HomeMy WebLinkAboutPermit Electrical 2003-3-27
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~ilIh~'1.lKI'd/iW'l%1 requir~ite~fIC lan~:~~"~L,.
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LEGALDESCRIPTlRN \'1o?>?Ai4~/ A.
OJ.'\f\ fo !5;.rCtM.r_r....~. rj ('CVlt.!> Service Included
JOB DESCRIPTION
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.
EI . ICAIIl::'"~,.<.; \'V)",,,no.' ,..I,J..~'./J--n~.
ectnca ontractoi.J......). X O~' ;Cf"1J~'m..~l.!!>.!.IJ_.,
. N~~~;~W ~UlI1" i:lu?prea by ihe Oregon Utiliiv
CZf%Bi\1?J/Cel1lAY'\,hr",,,'Cf'" '<i'}";/ .,
Addres~r((YllP~ J..\),v:-;, 'f,f ~u(;.' f1i\\S ~1.~~9t fOt._
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.c.ty (\ ~9-~~<i..~o~ !lJ,fiY ObptAhln CO~;-t;.;" w""O..,
. 1 \.. ^ c.:a{i~r,....t one .-I):-l~J O'-"-\.'\,: .
~ -= toll. \I~O,,,,. ill,fltJlepnone
number lor th~ Oregon Utility Natllicatia"n
supe~isor Licens~~~~~~~~.1 ~(j}Eq?~,t:n.
Expiration Date
'10 Ii I at.(
Constr. Contr. Nnmber hl.o- :f,ILic
loll fo?
Expiration Date
Si~ Snpervising Electrician.
'-- 0 Orv .
Owners Name \ll1\1L'Hrl, \" II at
Address \J),.(j ~ Q~\\hoJ..'S .
City ~~hone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent. '
Owners Signature:
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Each Manufac!' d Home or
Modular Dwelling Service or
Feeder
$50.00
B.
200fWl1eE:" . $ 63.00
201rmssp~~%M'~ALL EXPIR: IF THEWMf!<
40] A1J'llMcmi2M'OODER THIS P:flMlT tSJtJ6'P
601effl!1M~I\R?BiJ'eJWIS ABAN!)ON:D F~1f300
Ovel;r\qoq ~1J'~A\(o~!:RIOD. $375.00
Reconnect O~ly $ 50.00
c.
. Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D.
$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel
One Circuit /
Each Additional Circuit or with
Service or Feeder Pennit J
$ 43.00
$ 3.00
q-..3:> _ aD
.:?rs::>
E.
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Comnwrcial .
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcbarges
4.
40 . (j1)
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3.0>
.?I ,roo
63.'6'2.-
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drivc(T:)/Building FonnslElectrical Permit Application 1-03.doc
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City of Springfield
Electrical Permit Attachment
Status: missing from list
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: ELE2003-00086
ISSUED:
APPLIED: 3/24/2003
EXPIRES:
SITE ADDRESS: 621 CITY VIEW BLVD
ASSESSOR'S PARCEL NO.: 1703341404400
Springfield
TYPE OF WORK:
TYPE OF USE:
PROJECT DESCRIPTION:
Two branch circuits
OWNER! APPLICANT:
DURLAND TRUST
62 I CITY VIEW BLVD
SPRINGFIELD OR 97477
ELECTRICAL CONTRAcrOR:
DIXON ELECTRIC. 541-895-2440
33736 MARTIN ROAD
CRESWELL OR 97426
CCB # 66894 Expiration Date: 07/18/2003
Descriotion
.Amount Paid
Date Paid
Receint Number
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, AItcr, Extend Circ Ea Add
4.60
3.22
43.00
3.00
03/24/2003
03/24/2003
03/24/2003
03/24/2003
2200200000000000639
2200200000000000639
2200200000000000639
2200200000000000639
To Request an inspection call tlle 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.
Relluired Insoections:
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 certii)' 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 this project. I
furth r agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
str?~~:: the an;~f;ns, if applicable, will remain on the S3/~iV7;rig construction.
fner}rtontractors Signature Date I
1 of I