTION Zol'l\ ~ -- ~,ft. or less
s:.e if' \/I'(.f> (J"', ________Each adclitional500
. - (j !~~\gl'la\u{e -'- sq, ft or portion
Permits are non-transferlt~1 ~.~i1tte thereof
if work is not started witi4lV ~~0?f'r Each Manufd Home or
of issuance or if work i~~~j ~Wb $#;417 Modular Dwelling
180 days, , dJJY!1 ~ff1/C~ iJflJI), I!o,/!, t.{l~ Service or Feeder
. ' W~)@ w1!JJi ~I? r~ ?~~J:7
2. CONTRA~?OR I~ST ALLA 1 'l\Ul"I~ r!B ~~ lf~I}~~I.Ji~' ~ ;; r Fc.eders :
. '! ". ~~M iitJJVD~ !J1tY?!A '~~rn, AlteratIons or
Electncal'Con~~~~cto~ ~U I lde~ t:: '~+n C.ij!tOtYr ~ Uit>>fon: ".'.
Address-19-5' qoo'-S()() ., 200 (lIllpS or less "
::' ." .'. ';<i" . . ..,.. '.. ' 20 J amps to 400 amps .
City ~LXi.'et1e'>'.;, :Phone 4gs~ CA~Q'", 401 amps to GOO anips
f~~t ti6~~~e';~u;h~~r *~q, G' ".' , _ '~~'~l:l~lci;ot~l~~~~~::~'~ '~. .
;Z\,,: !;:!;t(~; (\:~\'o~":'.':":' ,'; , Reconne~t Only , '" ."
Expiratici~Dat~'f'I():;~rG'~:()'?=S' .:,;.,:,::;'.,:~t ';" ....- . .,:;::;' ,',
" .. . '~~~~~~;';~~e?(~~~~'~,: ",;r?r::1I~:tF~,~~:;;~;: !~~:;;'c~t;on
,c,;', '''''',;;~: ~",...Expiration Date Jt) - r.:.. () If "":.~:::':>~;;'J:~ioo:.anips'br)e;s' "
'r>.':, :t1'J;'~:: ':n - "" ' : 201 amps to 400 amps
,;i'; .:' ':'''' ~",~'$igll'aturc pen'isillg Electrician . '. Over 401 to GOO amps' ,
"''if?, iI;j:~/X // "~;~~b~~'~ "np' or 1000 volts see
.~"B'~:o\;:er; I~~,~~ '{;tJf: I ~ iu rd D~'''~;:,~~;~~;;on or Extension Per Par..I
'..,; ". ',.;J\d.dress4~SQ. CQ~ ei II '0
';';.:'.<'\: ~., F(nt.e:til
:. ";~:Cit)' . ~ .. '. .. Phone: ,:
,'" ... . . . . ~ . .'"
OWNER INSTALLATION
/:,The instaIla~ion is being made on
. ',. ' property 16~vn which is not intended
'. ". . for' sale, lease or~ent.' "
"'..' ,.
EL~;;'~"RICAL PERMIT APPLICATION.
;.. ..,:. ,.,.' .rtt&J. ..,...,,;.. ,"
"C' J I N I n.1IlIfv\ "NIO, . . ..
.. .... Ity 0) urn )er~ \, ~tkl1l ~ .'. '.. .. .,<,
'.. .
", ,
Items Cost
Sm:n
$106,00
$ 19.00
$ 50.00
I
U?3--
$ 63.00
. "$ 75.00 ..
$125;QO
$i63.00
$P5.00,
'$,50.00
0-,1',
'$50.00 '
$69.00
$100:00
One Circuit
$43.00
Each Additional Circuit or with Service
or Feeder Permit
$ 3.00
, .
1". ..!'
E. Miscellaneous (Service/feedel. not included)
-Each instnIlation
Pump or irrigation
Sign/Outline Lighting
Limited EnergyIRes
Limited Energy/Conun
$50.00
$50,00
$25.00
$45.00
'3 QlVllers Signature: ,.
~> :~<'
Minimum Electric Pumit Inspcction Fcc is S45.00 + Surchargcs
:: '.:.: .i-\rr~Nnoi'J:Ofe,gon lawU"eqwres you to
..,'" vollow rul@gadopieobytheOf'egon UWity
. :,YcHiticatior,: 8~nie,. Those rules are set foir
::'fl OAR 952000'; -0010 through OAR 952Q001,
'{'{l9D. YOIJ :nay obtain copies oi the rules by
".' calling 'the center. (Note: the telephone
numbe;- ior the Oregon Utility \!otiiication
~'"'\8"";"=r :.- ., ~?f;r'"r~0?_?~;;.4.\.
4. SUBTOTAL OF ABOVE
7% State Surchargc
8'1<, Administratil"C Fee
Lo? --
f)~
TOTAL
City of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2002-00136
11/14/2002
11/14/2002
5/14/2003
SITE ADDRESS: 4250 CAMELLIA ST
ASSESSOR'S PARCEL NO.: 1702323300800
Springfield
TYPE OF WORK: New
TYPE OF USE: Residential
PROJECT DESCRIPTION:
Electrical Service Change
OWNER! APPLI CANT:
TOM WEISKIND
4250 CAMELLIA
SPRINGFIELD OR 97478
ELECTRICAL CONTRACTOR:
BUILDERS ELECTRIC INC 541-485-0922
195 MADISON ST
EUGENE OR 97402
CCB # 4296 Expiration Date: 12/10/2003
Descriotion
Amount Paid
Date Paid
Receint Num ber
Cashier
+ 7% State Surcharge
+ 8% Administrative Fee
Perm Serv/Fdr 200 amps or less
4.41
5.04
63.00
11/14/2002
11/14/2002
11/14/2002
2200200000000000179
2200200000000000179
2200200000000000179
lIh
lIh
lIh
To Request an inspection call the 24 hour recording at 726-3769, All inspections requested before 7:00 am. will be made the same working day,
inspections requested after 7 :00 a.m. will be made the following working day.
Reauired InsDections:'
1 Electric Service: Approval required prior to utility company energizing service.
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. I
further certify that only contracto~s 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
,tre,t, and V aPrs:8~ ::m, i)'Plioab'" will remain on lb, ,tt, at all ttm" dnring .omtroc"on.
~Jcc S;gnotnre - Dm,
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
ATTENTION:Oregofllaw requires yo~ ~o
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the tel~~ho~e
number for the Oregon Utility Notlftcatlon
Center is 1-800-332-2344).
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