HomeMy WebLinkAboutPermit Electrical 2002-12-27
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
"\
City Job Number L-P' .-j,
ELE. lCAL PERlvIIT APPLICATION
Ll
3. C~\1PLETE FEE SCHEDULE BELOW
'-~~
,&.0 r:,0
r:,~0 ~ ~ew Residential-Single or
. \.eo'c:'~~\V \7> Multi-Family per dwelling unit.
LEGAL DESCRIPTION ~'O~: ",~e Service Included:
(g 0.5 3- '# '-t, ~ ()5gO$ <t':.' '3-'" ~p.o..~\\ fI. (II.
~6,; -(\0'- .
~~ er:,
J9B DESC~TlON o~\<" 0 00
_6 'Erne (Jr~~~ ~J!
0<:'- o~ "10<"
1: Q\ v '"
Permits are non-transfere'fJle and ex ' '3-~v\
if work is not started withinl8Q ,yso r;;:l~?
of issuance or if work is sus~ide~d6}
~'\'
180 days. 1'-->
1. ,LOCATION OF INSTALL~TION
',C; 4-1 LJ t.e- I/\TV/\ I C1. (
1000 sq,ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
2, CONTRACTOR INSTALLATION ONLY B. Scrvices 01' Feeders
\ I Installation, Alterations or
Electrical ContractoUO:se. ph Ovt ncll-- ~ (';I: Rclocation:
Address d~Z1) lAJ'''//OfI'''' Dr
/~n-~0\~I,'r),,:,. ','~ ' "lfl QIJ/iV
;:~'~{Iii~t~."" c.!]WJ 1i1VM6ft6~~\"i:j,QQc
;\j~~i~C~~I/';;:~~;;~' :;~t~jl~~ . th(9 c:G;;~[r/~':'L!~";;:;
\>w\,::~v~ t#lJ""'<""'.;~ r '-"'"""~C....: '",''''''.t\. ~...)
i~11 o~~~~q^.";'lCI)(.'tts~'NnliP.rn:iT:J::z::\u.\U?i ,;;:.t":.< ),),1
~~!i~~~M;;i;~~~~;;;;;b:;;~'~:i~' i' ""J! .i.
~>&l"~~'vl't-J !tlfJ .
'hI" ~t:t!-?t'\~(< ~~v dl;"., '!.,:"_
. ''':'C<JIl~tt~Dmfl
cr;~in'fY;:'\,~- ~'f4 d .~:"}<t')., _ ~"v
,~'W."l;irJi5 v":gw '}'~".,.':J"'" ",'
Expiration Date I V ";:~'r.'!.t~{i';\,
SC:;J"j3~:2a"
I . ,1 (JpjA11I 'Y
Ow~ers Name J7..e.V€. J c..JnayS 13t11irf
Address (.,<17 -W Unr,g.ntct /
City 5PF/()
Phone
OWNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
'\ _ ".,,' )~ -'. '\ ,. -l
. 2:Ot)~amps or less
"1'::12 ;22rh~1)}is3~:j$fl(tatn'NIl':::;:~ ~r:','
'" :.: e~T;lltP-TI?sJp!~r~ ~J1lP~;i "
(jQUHl-lp$ t\llOOO amps - =,
Ove{rOQO a'Hlp~~y.oIis '
Reconri~ct only ; ,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit
Items Cost
S m:ll
$106,00
$ 19,00
$ 50.00
$ 63,00
if' ,$ 75.00
$125.00
$163,00
$375,00
$ 50.00
$50,00
$69,00
$100,00
I $43,00 '13
Each Additional Circuit or with Service
or Feeder Permit 2... $ 3,00 &
E. Miscellaneous (Service/fecdcr not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergyJRes
Limited Energy/Comm
$50,00
$50,00
$25.00
$45.00
Minimum Electl"ic Pumit Inspection Fee is 545.00 + Surcharges
4, SUBTOTAL OF ABOVE ''1 r -
7% Statc Surcharge
8% Administrativc Fce
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:
ELE2002-00171
12/27/2002
12/27/2002
6/27/2003
SITE ADDRESS: 647 W CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703274305805
Springfield
TYPE OF WORK:
TYPE OF USE:
PROJECT DESCRIPTION:
3 Branch Circuits
OWNER/APPLICANT:
CENTENNIAL SHOPPING CNTR I
7831 SE STARK ST STE 103
PORTLAND OR 97215
ELECTRICAL CONTRACTOR:
JOSEPH BUNCH ELECTRIC
2525 WILLONA DRIVE
EUGENE OR 97408
CCB # 145024 Expiration Date: 10/10/2004
Descriotion
Amount Paid
Date Paid
Receiot Number
+ 7% State Surcharge
+ 8% Administrative Fee
Add, Alter, Extend Circ
3.43
3.92
49,00
12/27/2002
12/27/2002
12/27/2002
2200200000000000337
2200200000000000337
2200200000000000337
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,
ReQuired Insnections:
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete,
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 ertify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project I
furth,er a ree to ensure that all required inspections are requested at the proper time, that each address is readable from the
,t.. 'to aD ~att~L:~~L' 'fapplicabl,. will ..main on th, 'ili;" ~~"7d~ri;;'trDCUon.
Owner orfontractl1rs Signature . Date
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