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
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Electrical' Contr\,ctor '
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City , ' ! Phone
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:'j: ..J -C::onstr Contr. Number D
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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
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Installation, Alteraiions or '\,
Relocation: ,I " ' , - ' . "
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/'....,., 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 _ '
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R\W"f~"Y~~'P,~'Feeders.' ,,;
~t;;) S~~&.~~~I.~"'t Relocation !
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~'O'\:~,,\~'OO."::....9. or les,s ' . $50,00 ;
~ c,\)\"'~~~ to 400 amps' ' $69,00 ~
-.........'-~~i)ve.r:.401 to 600 amps ,:----'- $10000:.......,......,
OYer600"mpsor,!000voltssee ",,\0 ,-,', ,'.
"8" abo\'e "--~~'lO '~\'l .'
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8 ,,"neh Ci reuits ~ \'lJ.~ 00~ ,e:>~ ,...I:iJ\:) "
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New A teratlOn ohExtenslOn~Per Eane '~0'i> '
,.:(';-3~':',~~'Q\eT~QSe'~~~O""~~0f (\'Q.~ ':' '7
9ne q\!;CUlt ~\e~::'\J~,o>!j.'eSO\ _\M)~$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 '
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E, Mlscellaneous'(Se""lcelfeeder not mcluded) " " ,
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-Each'instalIation
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Pump or irrigation
Sign/Outline Lighti!lg
Limited Energy/Res ,
Liinited Energy/Comm
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'''. Sign;lt~;I~C of.Su)lcl"yising Electrician
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'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(
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Items Cost
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$106,00
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$ ...
19,00 ~
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$ 50,00 ;.'-.
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\$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
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City of Springfield
Electrical Permit Attachment
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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
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