HomeMy WebLinkAboutPermit Electrical 2003-5-20
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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:
ELE2003-00131
5/20/2003
5/19/2003
11120/2003
SITE ADDRESS: 1570 S A ST
ASSESSOR'S PARCEL NO.: 1703363206600
Springfield
TYPE OF WORK: Addition
TYPE OF USE: Commercial
PROJECT DESCRIPTION: Add 1 circnit
OWNER/APPLICANT: ,ELECTRICAL CONTRACTOR:
EDWARDS JAMES LF EST
16225 PARK TEN PL STE 200
HOUSTON TX 77084
LR BRABHAM 541-747-6638
68 WEST Q STREET
SPRINGFIELD OR 97477
CCB # 8699 Expiration Date: 12/18/2004
Descriotion
Amount Pailj
Date Paid
Receiot Number
OS/20/2003 \)\0 1200200000000001268
OS/2012003 \~eS '10\)\~\\'i1 ?9020000000000 1268
0512012Q,Q,~{eo.\.I e~O(\ ... \d2Q0200000000001268
OS/2.9I2003(\e O~ ~{e Se ",\1200200000000001268
...~e~ . ,-,I \ \ ^c, V' ,...,r;.;."" "'"
\\~.- ",\ev-' e\v' G)I)".~- .",:~":J-
To Request an inspection call the 24 hour recording at 729-37,69'\.Al\,i!Ispecti?!,Slfequ~ted be(C!,e~7:00Ilfm. will be made the same
working day, inspections requested after 7:00 a.m. willloe ~d~_t1i'eC;eM<?Wihl\~0:rKirl~.{t'Y9\ \e\e~>r:O\\o(\
\0\\0 _,\0(\ _",\,\j\) _"(\CO~ _.I'(\e" ,~>i\\\C-a:
:I.\\'v' <::;&--- 0"'- ~\).-. \\,! ' . .
Reonired InsDections: ~O 01>-0. ~O\) ,'(\\1.'1 e(\\e~' ~O(\ \)\~2?l'I>.'1
. , \(\ C). ~ \'(\e c O~e... C\.~?)
1 Rough Electnc: Pnor to Cover r.:;l:J?J ~\I(\~ ~ \'(\e. ,\-'O\l
2 Final Electric: When all electrical work is complete, ca: ",,'Oe{ \0 "."a{ \S
(\\)\'. c,e
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I further
certify that only contractors and employees who are in compliance with ORS 701.055 will be used on, t~~~Ject. I further agree
to ensure that all required inspections are requested al the proper time, that each address is reada~{.~(-,,'e street, and that
the approved set of plans, if applicable, will remain on lhe site at all times during constructio~ \~ ,'0 ~\)
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c.~~"{ \ 'Or;)
+ 10% Administrative Fee
+ 7% State Surcharge
Add. Alter. Extend Circ
Minimum! Adiustment Electrical
4.50
3.15
43.00
2.00
Owner or Contractors Signature
Page I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
ELE2003,OO 131
ELE2003-00 131
ELE2003-00131
ELE2003-00 131
Payments:
Type of Payment
Check
5/20/2003
City of Springfield
Development Services Department
,
Public Works Department'
Official Receipt.
Receipt #: 1200200000000001268
Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Paid By
LR BRABHAM
Received By
djb
3:22:22PM
Date: OS/20/2003
Amount Paid
Item Total:
4.50
3.15
43.00
2.00
$52.65
Check Number Confirm No
.
How Received
In Person
Payment Total:
Amount Paid
52.65
$52.65
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Page I of 1
cReceipt.rpt