HomeMy WebLinkAboutPermit Electrical 2002-12-11 (2)
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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:
ELE2002-00155
1211l/2002
12/ll/2002
6/ll/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
250 A ST
1703353202700
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Commercial
PROJECT DESCRIPTION: Add I circuit
OWNER/APPliCANT: ELECTRICAL CONTRACTOR:
SPRINGFIELD UTILITY BOARD SCOFIELD ELECTRIC 541-686-8612
"250 N ....A'''' ST" PO BOX 2765
SPRINGFIELD OR 97477 EUGENE OR 97402,;m'~
CCB # 38702 Exp~,:::.{ate: 1212112005
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,Descrintion ~mount Paid Date Paid R-~t~er !:ashier
+7% State Surcharge 3.15 12/11/2002 \..~i-~ ~~~8~00292 dib
+ 8% Administrative Fee 3.60 12/11/20~~\; ~....p. 0'6000000292 dib
Add, Alter, Extend Circ 43.00 \c;:,1j;i{U~o ~'V<.,; 00000000000292 dib
MinimwnlAdjustment Electrical 2.00 ~~~c.. ~'t.~~~tlt9 _ (\~ \~ 0.0200000000000292 dib
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To Request an inspection call the 24 hour recording at 726-376 ~,*I ~. o~g;lI'ested before 7:00 am, will be made the same working day,
inspections requested after 7 :00 a.m. will be made the followin ~~ ~:\)
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1 Rough Electric: Prior to Cover ~",eC '8c} e'C' ~\'
2 Final Electric: When all electrical work is complete. 0">\ \9.',"00 ':' 3S-'O\~ ~,~'1:r;:; ",'0'\
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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 a~d'OI'1 -r,ork,~j;fol1ielI)'~aJi'b(~_o~~in accordance
with the Ordinances of the City of Springfield and the laws of the Sta't'i ofO';:~go.)lpert:iiriing ti\"'the~work descrihed hereilL I
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further certify that only contracton and employees who are in 'compJianc~~withpRS<.0};055;will.,b~\tised on this project. I
further agree to ensure that all required inspections are requestell aUh~,,!)Ii~~tini~; thaf~acti~adilress is readable from the
street, and that the approved set of plans, if applicable, will. remai~:i,~th.~\Site,'3,!~II~ti\i;~s li';,-rlng constructiolL
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Reouired Insnections:
Owner or Contractors Signature
Date
of I