HomeMy WebLinkAboutPermit Electrical 2003-4-1
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CITY OF ~. t(INGFIELD, OREGON ,.
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rojec! as submitled has the !ollowing
225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (5.nr;211_3(Ilj910es not require spe~it:~ land use
ELECTRICAL PERMIT APPliCATION epproval C!..Q.,: .'
Zoning
City Job Number t:'i.1zcn '] --CD 0 7 7 Date 0'-1 0 I 0'3 4- '3 .- 6 ~
Date
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1. I LOCATIONOFINSTALLATION
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LEGAL DESCRIPTION 170327/0 03901
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JOB DESCRIPTION \
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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. I CONTRACTOR INSTALLATION ON!-Y I
Electrical contractordJLj\(\orr; S ~ ledi ic.,
Address 4..9.~ ~EJ\P'1 S:.,.
City~I'<:JC~LL Phone l4-l-o'8ll
Supervisor License Number :<-CDL7 ~
Expiration Date 10 / \ IOLf
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Constr. Contr. Number \~3'6
~JC6
Expiration Date
Signature of Supervising Electrician
L.~..{d /
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Owners Name ~e...W ~l!)S..
Address \9.K"l LQ II ,(0.. Nt:;-
City ~ 9~ Phone
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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3. I COMPLETE FEE SCfHtE11jlYUilBPm{)h-
A. !New Residential- Single or Multi-Family per dwelling
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B. I Services or Feeders - Inst,!llation, Altcrations or Relocation:
200 Amps or less $ 63.00
201 Amps to 400 Amps ,,\0 $ 75.00
40 I Amps to 600 Amps ~1~eS "\\\\il\'l . $125.00
,e\X of'. \0"
601 Amps to 100qffi!ipsoleg c.e\ _t'\~ $163.00
~,,\\ ",e 'c).~e' nov-
Over 1003Amps~9lts ~,eS X' o!::;" __ 'n'.$375.00
Re~<.>mieet9rIY~~oSe ~ 1(\O~. ~ t~\"- _ $ 50.00
",;.1<' .\pS'O-o.,,,,X. '_,Y\~o~g _0\\':".(\'(\0".-".<\
r' -.tri\.. t~"t1f< -,;,.. -('\l:P" llt'\'-::. .a\.\"~
\O'C;. .1.zI~empomi,!Sery!ces;or Fe~erko({\W'
~\o'i.I~IC o."t:?;S/.:v-;,,, 0'0''''; \..~0'~~'i.\'i.1\" ~~~o.,\.
\~ OInstallation, J\lte&tion:o.. ReloCation
\~Q200~p~~~\~e:SI OI~~()():~.Jv
v _~\\\' ~\O'" .\c:. \
2~\1!!'ps l~e~OO1Aihps
40 I Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
Over 606 Amps or 1000 Volts see "B" above.
D. ~ BrarlchCircuits
New Alteration or Extension Per Panel '?i~
One Circuit_ \c. "{\\~ 'l!~~1
Each AddltiYl1!lL Circuit or~t~It.'i-\'\t(.. t,?\JI\'t \'21
E'SI::i~;r~~~~~:~:~" ,.."".,",,~
Pump or iNtI,6liJ 0 $ 50.00
Sign/Outl Je Lighting $ 50.00
Limited EnergyfResidential $ 25.00 I
Limited Energy/Commercial I $ 45.00 4F>,oo
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.1 SUBTOT,jfLOFj\BOVE I 4-5.00
3.'S-
4-. so
f)~, InS-
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application I-03.doc
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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:
ELE2003-00097
4/1/2003
4/1/2003
10/1/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
1887 LAURA ST
1703271003901
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Commercial
PROJECT DESCR[PT[ON: Low voltage cabling
OWNER/APPLICANT: ELECTRICAL CONTRACTOR:
SPRINGFIELD NEWS
% ORE NEWS MEDIA [NC
ALBANY OR 9732 I
L H MORRIS ELECTRIC 54[-747-081 I
483 SHELLEY ST
SPRINGFIELD OR 97477
CCB # 0 I 838 Expiration Date: 06/08/2005
Descriotion
Amount Paid
Date Paid
Receint Number
+ 10% Administrative Fee 4.50 04/0112003 1200200000000000924
+ 7% State Surcharge 3.[5 04/01/2003 1200200000000000924
Low Voltage - Commercial Indus 45.00 04/01/2003. t: \NO"'\<. 1200200000000000924
..c. t:-.tP.~t." 1r' '-InI
To Request an inspection call the 24 hour recor~tp81t'li?6'37PP'~'\l-'iJ\speeti \l:E9\I#.i'i:clbetb'te 7:00 a.m. will be made the same
working day, inspections requested after 7:00 a'"l.!'\~JI\b'C\fri'a\i~ t I iYL<l\vnli\ or r...lt~i'.O'"
'c,.,-\.\(\",\I~O ~n Ie. ~'O"-NO
,.to EW,jt.uJ..
Reouired Insoections: CO\'.J\~8Q 0"-'/ 1l~"'\OO.
1 Low Voltage: Prior to cover. ~N'/
By Signature, I state and agree, that I have earefully examined the completed application and do hereby certify that all
information hereon is true and correet, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work deseribed herein. I further
certify that only contractors and employees who are in compliance with ORS 701,055 will be used(0-n'iIl1~.project. I further agree
to cnsure that all required inspections are requested at the proper time, that each address"i~'f~dablcir~in'the street, and that
I'e\..l,..... .I.OU\....:;, e\\v',
the approved set of plans, if applicable, will remain on the site at all times during construction. S ~Ia S CO'I
I"'~ ., 9\\0"'.' ula Q "''2-
f'. ,; \eS ().uO ,nosa I o/l-r\. 9;.1' '0'
\o\\o-N IU . ,...~(\\al. . ^ 'h,ou9n "hI>. lu\aS .
Owner or Contractors Signature \'lo\\\\C~~~.pl!le'\'\)~\~(\ CO?\~~n~\a\a~~O\\~n
I-=' O~ '(ou fila'! on\al. i.t-Io\~,\\\\'I NO'\I\ICa.
009 '\\\ng \na ca olagon "'2-.'2.'2AA).
ca. ...<\01 \ne _, .conn.';>"
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Page I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2003-00097
ELE2003-00097
ELE2003-00097
Payments:
Type or Payment
Check
Paid By
Description
Receipt #: 1200200000000000924
Date: 04/01/2003
Low Voltage - Commercial Indus
+ 10% Administrative Fee
+ 7% State Surcharge
LH MORRIS ELECTRIC INC
Received By
Check Number Confirm No
djb
Page I of I
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4/1/2003
2:35:46PM '
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City of Springfield
Development Services Department
Public Works Department
Official Receipt
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Amount Paid
45.00
4.50
3.15
Line Item Total:
$52.65
How Received
Amount Paid
In Person
52.65
$52.65
4l
Payment Total:
cReceipt.rpt