HomeMy WebLinkAboutPermit Electrical 2003-3-13
. . .
. . CITY OF 5" JNGFIELD, OREGON -,
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- o22-S"FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
1 . ELECTRICAL PERMIT APPLICATION The following project as submitted haf.s t~aen~I~~~ing
t::?5 - '. "9 and does not require specl Ie
City Job Number L::L-u"d.OO '3 - ono 7-pate ~ - I~" - o.~.~'ro~al .Cl)(L
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LEGALDESCRIP'Fl,O,N"'";'\",'-'}'ii,~'~'I""''''~'~'.''I~'-'Ii'''2'''';"',"'''1 . CSI C hu ngeo u -am)\ C 'e mgu.u.
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JOB DESCRIPTION
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Permits are non-transferable and expire if work is
nol starled within 180 days of Issuance or if work Is
Suspended for 180 days,
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SupervisorLicense'Numlier~ ;?N"'--) , M.7CA ht\10 . C. Em\l~~~~C;.!ts..'I.l.i.illic.eder.", U!X'!~
::O'GSfl:i~O ~i):.~~;~;-: ':~~IU~Cl'IOllr:Jllr,nl' ':" THISPERMIT.SHALl: EXPIRE.IFTHE "
Expiration Dat'egSI6~ :37:"0.: oH:. :_''''Mr ,,-,,'0 I fAOl101 InslfJ'W0'Rtl~'tiatip.m~~F'qR9t'~MIT IS NqT .
. .. ".~; ".l' U'-,"c.JU ...,:::.~- ~~::(: "'... 200rAmns,llflles.:'D OR IS ABANDONED HSBo.oo
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Constr. Contr. Number ~(){) I 20Ii~P~l5'J1Q9~RIOD. $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
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Electrica! Contractor OREGON ELECfRIC SRlVla
Address ~ 0 {1,,.,,, ~a,"'")
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Expiration Date q - ,v. - 0 <I
Sig,ll,ture of Supervising Electrician .
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Owners Name ~ Fr/'.....f..7.c-
Address ___ 1:'.
City
Phone~~/'~/q J
OWNER INSTALLATION
The installation is being made on property I wn which'
is not'iriiended for sale, lease or rent.
Owners Signatw'e:" '.o'J ".
Inspection Request: 726-3769
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1 000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
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200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Recoimect Only .
I
&,s A.O
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
.1
New Alteration or Extension Pcr Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Pennit
$ 43.0U
$ 3.00
Pump or inigation
Sign/Outline Lighting
Limited EnergylResidenlial
Limited Energy/Commercial
"... ~.., ." '. I:' "'11
Minim.{m Elcc'tric Permit'lnspection Fee is $45.00 + Surcharges
$ 50.00
$ 50.00
$ 25.00
$ 45.00
4.
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7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding FormslElectrical Permit Application 1.Q3.doc
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City of Springfield
Electrical Permit Attachment
'I
Status: missing from list
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-37691nspection Line
PERMIT NO.: ELE2003-00077
ISSUED:
APPLIED: 3/18/2003
EXPIRES:
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
550 KELLY BL YD
1703341401100
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Public
PROJECT DESCRIPTION: Replace Meterbase
OWNER! APPLICANT:
EVANS H THOMAS & DARLENE
2549 GARfIE~D ST,v,vJIt::YlJ" :dV, i"'4ulI"'~;"
EUGENE OR 97405 adopted by the Oregon Utii
follow rUles ;
""'..~.~.. Tho"....,... r-1,IQC ::\(P C:;P. ti'
ELECTRICAL CONTRACfOR:
OREGON ELECTRIC SERVICE 541-343-1681
PO BOX 2237
EUGENE OR 97402
CCB # 38001 Expiration Date: 09/14/2004
Descrio~i~~;AR952-001:601 0 ti1~Amoimt{P-;;id52'(\ Date Paid Receiot Number
+ 10% A~~~istr1'tive Fe~Y obtain cOPI~'~~Q:hl e ~Ie~ [ 03h~~~~E: flmmOQ~E~m4~
+ 7% State Surcl1argethecenter. (Note. t4~41v spr.Otr:' 03/W!1'oihERMIT SHALL E1 ,QO Q
Perm ServlFdr'200:ampsO'r.leSs'regOn Ut63:60'o\;IGc1 " 03/,I-SiioffiRIZED UNDER Tt lJo, do
..-.' - . . .. ....,....... "'~,. 1")' 1'11\ ...............,........... on 1("" ^O^,.ln(\~ICn eno
'" -, \. -~ VVIVIl.I~I~V...J It u......1\t~__,.__. -.
To Request ap ipspection call the 24 hour recording at 726-3769. All inspections re~'V'5\~19m7fl\9Pll'llmill be made the same working day,
inspections requested after 7:00 a.m will be made the following working day. ,,,
Reauired I nsoections:
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
By Sigoature, I state and agree, that 1 have carefully examined the completed applicatioo and do hereby certify that all
ioformatioo hereon is true and correct, aDd 1 further certily that aoy and all work performed shall be done in lICcordaoce
with the Ordinances of the City of Spriogfield 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 he used on this project. I
further agree to eosure that all required inspectioos 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 duriog coostructioo.
Owner or Contrnctors Signature
Date
I of 1
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2003-00077
ELE2003-00077
ELE2003-00077
Payments:
T)pe oCPayment
Check
Paid By
Descriotion
Receipt #: 1200200000000000842
Date: 03/1812003
+ 10% Administrative Fee
Perm ServlFdr 200 amps or less
+ 7% State Surcharge
OREGON ELECTRIC SERVICE
Received By
Check Number Confirm No
njm
16477
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Page loCI
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3/1.
9:09:ll~.
i
City of Springfie}d
Development Services Department
Public Works Department
Official Receipt
Amounl Paid
63.00
6.30
4.41
Line Item Total:
$73.71
How Received
Amount Paid
By Mail
Payment Total:
73.71
$73.71
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