HomeMy WebLinkAboutPermit Electrical 2003-3-25
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Status: missing from list
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
54 1-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1625 HENDERSON AVE
ASSESSOR'S PARCEL NO.: 1703344313302. to
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PROJESI,;'?J,~y~gifLQ~ :;Jt':.Serylcet~~"'!. ~.~~<<m In r:
:\' 1.;+,"'''T1n'11 ,'''IILal. III........... .--- .
OWNER/.A\ffi~~~;!;:, -001 0 th~ough OAR 952-00,
MIDWAY ~NOR(OU may obtain copias oj the rules b
924 TOWN CENIW,o!he center. (Note: thetele~ho~e
MEDFORD O~(8~~8gr for the Oregon Utility Notljlca\tOn
I"M>n,' k 1_Rnr.-?,:i2-?344).
Descriotion
Amount Paid
+ 10% Administrative Fee
+ 7% State Surcharge
Add. Alter. Extend Circ
Perm Serv/Fdr 200 amps or less
7.80
5.46
15.00
63.00
.
City of Springfield
Electrical Permit Attachment
PERMIT NO.: ELE2003-00087
ISSUED:
APPLIED: 3/25/2003
EXPIRES:
Eugene
TYPE OF WORK:
TYPE OF USE:
ELECTRICAL CONTRACTOR:
C & SELECTRIC 541-741-2236
P.O. BOX 1482
SPRINGF.IEI,.D OR 97477
ccWi) '(\849;. Exprrabon.DateREOI'tlO.'V~Q40RK
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Date. Paid\RIZED UNDER Rece.Jjt !,!umber
, .- . . R IS ABI-\NUUI~(.U . \...
03Uol.2'ddiiNCED 0 2200200000000000643
03/~mO~$O DAY PERIOD'2200200000000000643
03/25/2003 2200200000000000643
03/25/2003 2200200000000000643
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 am. 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 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 eusure that all required inspectious are requested at the proper time, that each address.. readable from the
stre4 and t at the app~ if applicable, will remain on the 3E~J~~s during coustruction.
Own. . or Contrnctors Signature Date
I of I
:;';':.>':'.. ~'":.:"'Y;~'tlfY DE~! mOFiEtb;"tJirnboN . h). '. '.
\..~,.l,o.. '::-.;v..__~_,._....._..........._~~ +.'._.'..,; . ....... .... .
ct as submitted has the following
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX~m~~:flfil'9' nol require ~pecific .Ian~ use
ELECTRICAL PERMIT APPLICATION Zoning / MA .
CityJobNumberGLe:f-C03-000'67Date 3/d.F;/~On~le "~"-Z'1d-:; I
/ I ~ I
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LEGAL DESCRIPTION .
\ 1 03 3l-f Lg (330)..
JOB DESCRIPTION
~{\!~U / -\-71 '^' \'vlG.<h0P
Permits are non-transferable and expire If work is
not started within 180 days of Issuance or If work is
Suspended for 180 days.
Address " 1 '.,
. 011.~"~' .,,,,"""I,jU. ;u:~~-':;r.g""; u,i,"Y
City u-pflW'.' = ft&r~l{c?n~::J~,liZ2:36
Nc.l.iticat r :\ L<"" ,,81. 111 = h QA9 952-00
in OAR 952-001-0bOt14~t~noq,I~9~ 'S~l ti18 rules l
S . 'y['''' "-N rYlc\J 0 - . hone
upelVlS0r\~lcensel. umuer. ~.l' ...~ k' ~ _ ~ te190
calling thecc,uv" ,. ..'. .~i \I Nolification
I .\,,...1:-. r\,A'\nn & - I
Expiration Datelber or (J 'O'!:'L:: nM_')~tL,,".
Gem.t:lI';: .-". . '
Constr. Contr. Number :) '6' Lj (1
q -I -oLI
Expiration Dale
ignnture of Supervising Eleciricinn
/!:~
Owners Name t"'v\; ~tl.. ~11 d ('ry] (V\ Y
Address 1.La. M h.\(.Drf } 1\ ?on....-v--
City ~I J PhOl: '7~.. -754
OWNER,UlISTALLATION
The installation is being made on property I own whieh
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
A. n'~~~1!.~1(~~~[[~~~llig!!!2;;M~!ijl~r.:nliir~'ij~xrc!W!lling);1iiit1:: ~ .
Service Included
1000 sq. ft. or less
Each addilional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
S 106.00
S 19.00
S50.oo
/
1/13. em
200 Amps or less
20 I Amps to 400 Amps .
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsIV oils
ReconneNBfr'CE:
C. I'Telii"Ult. ..
Pij/.I.U--,,!JI.:,.~.~
AUI EMIT IS NOT
Installa(iQW~t~il cfrf~ffi>!'ii.!1il!l!DONED FOR
200 AmM'bYI~&O DAY PERIOD.s 50.00
201 Amps to 400 Amps S 69.00
401 Amps to 600 Amps S100.00
S 63.00
S 75.00
S125.00
S163.00
S375.00
S 50.00
j
Over 600 Amps or 1000 Volts see "B" above.
D ~".'''.T.'''''''h-'''1-~''''I~.'~"'. ~~. ~"" "'" .~. ~'Ii!ii...tM
. "IJ.fODC ". . ~. .' . ..".... _ ~i ;
I ",~.:.,,,.:,J.~ ~) .r'i~ " '<I' ... '!'~'" .', .. _ i.~. ,~ ~'",I
Nrw AItrl'nflllllllr Itllrlllllllll'rr I'nllrl
One Circuit
Each Additional Circuit or with
Serviee or Feeder Permit
S 43.00
S 3.00
\5
/6 '00
E. !~Mis.'''€fiiiiti~iffi'f's~1''lfld~j!fij~''iAmil'.n;'\if~Enli\mfliIiU~
a~~!if~~"3"i"t'_"A....,\!lili':l'r1\"lI~:~~~"">;''''''''''_ nt~~rl"~'P'....~,9}~.......,
Pump or inigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
S 50.00
S 50.00
S 25.00
S 45.00 ,
Minimum Electric Permit Inspectlon Fee Is $45.00 + Surcharges
4. (!,sDBwtAl1011:JAhCl__l!li
rt~~'~'.lti-tl'*'4~~u..~l!iit.it,,) .~ . . rlJ
It. (JiJ
5.40
'7.KlJ
all ,:.::2{~
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drivc(T:)lBuilding FormsIEIec:trical Permit Application l-Q3,doe