HomeMy WebLinkAboutPermit Electrical 2003-3-24
, ~ 'eITY OF S," ,lNOFIELb, OREOO,&" ; , :() '. 1 :' ;,
. .. . ~ . .. , , ' , .. . ' ~-.
225 FIFTH STREET. SPRINGFIELD, OR 97477 . I'H:(541)726.3753 . Ft\:i\:I($,4,Mil~(Ho/i89assubmitledhasthetolloWin9
d d 5 not require specIfic land use
E.1,ECTJUCAL PERMIT APPLlCA nON " . ~~;';og~a~n oe IL-
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"d()(o'd. LOlY1n
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LEGAL DESCRIPTION A. liN.sr- 1~~sidc,'lt~t'":,~il\~I~;~~,~}u~thr~,~,i~rP~f:~,~~eillI,gl~~~~~
170')l5"''-I3 D7.sao Ser"icelncluded
.1013 DESCRIPTION
J.c6-\-agp .J,{at -tuh 0/1 r u\'L
P('rmit~ are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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1"60N;FRAGTOR'INSTALLATION'ONLY'.'
2. .1"'_' ';~-,rt.""-:"~~ .':."~' ~_:'::'I!:~,-'-~h;'..r.I..!..Ut~L'_':L..<'~;- :
Electrical Contractor
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CIC:till{ /(:(
Address
)qc)
"-loci i ::;;" I''')
Cily
!~ l )~J\:.;'ne
4QC..... CI"'\')
Phone 1')--) \.."," :l-_
Supervisor License Number
'3,:}C"O "
'.. ~')
~ - I
Expiration Date 10' I '(, II
COlls11'. ContI'. Number 4,.JCJ (p
Expiralion Date j ,) . in" () .~
';"z2:~;;:;:""
OWllers Name .~(' II 5cucv-
Address 0.0 lp'J. Lamorr!
Cil)' SPIi~I=''-C Id Phone
OWNlm INSTALLATION
The installation is being made on property I own which
is !lot intended for sale, lease or rent.
Owners Signature:
Inspeelion Request: 726-3769
.
1000 sq, ft, or less
Each additional 500 sq, ft, or
p0l1ion thereof
Eaeh Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19,00
$50,00
r ,'"<,.-', _'. ,- ':-~~J, ~1"'';'';.o;;rr7V7!~-'''_T;''T7'''t'''.'':;-'lr...~r;,~.~'' ,. ,.._,..t ~,,;:'"':"~"'r"'~-,rw,~
II. ; :Sei'\'ices iir'Fc'edel's'.{lustalh\tlon; Altehilioll'soi;,Reli.eation::r'iI
: . ':""_'~'>.l ~"-i'" ~',tj~~ ' " ~T:,t. ,':,,!,t-;l':tf t:t;i;..;<;<: 1 ~r:t~..::'~ ~~'~'.i"'-"jft~.... ';:~.'f.:.~',l-,.; ';'~VJ3'
$ 63.00
,.,r, $ 75,00
]O\.-
401 Amps to 600 Amps \,eS' , ..\\\'.:-l $125,00
,P.o.'V 0" '-" \O{"
60 I Amps to I OOOc:..AmP'b,eg .0\ $163,00
.\0\\\ ,'",e '(e :. \)\J
Over 100.9,AmJ1s0'plts \eS'<l' ....r:..'l:' ~ $375,00
RccOl\i~ct,0j,jY~....ose~U: ~Ol>-?-- ,,\\e'" - $ 50,00
.\-10' 0-\.),...n \\' t'\\' '"
. \ ,~ 'eS ,pI, -0'V"'....\ \\,... "'0""
F- ol'l~'~" "re\'>''''''"iil\.'('\'', ~J' ~",G"''''''-~):;F . _ ~,.no=-'
\O~Q. f;.l~inp"ornrWSer"ices1Q'r~JteederS"'i-;~io';'~(!.~ ~;~ j111'j~~/~? ,",)~ t..i-V~l:,j
'~ C'Q.'\.' r ..\j\J \' '~e.\' \... -:\e'~'>,;."\"~ . ~O",~\''iI:t{~ 'I . ,.~ ~~" r, -~,. 1',.... f ,",,"';';
~O\\ \ fA 9,st ",a.'l O'Ci'o\.l~Q \ \\\X\\'l ~ ^ ~,.
