HomeMy WebLinkAboutPermit Electrical 2005-8-8
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, " CITY OF S...JINGFIELD, OREGON ().
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submitted has the following
quire specific land use
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . ~-.(51'11)726-3689 cl- u (L
ELECTRICAL PERMIT APPLICATION Zoning ~_ _ 0 ~
City Job Number PI ;::-:1tJ01- 0.0/73 Date Date '(
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I. [LOCATIO'Jl..FINSTALIA110N. 3. COMPLETEFEESCHEDULEBELOW
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JOB DESCRIPTION
ILPtntd'? ;~ /Y7))./ ~A ".d-~
~ non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. I/CONtRXcJtORlNSIALr.Al'IONONLV'1
Electrical Contractor Hrr: P/L?/lr/c::5x::..
Address q ~?;(3 JJLUcl 91 (5ovl/;
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City ~U,jP/)f'. Phone 7t/J- 0'171/
Supervisor License Number .4J 0 7 9 S
Expiration Date / D _' / - 0 t../
;}o - (/03C
I{) ~)-03
Constr. Contr. Number
Expiration Date
""'=W","d"
ownerUe f i'VlO r-J- - ~
Address ry .~'1~D U1~
City ~ Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature; 4.
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A.I N,elyResidential-Singleor~w.ily per dwelling unit.
nreoOn law le~ Tt
ATTSro<\UQIllCl1idetl d by the Oregon Uti I Y ,
-'d1e.s adop.te re set fort
fo\lO'f{)~ sq;--.tt orJ.esSfhose rules a _ eo' $106.00
NotifilEa\JJil!ldtli~1li\a1J-P8 fflr~U01\l OAR l:lO"- \
in OAPbflm'ih\1g:eo'f t 'n'c'opi~S of the rules, $ 19.00
90 Yo~may ob al h telepnoll"
00 E,~ch an'l!~q\t'!J!id,it1e:JoJ;: .t. eN t'f'ca ion
C~ci6IFc'f:W\eJI~~ooeJb~Ity 0 I I .
nuunle!tJr or to. 1" 800-332-23 ,
r."nler IS -
B. LS~'r~~ic~s o~"F~ders - Inst~ii~tion,Ait~?i.tions()r:R~I'ocation:
00
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$50.00
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c. I Temporary Services' orFeeders' f>'~
I
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps 'aOI1:l3c:1 ^VU UlJ '$Md~OO
OV~~~~(~i~~~f~!~S~~'~\~~f?~g~'I~~;
D. .Bran "_HUltS.' }(]llV-HS il~~!\J'!d 'tl!!l
New Alteration or Extension Per Panel :3311(11\1
One Circuit ~, 43.00
Each Additional Circuit or with
, Service or Feeder Permit $ 3.00
E.IMiscellal\~o;iS,(Service/feed~rnot incI~did) -:Eai'!'.in;t"Ilnti~n1
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimnm Electric Permit Inspection Fee is $45.00 + Surcharges
..:;Joo. 00
))1: 00
c2 t), 00
~c'? j/, 00
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding Fonns/Electrical Pennit Application 1-03.doc
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City of Springfield
Electrical Permit Attachment
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Status: Issued
PROJECT DESCRIPTION:
PERMIT NO.: ELE2003-00173
ISSUED: 8/6/2003
APPLIED:, 7/2')/2003
ATTENTIOIII:Oregon law n~4ulle" ye,:,,~
follow rules adopte<..EW\H~.s!eg~/612004'
Notification Center. Those rules are set fori
in ()AR 952-001-0010 through OAR 952-00
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4750 FRANKLIN BL~~Klt.'tu&~;i~~.'iN~~~ene)lephone .
1803031103500 number for the a;~~l1g{~!J~'~,~btific[.l\,It~ral1o.n
. 1 'PKCllJ I:)S":,) ReSldenl1al
Center IS - O.:;j3..-2,,'l,+.
Upgrade MH pedestals (I service and 3 feeders) on spaces E2-E4
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
OWNER/APPLICANT:
OGG ERNEST
2415N 17THPL
SPRINGFIELD OR 97477
ELECTRICAL CONTRACTOR:
ARC ELECTRIC 541-741-0494
85783 HWY 99 S
EUGENE OR 97402
CCB # 115113 Expiration Date: 07/1112004
Descriotion
Amount Paid
Date Paid
Receiot Nnmber
+ 10% Administrative Fee
+ 7% State Surcharge
Manufactured Home Feeder
Manufactured Home Service
08/06/2003 2200200000000001350
08/06/2003 22QQ2O,OOO\lQQ0001350
N01~1J1{i/2003~ ^ll E~,P\Rc 12ZdOJoo.OQpQQ0001350
il-1\s,qlli..<lq(7,OO3:>'~'';:,CD.l\1\S Pc\!;l~~2j,~OOO00001350
. ~I-\()\-\IL\:U t;.:-. . ~N\l\J\~CV ,'~,
To Request an inspection call the 24 hour recording at 726-3769. All\insp~ctlons~~q}f~sl&1lbWllr~7:00 a.m. will be made the same
working day, inspections requested after 7:00 a.m. will be made theJQn~~~'wO'~-tirltP,~y':O.
r.N'I,8U
20.00
14.00
150.00
50.00
Required Inspections:
1 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the
panel.
2 MH Service: Approval required prior to utility company energizing service.
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 fnrther 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 this project. I further agree
to ensure that all required inspections are requested at the proper time, that each address is readable from the street, and that
the approved set of plans, if applicable, will remain on the site at all times during construction.
Owner or Contractors Signature
Date
Page I ofl
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
ELE2003-00 173
ELE2003-00 173
ELE2003-00 173
ELE2003-00 173
Payments:
Type of Payment
Check
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Receipt #: 2200200000000001350
Description
Manufactured Home Feeder
Manufactured Home Service
+ 10% Administrative Fee
+ 7% State Surcharge
Paid By
ESTATE OF ARC ELECTRlC
Received By
ddk
Check l'iumber
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 08/06/2003 lO:15:08AM
Amount Paid
Item Total:
150.00
50.00
20.00
14.00
$234.UU
How Received
In Person
Payment Total:
Amount Paid
$234.00
$234.UU