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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- ~"';:::~;:;;;~~.~'12NL".''"'" '~;1i~!~i::1ii~}};'~t~~il5~':lli "d()(o'd. LOlY1n ';7~_'-_q,"-" ,.....-..c'-;;-..'7:'.....,':"~ri-:""~~~!l'....~".!-;-:.....l.'f"-_ ~,-, ~~~ 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. f<.'(Z:";'.:.........- ..-.,..........-.~l'ttm:-:;:t.~'j"':w...-l,;..",.,..._,. ,~ 'p;-:'( 1"60N;FRAGTOR'INSTALLATION'ONLY'.' 2. .1"'_' ';~-,rt.""-:"~~ .':."~' ~_:'::'I!:~,-'-~h;'..r.I..!..Ut~L'_':L..<'~;- : Electrical Contractor ;,,:, 1c't-r S 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 Page I of1 cReceiplrpt