Ohnstallatinl1 Alterafion'i,r'l{elocation
W 0(\: ,- ~\\\e'Vv ~O,e~- ,?ibl-"
00 -200,Amps or'less . !ofCI'\l
r"O-"- ....( \0\ ~ ',c'
20 1-~rnpS.lo\400 Amps
n\)\' VIO .
40 I Amps to 600 Amps
200 Amps or less
20 I Amps 10 400 Amps
$ 50,00
$ 69,00
$100,00
Over 600 Amps or 1000 Volts see "B" above,
D ~'l ;T'1-;:~1 'c'" .~. ~"il~,\\,:r~ i~...\'tk''':*~~,t-'''';'~n<;t~'...."!.r'i?ii-....."~~..''Ff'',:,, 1f'-!~';"':
. ,M I aor t ')rCUlts", ':i1';~4. ~j""t;r._,t:: i)'f."c~ '.,.F.\ '~';r' ""it'll .,:'f,. .t~,l\:"l"\" :'1, ""'I'~~
:I' .- ,,'." '-"i .'!., ~-"., ."..,' ....:.~..'.'.. :...'!.",;..;",~_t':.>'.!;,,, ."'~''''1,,1 ,"~'I(}':: t,.,,:..;....'MI.,t,~~")'1t~_ lVj!'-1f
New Altel'ation or Extension Per Panel
One Circuit
Each Additional Circuit 01' wilh
Service or Feeder Pennit $ 3,00 ,
"-"""'TlI\Ttr.~';~?",.=,r:;t:.~.~r."W~~~\~\\~ ,. "1T":rm
K t !\1Jsdl!JllIiI~b'i ." , tJeue'r" I ,~ael1,liistall:\tio'iI1
1-",,," it\IS'P~I\'.~~dtR'i' \S,~~~:~ ~'OR' ',^; "..,,1 '. "",]
Pump orAijii,~MlIll~~\) OP- IS I"-'ilM,mON $ 50,00
Sign/Outli~n!ialiii\'i\f\'{ PEP-IO\). $ 50,00
Limited qne\)\y,fi'~iaential $ 25,00
Limited Energy/Coll1mercial 45,00
1\1inirnurn Electric Permit Inspection Fee ~oo + SIl charges
rz:;'I'.!:"~ d""!;'i:;"':":r~n;'7~""';'!;;'"'R:o.nr"'i.;~\( t ~;"'rb.~ ,~.\f'"';,"~'I.r.:'T1t;"1l
4, t,ISunTOTAL' OFABOVE$,-:~)~~'}:~:-:;~::J\-i.'.f(~~~3:
~~~).;; A\~~'l;:rtlllt; ~l':" ",!-;,. ',l>-,.~'\~"~."1'~fl~,,.~';:R\.:i~t;l;j~~;iit:,::/t~.1!i,~~;
$ 43,00
43-
7% Stale Surcharge
I 0% Admini~trati\'e Fee
l/:;
51 )---
'-(fV
5'Z 6 ')
TOTAL
Shared Drivc(T:)fBuilding Fonn.'lfElectrical Permit Application I.03,doe
,.-'
,
.
.
