Loading...
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