HomeMy WebLinkAboutPermit Electrical 2003-2-24
"', 225 FIFTH S~ET i' ~'\ r '. 1 - 'I - - Ii'; ".. ELaCAL PERMIT ~PLlC~TION "
,I SPRJNGFIELD, OREGON 97477 J ....J ' II ,: .
. ,- : INSp'ECTlqN REQllli,ST: 726-3i69=' "j S C~y ~ob Numher~r= ~J" - &:%J S' Z,
:! OFFICE 726-3759 \' I i I ~~J I \ '.-.J I . 1; I '-, '
!: .), r - '" ! I \, \ 1\..'7 "; ! I 1_. '3. . COMPLETE FEE SCHEDULE BELOW
\ ,. I I ,I. 0~TI6N:QF)N:ST.AL~t~9N ! i ;a Ii' :: /' i, .'
'-. .. -' --q::.L,4t 9 "7!1 q#"/.Yf'/~5 t'~.i~.. N eir Residential-Single 01'-- - - J. . - --'------ - . - ---
, , Multi~Famil)' per dwelling unit. ~
f,
LEGAL DESCRIPTION 1"VlL1..PI 2.. Service Included:
4t"'J 2 ';;!.t!!> L!J1t) c;.A/~ Items Cost Sunl"
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".
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$106.00
JO~ESCRIPTION /. 1000 sq.ft or less
~~ Mlf~L..H"C::- ~ Each additional 500
, ~~ .
t, zOn' OWingp. sq. ft or portIOn
.; 'fJR a fOlecf
Permits arc non-transferable and.:wwtl~' nd dOes . as sUb . thereof
. .' , . . al. 001 o"lle....
If work IS n9tstarted W1IIun 180 days reqUire s caahl~~nllfd Home or .',
of issllancc.Dhf work is SllSpe'l9s?/or ~~iog f YL '1eflflR,lap;J33~I!1ti!lg . . ~ ,
180 days. ( l A. ~-~ _ ServIce or ~eder . .' $ 50.00
;: ~..iS, Ufhonzea. 0 J ! ~ .~
2. CONTRACTOR INST ALLA TION O~"Plure . or Fee e .'
;' \ / ./0 . C' C I ~. Alter~liions or
Elec1ricaI' Coinractor' G ~ ,) 0 '('LA riG n: /
Address l;~ ,0 .iBo)( 1l.W2- //'c" . 200 amps or lei '.
('l. _ (.).-J. \ 6' I'. "'" 20 I amps 10 100 amps
Ci1)' DV'r"cl Phone ,4tZ231c>-" 401 amps t~600 amps
'. ,'1, \ I) . /I"~~ 6Q 1 amps fO 1000 amps
Supervis9r'Licenstc/Null1bqr / ':l.~~:: , Qver,lOgo.arnps/volts
j"'V' r6[ .Ii nJv,;t't:RMIT SHALL ExrM'E''If!.'Tf:l~n1Y: .
E~piratiOll Date' . ..1, ;O.~FirJRI7PD'9ND}RJHI~ gpo' ! ' , W~RI(
L. :., . 'tY;!, lENCfD OR 'is TFP'1):o '""Y\sUI,'/&lIIfT1Feeders
,. Constr Contr. Number '3~ 49. . ,,, "'"Y PERI .Jns~h\UaJi,;0.Iffi'Rtion or Relocation
, ~'---------Ql 'I u. ." ~n 100. . .
"':-Expiration Date -, I, ,~.IAI ! k N' IQd.Vlt:yU:. ;;"200'ainjis;or.lessj ~',
" , fOlrOW'Rlle~Opled bY2bl!a'riips;Url!60'aiiIps
. Signatu'I'eof SUjlel'vising Eleetricia'rification Centerr.'fhm0yer:401,10:600"lnfps' '. '
~. ". ,.e. """_" in OAR 952-001-0010 thr0.vsf;/i bo\amjiSior:!!.~~o yolls see.
.. . . . ;'J;~'. 0 omrQrou may obtain cu~iE.'l9~;e;he rules l:-----<.,.
~/ ....... '.' A,~.....,- '~.: center. (Note: i~M~lephone ~
. . {JO J fJ.:~~ 'n;t:'1/berforthe @r~UH'f.l\i~W'lI~~~ification /' .