City of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfiel~Oregon 97477
541-726-3759 Phone
541.726.3676 Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00084
3/24/2003
3/24/2003
9/24/2003
SITE ADDRESS: 2062 LOMOND AVE
ASSESSOR'S PARCEL NO,: 1703251201800
Springfield
TYPE OF WORK: Addition
TYPE OF USE: Residential
PROJECT DESCRIPTION:
I circuit for hot tub
OWNER! APPLICANT:
BARR MARK D & JEANNIE K
2062 LOMOND
SPRINGFIELD OR 97477
ELECTRICAL CONTRACfOR:
BUILDERS ELECTRIC INC 541.485.0922
195 MADISON ST
EUGENE OR 97402
CCB # 4296 Expiration Date: 12/10/2003
'"v
Descrintion Amount PaidlO\} '1\~'1
,~,,~ 0'1J. ~,
+ 10% Administrative Fee ~ ~150\~ eQ,oC:- <;,e\ \0 !\)'\
+ 7% State Surcharge ,,\'0- )~!15)~ 'C>-~e S7:r;) 'Q',
Add. Alter. Extend Circ ~0QP 'Q'143,QQ,10<;' -r<?- 9j ~.s.0<;'
MinimumlAdiustment Electric~l) <\\00 ,^0~2~00^'C\O l \'C\0 :f:\0c:-0"
\u. ..\0" ~\.~ .,...\\\.f) ('\\. ......(') ,,\0
y.y'" sv ,e" ('\~,. .,...:,e..., lt~'- .,....c,V'.
To Request an im;jl~lio~,~Jf~eJ~i~o.\";;,.r'ec,~~l9g'~t 7~6!,3?~;'~1I inspections requested before 7:00 a.m, will be made the same working day,
mspectlons requested'after 7:00 a,nLwllI be maile.theffollowmgr);Vorkmg day,
\V'.,\c,'O-" S/':v' ,,0"" ~S~ \)"" r[.'"
. _\\.\ .-. 01 -"~, ......\0 ....(\~ nf"J:'
\~' ()\'" -{O'V' c,"'" O\..,~ ~C\..r
Reouired InsDections: <;;>.\l> \'C\0 ~\'C\e . c. ,,'i'l
')V "\" .\0 0\~' o~
1 Rough Electric: Prior~9,Govsr:'< ~'C. ~()" i\
2 Final Electric: Wn~tall el~trical work is complete, ~\'?-'C. \'i: ~~~, \':1 ~Q
'1 M.,\j.1 o~,?-\~' (\9-
By Signature, I state and agree, that 1 have carefully ex ~!t.!\~l\!li1e.!;~ ~d.tiR\\'a'UJ'lI'o hereby certify that all
information hereon is true and correct, and I further c 't''ilWl,\\Y,illd ~~\ltdrmed shall be done in accordance
with the Ordinances of the City of Springfield and the 5, ~'5f.l ~l9~ ~ pertaining to the work described hereilL I
further certifY that only contractors and employees who lll-1'i ca..l\liIi 'l I~RS 701.055 will be used on this project. I
further agree to ensure that all required inspections are r~~~~i<at3 proper time, that each address is readable from the
street, and that the approved set of plans, if applicable, wil~'itllhn on the site at all times during construction.
Date Paid
Receiot Number
03/24/2003
03/24/2003
03/24/2003
03/24/2003
1200200000000000867
1200200000000000867
1200200000000000867
1200200000000000867
Owner or Contractors Signature
Date
I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line I terns:
Job/Journal Number
ELE2003-00084
ELE2003-00084
ELE2003-00084
ELE2003-00084
Payments:
TWe o(Payment
Check
Paid By
BUILDERS
Description
Add, Alter, Extend Circ
3/24/2003\
10:04:2 lAM
.
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 1200200000000000867
Date: 03/24/2003
-
Amount Paid
43,00
Minimum/Adjustment Electrical
4,50
+ 10% Administrative Fee
+ 7% Slate Surcharge
2,00
3.15
Line Item Total:
$52.65
Received By Check Nnmber Confirm No How Received Amount Paid
djb In Person 52.65 e
Payment Total: $52.65
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