HomeMy WebLinkAboutPermit Electrical 2002-10-9
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225,FIFTII :>TREET .~-.\ " ''':r " ,- '-;, ELaCAL PElUvfiT APPLICATION
";SPRI!'IGFIE,LD,OREG9N97:17?!_c.Ji L',:I i ! -,.' t !-;7..ft- f-.;."'ro7
" INS~ECTION REQUfST: 726,3(69 " Ii' , :City Joh N1 umhCO' t:;{.I::.' 7-002 - \.....)\...)
,i OFFICE: 726.3759 'I:; ii' \ I ...J I I "
Ii r' : ,.' :: " ' , t' 'I II f'" I ; I'" '],'-COMPLETE FEE SCHEDULE BELOW
.' I : L LO?fJIb5ot~rrALI,1iWN : ' I Ii ;\ j , .'.". <,
,~, ( - q '.. rtl1(\T. L) 1~-,"-___dA-.< Nc,y.Rcsidcntiill-Singlcor'....:..-..-....''----
~\\!jJ\~uuiIy per dwelliug uuit.
LEGAL DESCRIPTION I'''s\I'~'\li't\: Included:
J 70J27/0 0 Z1l7 ~""I~eO"c\\lc\". Items
&s'&u '10 s9
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JOB DESCRIP1}O~" o'!'\"~oeS ,,0 , Iv\)\ v.
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Permits are non-transferable and ~pire 1..0 / reor
if work is notstaned within 180 da)'s ,~,. Each Mnnufd Home or I
of issuance biif work is suspended ft)!'w . eO ~I\l"" Modular Dwelling I
180 da)'s,," ""'1'0'11- Service or Feeder
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Cost Sum
$106,00
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$ 19,00 "
$ 50,00
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2, CONTRACTOR INST ALLA nON ONLY B. Services or Feeders
1 C C, _ J.. Installation, Alterations or
Electrical i::~ntiacto~' i ~ lA:!;'C;w I e Relocation:!
Address ip.b, j ~ 14 f2- /"c" 200 amps or lei -.L $ ~3,~:dp3
City 9rc~/. Phone 7~,I/~~r~ '~','~~:~:::~~;~~~~~~~:~~s ~~;~~,~~_.
::::::isC ~::,:s~il6:t~'-T~48':~S ":':'.. J:~~~~~~~~;~i:~(;~:; _ ~3;~:gg
('~ I '. . C. TCDl)Jonll")' Scn'iccs or Feeders ' *" . ,
'-Constr .<;;outr, Number 8 W''-fC1 Installation, Allel'ation or Rcloe:l{\l(e 'l'I()~1 '
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'<-ExpimtionDate ---...c'1"~T '~. Oa!l;p~!tlj€F~\S'?tv.~\)~~ $50,00 ~,
" "-_.. ',.... \\\)~~ ~" ~'1li.p~ ~'Q()\\~ , ' $69,00 _
Signatnre of ,Snl'en'ising Electrician ' \\\\~' I ~1~f>I _ $100,00----,
" , ~\\\\li~ ~ {d~qo volts see ,
~r. ~~..r- ~C()\tN~~~, '~ ,?r.\II ''-----. \
T:JII \ (\, h ,L D, B~1h Circuits )
Owners Name--1J.L 1J'f'V' ~ IT New'Ahemtion or,Extension Per Panel
Address 2 5 ~ /'J 31 sf:- on~~irC\Jit ", ,I : $43.00
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(" (J./J,.., 7 Lf U ..n Illl I ' ..\'CP.,S'JO .,\"1
Cit)' . 0 I c::;j.; Phoue 1 '0 T Each Additionall<i:ircuit,gr,Ii'ith se~'i Lr
- \!;\\I'IIy n"",' \0\\\
'I or Feeder.PermibOle" ese\ c.." $ 3,00
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OWNER INSTALLATION ,..~\\Ol"" Ao~\eU'" elll\eS p.90~' 'i:>~
The installatiou is being made ou. ,,\ \E: l\Iisccllnneous'(Sa'l'ice/fCil!h1r not<iilfluded)
r t\),....- 1''-''3\-',. "I"',U':)' ,\'{\t'l .' e'
property I oivn which is not intended' \0\\0'J'l , \\GE"ch&wdl}n~onas 0" ?~o\\, '
for sale, lease or rent.' NO\i\iC~\\~'l.P.Sih1p\~liJpif.itiq~.\~e\e\~~~iC~\\O\\ , $50,00_
O"?< 9 SI!!11l0Rtline. t:tgI!tilw",1 ~o ~ $5(),QO
\\ r '/ I) ,,-, ,~,,' \1\"'''' Al - -
\ 090., 0 t"!lited'f~\e,s@iReJ;??'2>A . _ $25,00 _
o ca.\\\\\~L{8\1t'edl!,ne(.gYZaOnlIn _ $45,00 _
lI''Oel lA' 15
I\~P~in1Un;t~~tric Permit Inspection Fcc is 545.00 + SlIl"chargcs
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OWllers Signatllre:
4, SUBTOTAL OF ABOVE
70/0 Statc.Su~.ch.argc
So/(, Administrative Fce
11,00
5. /,p -;
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q 3 -15
TOTAL
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS:
ASSESSOR'S PARCEL NO,:
PROJECT DESCRIPTION:
OWNER/APPLICANT:
GERHART WILLIAM A & CATHY
2580 N 31ST ST
SPRINGFIELD OR 97477
Descriotion
+ 7% State Surcharge
+ 8% Administrative Fee
Add, Alter, Extend Circ Ea Add
Penn Serv/Fdr 200 amps or less
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City of Springfield
Electrical Permit Attachment
PERMIT NO,:
ISSUED:
APPLIED:
EXPIRES:
ELE2002-00I07
10/9/2002
10/9/2002
4/9/2003
2095 LAURA ST
1703271002117
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Residential
Service and 6 circuits
ELECTRICAL CONTRACTOR:
C & SELECTRIC 541-741-2236
P,O, BOX 1482
SPRINGFIELD OR 97477
CCB # 3849 Expiration Date: 09/01/2004
Amount Paid
Date Paid Receint Number Cashier
10/09/2002 1200200000000000039 dib
10/09/2002 1200200000000000039 djb
10/09/2002 1200200000000000039 djb
10/09/2002 1200200000000000039 dib
5,67
6.48
18,00
63,00
To Request an inspection call the 24 hour recording at 726-3769, All inspections requested before 7:00 a,m, will be made the same
working day, inspections requested after 7:00 a,m. will be made the following working day,
Reouired Insnections:
1 Rough Electric: Prior to Cover
2 Electric Service: Approval required prior to utility company energizing service,
3 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
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 streel, and that the
approved set of plans, if applicable, will remain on the site at all times during construction.
Owner or Contractors Signature
Date
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