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Home My WebLink AboutPermit Electrical 2003-4-1 003- · I .. .. . .. the !ollOwing . s ubmitted h~~ and use ' . SPRINGFIELD, OR 97477 . PH:(541)726-3753 .~I(64Il~n~'$R~eQUire spec,l\C I . ELECTRJ PERMIT APPLICATION zoning, a1nd ~(l- - ) ) II approva . L-- .ityJObNUmbe~.J; -n....--'~. Date C3:3 0:5 Zoning ,-O~ ~ i. I LOCATIONOFINSTALLA110N .1 3. (.C.O~PLE11':.PJ!Itst:ifEPJl~~'~1~W- . '7 q ~ 'IJ. /) / /\Ulno"..- S 9 J _ ~ IN'.A'oJ O^ /4<f- /W LEGAL DESCRIPTIO A.I NowResiaential- Single or Multi-Family por dwelling unit. 1'J@A5~l /~. JOB DESCRIPTION J1/h F~ .. I .-. /f1' Permits are non-transferable and expire if work is not started within 180 days of issuanoe or if work is. Suspended for 180 days. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 2. I. C;ONTRACTOR INSTALLATION ONLY.j .8.\ S~r\'ices .or Feeders ...Justallatiou, Alte,:atious or Reloo:ltion: ,I Electrical Contractor Ie 5 E;t ~"II'''~ f l'rM.ru.lf...()-c.' 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 10QQ~~~0Its $375.00 Reconne~'dl...~E. $ 50.00 THIS PERMIT SHALL EXPIRE IF THE WORK C. t TempA*liffl~'lNiE.g QJ,'1J.te~dh'SHI$ PERMIT IS NOT COMMENCED OR IS ABANDONED FOR Inst:lIl:lt,l@YAlIWlitWt 'P@ll\9tl\tion 200 Amps or less 20 I Amps 10 400 Amps 40 I Amps to 600 Amps. Address (1. () . f, 0? :1- 111 S Arl ~N.IIUI\I:Ulegor,law reqUires you to City fo' ,"t:. r"le<',adoptedpIiblfee&wor6~ti7(;1 Notific,. .Ion lJenter. I.hose rUles are se! TOr! in OAR 952-001-0010 th;ough OAR 952-00', . f'of'oe>f'o "", m;'. n~t~.ln C(31'lrz~f7'''crules b' upewisor License'Numoer . y'y . 'J' . calling the center. (1II01e: me lele~.lIIUIII:I Expiffiiion~aiefOr the f.'80!n!ll"yJ Notification Centerls H:llJlI-::J::JL-L::J44). Constr. Contr. Number "7 u.r.rtf /d-13~/O $' Expiration Date Signature of Supervising Electrician -::(~-v-U/ , f Owners Name r\.u I, .:::Jd f6<J S(JI,\.J Address -/-2-; 2- ~/>'-' 61', ~ /,./ City s: j ",to Phone 7 </ 7....p.p-.f" ~ OVVNERINSTALLATION The installation is being made on properly I own which is not intended for sale, lease or rent. Owners Signature: . I ~.\ ____1 (:_)'-' .____ ~ __ -_ _ r-- lOspection Request: 726-3769 f' " $ 50.00 $ 69.00 $100.00 . Over 600 Amps or 1000 Volts see "B" above. D. IBr~rich'<;:ir~uits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit $ 43.00 $ 3.00 'I 43. 6D I E. I \\1isceli~';"olls/Ser;'i~~deed,erllotinchided) -~achii,stall:liioi,l Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. t:S~TOT~O~:WOYI!; I 45.UV '..2. /5 4.5f') 6.:i . ~S 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application l-Q3.doc i Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION: OWNER/APPLICANT: JOHNSON GUY L & BARBARA A 1792 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 Descrintion + 10% Administrative Fee + 7% State Surcharge Add. Alter. Extend Circ Minimum/Adiustment Electrical . . City of Springfield Electrical Permit Attachment PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00092 3/31/2003 3/31/2003 9/30/2003 1792 HAYDEN BRIDGE RD 1703252112400 Springfield TYPE OF WORK: TYPE OF USE: Addition Residential Gas Furnace ELECTRICAL CONTRACTOR: KS ELECTRIC 541-686-6236 PO BOX 24933 EUGENE OR 97440 CCB # 70889 Expiration Date: 12/30/2004 Amount Paid Date Paid Receint Number 4.50 3.15 43.00 2.00 03/3112003 03/3112003 03/3112003 03/3112003 2200200000000000663 2200200000000000663 2200200000000000663 2200200000000000663 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. Reunired Insnections: 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By Signature, I state and agree, that I have carefully examined the completed application and do bereby 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 street, and that the approved set of plans, if applicable, will remain on the site at all times during construction. Owner or Contractors Signature Date Page I of I \ ! .,.---. .. Status: missing from list 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: . . City of Springfield Electrical Permit Attachment PERMIT NO.: ELE2003-00092 ISSUED: APPLIED: 3/31/2003 EXPIRES: 1792 HAYDEN BRIDGE RD 1703252 II 2400 Springfield TYPE OF WORK: TYPE OF USE: A'.' t:.1\l "UI\l.UII::gUI"cl"" ''''4UIl''''' you.~~ ... ..__ .rlnn.,.,rt h" thl> Orenon Utili LV f:ELEC,iRICAI2CONfrRW@T0R:>et lore irI<:S,EtE0TRIG1-001 0 thro~gh UAli l103:H?686_6236 CPOlBOX,.24933 obtain caples of the rl.iIC;:'~. EUGENE 0R 91440r (Note: the telephone CCB'#"70889.t-h~' Expiration Date: rl'2/30/2004)O nllmber tor e UldYUll UlllH)' .......~...-_. I"'enter i" '-HI )11-;<.1/,-'. ,.,~ ,. Date Paid" Receint Number Gas Furnace OMlNitW&\.PPLlCANT: JOWN~crn:8WrS&j&WRB~fi'..IF THE WORK 17~iJiM(ffi'W!E~IS PERMIT IS NOT s~unmmrg~4~ABANDONEDFOR ANY 1 RO nAY p~Rlnn Descriotion + 10% Administrative Fee + 7% State Surcharge Add. Alter. Extend Circ Minimum! Adiustment Electrical Amount Paid 4.50 3.15 43.00 2.00 03/31/2003 03/31/2003 03/31/2003 03/31/2003 2200200000000000663 2200200000000000663 2200200000000000663 2200200000000000663 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 Insoections: 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By Signature, I state and agree, that I have carefully examined the completed application and do bereby certify that all information bereon 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 tbis project. I furtber agree to ensure tbat all required inspections are requested at the proper time, tbat eacb address is readable from tbe street, and tbat the approved set of plans, if applicable, will remain on tbe site at all times during construction. h}A /~-0----:J? k ,,{s:-1-/~ ~fuc. J /3 ~ 3 Owner or GlS'ntractors Signature v b <f (0 e;.2 S 6 Date . Page I of 1