Owners Na~c 1\1 d.l Q.JY rVl ~~-tp'rif 1_~nnNC~\)'Nt~raqon or"Ex,tension PerPa~el
Address 4071 . t-tt'qh Ban(s!2l On'~'~ircuit; . $4300
'i...C;-o~ pYone' 7 tf7~ Each Additional Cir~uit or with Service
U or Feeder Permit. $ 3.00
$ 19.00
,\,
:\
.,
"
,
- "
,.. .......-.
.: $ 63 '00 V
" $75:00 . '
.$125.00
-,: . "$163.00.
.,....,...-... -l
" ----:-t $375.00~'
--4 $ 50.00 ~.
. ,
_ $50.00
~ $69.00
----':',$ 100,00
-'
Cit~.
OWNER INSTALLATION
Tho' installation is bei'!g made on
property I O\rH which is not in1ended
for sale, lease or rent.'
,j'
,
E. Miscellaneous (Service/feeder not included).
:-Eachinstallati~~ . .
, Pump 'or'irrigatio'n
SigozOutline Lighti1,1g
Limited Energy/Res
Linlited Energy/Comiu
OWllers Signature:
$50.00
$50.00
$25.00
$45.00
1\linimum Electric P~rmit Inspection Fcc is S45.00 + S~II.chargcs
4. SUBTOTAL OF ABOVE
70/0 Sta.tc Surcharge
80/0 Administrative Fce.
5.9.-su-
3
5'? .56
TOTAL
.
.
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:
ELE2003-00052
2/20/2003
2/20/2003
8/20/2003
SITE ADDRESS: 4949 HIGH BANKS RD
ASSESSOR'S PARCEL NO.: 1702280000802
Springfield
TYPE OF WORK: Repair
TYPE OF USE: Residential
PROJECT DESCRlPTION:
Replace meterbase jaw
OWNER! APPLICANT:
BRlGL RODNEY
4949 HIGHBANKS RD
SPRINGFIELD OR 97478
ELECTRICAL CONTRACfOR:
C & SELECTRIC 541-741-2236
P.O. BOX 1482
SPRINGFIELD OR 97477
CCB # 3849 Expiration Date: 09/01/2004
Descrintion
Amount Paid
Date Paid
Receint Number
+ 10% Administrative Fee
+ 7% State Surcharge
Service Reconnect
5.00
3.50
50.00
02/20/2003
02/20/2003
02/20/2003
2200200000000000507
2200200000000000507
2200200000000000507
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 I nSDections:
1 Electric Service: Approval required prior to utility company energizing service.
By Signature, I state and agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is true and correct, and I further certify that any and all work performed shaIl 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 hereilL 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.. readable from the
street, and that the approved set of plans, if applicahle, will remain on the site at all times during construction.
Owner or Contractors Signa1ure
Date
NOl\CE: XPlRE IF I\-1E WORK
1\-1\5 PERMll S\-lf..~~ \\-I\S PERMIT IS NOl
f..Ul\-10RIZEO UNO IS f..Bf..NOONEO FOR
COMMENCEO OR
~ NY 180 Of\Y PER\OO.
, . '8\J\ 1t.:L\ullt,.;1:. ~"J.). .~
\ t.1'l \ IUI'l:U"'',lu,,' ne Ole~\on lI11II.'/
t~\\ow r.ules ~~~~:~~:~s~ rules are s;~_t~~~'
NotiIiCa~~~~01_001 0 thrOugh O~~: rules L
inOf\Ry u may obtain COpIes Oe'~')\ "',,"
0090. 0 'Note .hE' '.
calling the center. \ on Utility .\'01 ,It-utl'-.'
numberlorthe.o~e~()n_q~?_?' .'.
Centens -
I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2003-00052
ELE2003-00052
ELE2003-00052
Payments:
TWe of Payment
Check
Paid By
Description
Service Reconnect
+ 10% Administrative Fee
+ 7% State Surcharge
C&S ELECTRIC
Receipt #: 2200200000000000507
Date: 02/20/2003
Rec eived By
Check Number Coufirm No
lkw
4812
Page I of 1
2/20/2003 f
1:25:46PM
if
City of Springfield
Development Services Department
Public Works Department
Official Receipt
.
Amount Paid
50.00
5.00
3.50
Line Item Total:
S58.50
How Received
Amount Paid
In Person
58.50
S58.50
.
Payment Total:
cReceiptrpl