HomeMy WebLinkAboutPermit Electrical 2003-2-10
! as submitted has the following
225 FIFTH STREET. SPRrNGFIELD, OR 97477 . PH:(541)726-3753 . FA~~~?jJJ'rf2.d6~6g9not r~uire specific land use
ELECTRICAL PERMIT APPLICATION /~~ zoning:t)vL
City .lob Numb". ES r 000 Z- "j Date 0~1i7 03 Da" . ;).,-,';( ~""M
1. LOCAITON OF INSTALLA110N 3. COMPLETE FE!uY;f!fffnYJ18}}:~bLU HI
/ tJ }- ~ La, rf ~v Li/\.
LEGAL DESCRIPTION
/70325"""3 Z / S-700
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps '/.. $ 69,00
401 Amps to ~~~~~Q~;l $100.00
:l\\ii.: ~~~~\~i\\lllV\l~cg~~" "" "B" abow.
~O ~t."~\' D~:i\~~~~~ ~a~
,\\\'5 \It.D \) \C ~~~WJ\
1\\}\\\Q'r' t.D ~wAlreration or Extension Per Panel
GO~I\~t.~C ~ ~~\e\}<!uit
R ~:i "\ 'DO O~ Each Additional Circuit or with Z
l) J\ I (\ ""\ r" , Service or Feeder Pennit ,
Owners Name ~v 1". a ~ U 'l
Address -L!t:-i ']5 { a.d- -e ,r- ~i_ f./\ E. ,Miscellaneous (Service/feeder not included) -Each Installation
City ~ r:;.Q" Phone 7'f'(" :J -$04>
JOB DESCRIPTION
5:6!LJlC(5' Ct+AtlGrC!:
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.
CONTR..4CTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
."....
(
Snpe",;,o, Lieen,e Numb" ~ ~
J
(j
Expiration Date
.......
Constr. Contr. N~er
Expiration Date
Signature of Supervising Electrician
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
k:;;;d(~ fr
Inspection Request: 726-3769
A. New Residential- Single or Multi-Family per dwelling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106,00
$ 19,00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B. Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/Volts
Reconnect Only
(
~~
$ 63.00
$ 75.00
$125,00
$163.00
$375.00
$ 50.00
C. Temporary Services or Feeders
$ 43,00
$ 3.00
b
Pump or in-igation $ 50.00
Sign/Outline Lighting law rpnlllres V($L!i~O
--, '\lM\\'l.1regon " ,~\ 'Lit))
Lil11:itfdll~'IfE!r~yrKeHaefi~'tl by the Oregon ':b'tli~o
Lit!GM@iS~l~~~~~~~lrc1:t\ose rules are S~~!o91ogt
\\Io\i.w~atlon'Cel . . 1 + ~ h Ob\}1 ~52- '
Miniml)i'nO~~~'5~eOOWOO~~og~e iS1\WeOfut~tc}larges
In ,obtam CopIes 0
4. s(jfJm1f~ r~~"Y.4Note: the telepho~e b (
calling t e v ., Utility Notification
7% Slli~"i~\W'lh~9Uhe.o1re8g0o~_332_2344). LI 8')
Center IS -
10% Administrative Fee b 7 V
TOTAL 5(0 7.3
Shared Drive(T:)/Building FOllns/Electrical PCllnit Application I-03,doc
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:
ELE2003-00029
2/10/2003
2/10/2003
8/10/2003
SITE ADDRESS: 1628 CARTER LN
ASSESSOR'S PARCEL NO.: 1703253215700
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Residential
PROJECT DESCRIPTION: Service change and 2 circuits
OWNER! APPLICANT:
RONALD RUPE
1628 CARTERLN
SPRINGFIELD OR 97477
541-744-2806
ELECTRICAL CONTRACTOR:
RONALD RUPE 541-744-2806
1628 CARTER LN
SPRINGFIELD OR 97477
CCB # Expiration Date:
Descriotion
Amount Paid
Date Paid
Receiot Number
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
6.90
4.83
6.00
63.00
02/1 0/2003
02/1 0/2003
02/1 0/2003
02/1 0/2003
1200200000000000677
1200200000000000677
1200200000000000677
1200200000000000677
To Request an inspection call the 24 hour recording at 726-3769. All inspec~ requested before 7:00 am. will be made the same working day,
inspections requested after 7:00 a.ill. will be made the fOllOWin\f~Q\
o;:"O\?t. ,t\"t \~
. ~\. ~I\l ~'c.~\iC, Q?.
ReQuired InSDeCtio{\~"\\C~~~\\ ~~~t.?. '\'\\~\)Q~t.\) f,
1 Rough Electric: l1iA't~~t~ttC.\) ~ ~ \~ ~'ON
2 Electric Service: W\~a \t~~~~~~ility company energizing service.
3 Final Electric: WheQ,~~,~oa~ork is complete.
By Signature, I state and agl'ee, 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 th~wr6 described herein. I
further certify that only contractors .and ~mplo~ees who are in c..?-~rl!~?c.~~l%~aOl~os5'WilrtiUt~~&on this project I
further agree to ensure that all reqUired mspectlODS are requ~~fe(l:atitlil?proge~~~tf"a1QkCj~U'dfes'&lleadable from the
street, and that the approved set of plans, if applicable, will r.e9,\lYn' 6'rl1(h~~n:e'~t gI11tigtS$tdtoor?g:Pco~1-lqetion.
Iv . center. TI 0 OAR 95~-vu I
, ~otiiica~~~_001_001? t~~~~~ oi the rules by
"I OAR" ,li'lo-<>"" 001(1" I '"'vr-' - telept10n~
Owner or Contractors Signature 0090. 1 ou \lVi1!lq (Note: the .' '
calling the center~ on Utility Notiilcatlon
number ior the.O~ _~00-332-2344).
Center IS
1 of 1
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2003-00029
ELE2003-00029
ELE2003-00029
ELE2003-00029
Payments:
Type of Payment
Check
Paid By
Receipt #: 1200200000000000677
Date: 02/10/2003
Description
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 10% Administrative Fee
+ 7% State Surcharge
Received By
Check Number Confirm No
RONALD RUPE
djb
Page] of]
2/1 0/2003
10:05:10AM
City of Springfield
Development Services Depa..lment
Public Works Department
Official Receipt
Amount Paid
63.00
6.00
6.90
4.83
Line Item Total:
$80.73
How Received
Amount Paid
In Person
80.73
$80.73
Payment Total:
cReceipt.rpt