HomeMy WebLinkAboutPermit Electrical 2003-05-08Gity of Springfield
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00119
5t8t2003
st8t2003
Lu8t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
1661 Mohawk Blvd
17032s310s800
400 amp service and 2 circuits
Springfield
OF WORK:
TYPE OF USE:
TYPE New
Commercial
OWNER/APPLICANT:
HAMMERBROTHERS LLC
POBOX2266
EUGENE OP.974O2
ELECTRICAL CONTRACTOR:
ROSE CORPORATION s41-686-0e05
89976 DAY LANE
EUGENE OR 97402
CCB# 54431 ExpirationDate: 09/3012004
Description
+ l0% Administrative Fee
+ 7oh State Surcharge
Add. Alter. Extend Circ Ea Add
Perm Serv/Fdr 201 to 400 amps
To Request an inspection call the 24hotr
working day, inspections
Date Paid Receipt Number
1200200000000001 149
1200200000000001 149
1200200000000001 149
1200200000000001 149
inspections requested before 7:00 a.m. will be made the same
the following working day.
Amount Paid
8.r0
5.67
6.00
75.00 \t
\$(r
\r \
Required Insnections:
1 Rough Electric: Prior to
2 Electric Service: Approval prior to utility company energizing service.
3 Final Electric: When all electrical work is complete
By Signature, I state and agree, that I have carefully examined the completed application and do certify that all
information hereon is true and correct, and I further certify that any and all work performed in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon
certify that only contractors and employees who are in compliance with ORS
to ensure that all required inspections are requested at the proper time, that
the approved set of plans, if applicable, will remain on the site at all
herein. I further
I further agree
street, and that
?.{\o\$e
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Owner or Contractors Signature
Pase 1 of I
{TTffiD
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 12002000000000 01149 Date:05/08/2003
ELE2003-001 l9
ELE2003-001 t9
ELE2003-001 l9
ELE2003-001 l9
Perm Serv/Fdr 201 to 400 amps
Add, Alter, Extend Circ Ea Add
+ l0%o Administrative Fee
+ 7Yo State Surcharge
75.00
6.00
8.10
5.67
Item Total:9T1T
Pryme r:
CreditCard ROSE CORP djb 000062 008120 In Person
Payment Total:
94.77
s94.77
s1812003 l0:25:43AM Page I ofl cReceipt.rpt
12
Multi-Famill'' per du'elling unit.
s 3.00
cluded)
Energv/Comm
$50.00
s50.00
$25.00
$45.00
i\'Iinimunr Electric Permit Inspcction Fec is S-15.00 * Srrrchnrgcs
1. SUBTOTALOFABOVE
7'h StNa Surcharge
8%o Atlministrativc Fce
KI
Fo
rtt
properfy" I
for sale.
made on
is not intended
Orvncrs Signature
TOTAL ?r 77
ELEL IRICAL PERMIT APPLI CATION
City Jol Numrrcr' &-L-ZC'.I,
-
1 | ]
LOCATIONtLL,l
LEGAL DESCRTPTION
t7O'., ZS) t C 5KC'c i
JOB sbte 2 a, gL',1 ,\
Permits are rlon-transferable and expire
if w'ork is not sta(ed lvithin 180
ofissuance or ifrvork is
180 days.
2. CONTRACTOR
sq.ft. or less
500
Homc or
Drvelling
or Feeder
Ser.yices or Feeders
Installation, Altcrations or
0I,l Relocation:
200 amps or less
201 arnps to 400 arnps
401 amps to 600 amps
601 amps to 1000 amps
Orer 1000 amps/volts
Reconnect Only
C. Tenrporary Senices or Feeders
Installation, Alteration or Relocrttion
200 amps or less
201 amps to 400 amps
Ov'er 401 to 600 amps
Orer 600 alnps or 1000 volts see
"8" above
D. Branch Circuits
Nerv Alteration
One
Items Cost Surp
$ 106.00
$ 19.00
$ 50.00
$ 63.00
I$ 75.00
$ 125.00
_3s
_ $163.00
-_$375.00 _
$ s0.00
$5o.oo _
$69.00
$100.00
Panel
$43'.00
(-
1O
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r^clh
Citr Phone__
S,rpcn isor Licerrsc NLttttber
Expiration
Constr Contr.
Expiration
Signrrturc of Srqlerrising Electrician
o I
Orvners
Electrical'
The
rent.
PO
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l.\
56-t
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