HomeMy WebLinkAboutPermit Electrical 2002-10-1
\
i,'
l:90~,
:39N
08,'6
300"
J..9W
.Z,-{) 117L{ -C) I
1
.
, C'
~ > l
~ :1-"
.5-
Leo
m:,;j~
~~\V
, .'
~~
1f'fJ .
Sq I 'lIJ
TRANS#:01-0010767
DATE:OCT 01 2002
AMT RECD:2 $ 59,80
CHANGE:
CASHIER:061
.,
.
.
.
City of Springfield
Electrical Permit Attachment
WI......r^.."..
... " '..
'.. ,. !,'
Status: Finaled
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
01-01437-01
12/28/2001
12/28/2001
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
3560 Hayden Bridge Rd
1702190000501
Spr
TYPE OF WORK:
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION: Scope: Electrical Only, Install 5 new circnits
OWNER/APPLICANT: ELECTRICAL CONTRACTOR:
loa Westerholm
3560 Hayden Bridge Rd
Springfield OR 97478
(541) 726-8861
LR Brabham Ine
68 W Q St
Springfield OR 97477
CCB II Expiration Date:
(541) 747-6638
Descriotion
Amonnt Paid
Date Paid
Receiot Number
Cashier
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 InsDections:
By Signature, I state and agree, that 1 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 descrihed 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 sel of plans, if applicahle, will remain on Ihe site at all times during construction.
Owner or Contractors Signature
Date
Page 1 of 1