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HomeMy WebLinkAboutPermit Electrical 2002-10-3 ;".,,' i"225,FIFTHSTREET ": '., [""jl'I-';I: \,....,., ELE~CALPERMIT!\PPLICATION>::. L :"~'..) !iSPRlJ'lGFIEeD~ OREGOj'J 97~77! ...J 1_ 'I' I .'.,"; ',,:... " ,,' , I V::., : 'INS'pEC,TlqNRE"Qu,ESl72,6'~769'-j I ,IF I !! i CitYJ,OhN,UmherF:Lf::. ZOO, Z:-, 0010 <~ ',; I OFFiCE: 726-3759,.1 .!); I:'" I! i ., I! I! j, t,'.', , Cs \', J II ! : n ;! i '.,', : I,': II' ~- , i r t=~ ;3,',cOfVlPLETE FEESCHEDULE,BELOW \~ " ,II \ L LOC~TIO :9HNS ALIIATI~ I ! f \l il',,/ ! ' ,', .." '..' '", ~;,( ". . "'," ,,,,(, -~,~_ A', New'Rcsidentiitl'Single or'-"-'C"'''- , Multi-Family per dwelling unit. LEGAL DESCRIPTION Sen'iee Included: 1702 \91.(( (')/'00 I' ' Electrical' Contr\,ctor ' I' " \_,' i . \ Address ii, ,\ j . City , ' ! Phone ; , t,'! / Sup~rvis~r Lic~'n~elNu'mb~r / J '" [ " c;~Piratio~ D;te Y J ;10V :'j: ..J -C::onstr Contr. Number D "t ----..<" f_ L,' . ~'"" --..~ 'r. ~,. '-Expiration Date . - ---........ ';",:,' .:.,'}...."';- :.,'--.. ! ..;.... .. " I',: ":" 1 , , ''';' ,',' . j "., ',.~' , . , " .. ~" . . , ~ . ' I, ' F' ' " ' r: ", JOB DESCRIPTION. ' , 1000 sq.ft. or less ;JD ~I) ,!),1tt 'Y'i(irJ Ct~('/~tnbdhasthOtO\lOWinl!:aCh additional 500 . f. The1o\lOwing pfO\eC1 ~~:~Lli'e specific land LIse sq. ft or portIOn Permits are non-tr~alll61a1Rl'H}\\rc thereof if work is not \start~pP"it-l~n 180 days CD VC-- ellch Manufd Home or of issuance br if work is su~68aibr /' 6'1 .0 <--3- Hedular Dwelling 180 days, " ' _ fO eM S"lvice or Feeder . . ~ Date - - 2, CONTRAtTOR~~~~~ION'ONLY ~ B, Scn'ices or Feeders , , Installation, Alteraiions or '\, Relocation: ,I " ' , - ' . " ,I. ./. > .:;:\ ,t /'....,., 200 "mps or les!', ", ,$ 63,00--::'>> / ' '-'. 20 I amps to 400 amps ~~'+- ----: $ 75,00 " ' . 40lampst~600amps ~((,,~\\\)~'$125,OO_:' '6QI mnps ~o 1000 :<:1l~ &\f.> _ $16~,OO_: Oyer 10~0 am~~~~ ~:/'(\)~'~ $375,00 -,----" .' Reconne&.~\>~~~ ~\\~ ~ $ 50,00 _ ' . '..~~ ~~~~~~"'\ ;..~'Y, I R\W"f~"Y~~'P,~'Feeders.' ,,; ~t;;) S~~&.~~~I.~"'t Relocation ! '\~\ ~~~~c,l(.\.l ~I(.~ ' , , ~'O'\:~,,\~'OO."::....9. or les,s ' . $50,00 ; ~ c,\)\"'~~~ to 400 amps' ' $69,00 ~ -.........'-~~i)ve.r:.401 to 600 amps ,:----'- $10000:.......,......, OYer600"mpsor,!000voltssee ",,\0 ,-,', ,'. "8" abo\'e "--~~'lO '~\'l .' (\ ~\~ ,~;';:;\\ ~'" . , ' \~e~ a~O, ~p,\>;P :\".... 8 ,,"neh Ci reuits ~ \'lJ.~ 00~ ,e:>~ ,...I:iJ\:) " I ",n" ,." ' \l.' -"'I'" <o-q " New A teratlOn ohExtenslOn~Per Eane '~0'i> ' ,.:(';-3~':',~~'Q\eT~QSe'~~~O""~~0f (\'Q.~ ':' '7 9ne q\!;CUlt ~\e~::'\J~,o>!j.'eSO\ _\M)~$t.~SOO ~ \,\ ct1'~" (',€ 'f;)~'\ Co'Q' ~'~ ~\\c 'O\\a~h'i:.?~d;fi~',;I,€irifit'or:\f.iill\Se~ce" . ~\,... r!:)..... 'l."" "" ;T' ~ \)\.\'. C'l..Ur'il ,,,\,OoOr Eeeaer Pej-lnit~",\e"",O~ n.ofl."" $ 3,00 ' , ,r' --(.(lV" C.", '0", ~"",- ,- :'.~(>9F)',',n() \Y;.e_,'(\eO~..'O()()', " . E, Mlscellaneous'(Se""lcelfeeder not mcluded) " " , . \.I.... . <::;". ~,. , -Each'instalIation , (\VO. -...... '. Pump or irrigation Sign/Outline Lighti!lg Limited Energy/Res , Liinited Energy/Comm " '''. Sign;lt~;I~C of.Su)lcl"yising Electrician . . " .'" -.'. ~. .'-" " . ...... ~~'i'~, ~ ) 'owners Narn:be-0/{Si.' "./VWt2.IC!L D, Address 3 ~2 S- /~ J.p...~ I U.rL( Cit)' <:;1'(-=0, Phone '77'Y77 , ,,71{7:- '8%20 , OWNER INSTALLATION , The'installation is being made on property I 0\\'0 which is not iutended ' for sale, . lease or rent. Owners Signature: . - "JJf)11fJJJ Jnr (I( ";< ......:..-.''('.'-; _i Items Cost '. S~m , /. i ';. ,':.' "" ) $106,00 , $ ... 19,00 ~ " $ 50,00 ;.'-. , , , . c ;---:- " \$5000 ....::..-.... $50,00 $25,00 $45.00 I\linimum EI~ct;.ic Per~it Inspection Fec is~ SlIJ"c'hargcs 4, SUBTOT~LOF ABOVE {/~ 7% State Surcharge 3' J 8% Adminisiratiye Fee .3 b <> f 5/7> TOTAL 'r . . 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: ELE2002-00101 10/3/2002 10/3/2002 4/3/2003 SITE ADDRESS: ASSESSOR'S PARCEL NO,: 3825 HAYDEN BRIDGE RD 1702194101100 Springfield TYPE OF WORK: TYPE OF USE, Alteration Residential PROJECT DESCRIPTION: 20 amp branch circuit OWNER/APPLICANT: MYRICK DANIEL J & DENISE L 3825 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 ELECTRICAL CONTRACTOR: DENISE MYRICK 541-747-8820 3825 HAYDEN BRIDGE ROAD SPRINGFIELD OR 97478 CCB # Expiration Date, Descriotion Amonnt Paid Date Paid Receint Number Cashier Add, Alter, Extend Cire 43,00 10/03/2002 2200200000000000013 dib Minimum/Adjustment Electrical ' 2,00 10/03/2002 2200200000000000013 dib + 8% Administrative Fee 3,60 10/03/2002 2200200000000000013 dib + 7% State Surcharge 3,15 10/03/2002 2200200000000000013 dib 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 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 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