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Home My WebLink AboutPermit Electrical 2003-04-30Gity of Springfield Electrical Permit Attachment Status: lssued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00116 4t30t2003 4t30t2003 r0t30t2003 AVE Springfield TYPE OF WORK: TYPE OF USE: NOTICE T A C A, o trhx 541-741-8460 3474 OR EUGEN CCB # 63473 Expiration Date: 01126/2005 Description + l0%o Administrative Fee + 7o/o State Surcharge Add. Alter. Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid 9.30 6.51 30.00 63.00 Date Paid 0413012003 04/30t2003 04/3012003 04/30t2003 Receipt Number 2200200000000000793 2200200000000000793 2200200000000000793 2200200000000000793 To Request an inspection call the 24 hour recording at726-3769. 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. Required Inspections: 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. 3 Rough Electric: Prior to Cover 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 if applicable, will remain on the site at all times during construction. 4-3e^ AS Owner or Signature Pase 1 of 1 Date allHeE3,tl SITE ADDRESS: 3474 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department, Public Works Department Official Receipt Receip #: 2200200000000000793 Date: 04/30/2003 ELE2003-001 l6 ELE2003-001 l6 ELE2003-001 l6 ELE2003-001 l6 Perm Serv/Idr 200 amps or less Add, Alter, Extend Circ Ea Add + l0%o Administrative Fee + 7Yo State Surcharge 63.00 30.00 9.30 6.51 Item Total:$108.81 Check OLSSON INDUSTRIAL ELECTRIC njm 034716 In Person 108.81 Payment Total: -$10-EEf 4130/2003 l:15:54PM cReceipt.rpt *FNIOFI*LN Page I of I 225FIFTHSTREET . SPRINGFIELD, ORg7477 o pII:(541) ELECTRICAL PERM IT APPLICATTON City Job Number 726-3fi40ilmffi ptgpflTrdrlB$f ed has the tollowing zorlrng ano dobs n'ot require specific land use ap Qt out" 1. 3474 Orqon St. -Springfield, OR 97478 LEGAI DESCRIPTION JOB DESCRIPTION Relocate Service Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder )c 3. A. Permits are non-transferable and expire if work isnot started within lg0 days of issuance or if work isSuspended for 180 days. $106.00 $ 19.00 $s0.00 UI\:UI I} 601 Amps to 1000 Amps Over 1000 AmpWolts Reconnect Only D. Pump or irrigation Sign/Outline Lighriry Limited Energy/Residential Limited Energy/Commercial Minimum Electric permit Inspection 7Yo State Surcharge t0% Administrative Fee TOTAL 2fQ€l?f6prless I $63.00 63.@elltel 1a\ lhose r Box 70413 ohtaio Cu h1+ffiteHffi.rr;f;:il F0r$163.00 $375.00 s 50.00 Supervisor License Number Expiration Date 3334S C. 1G1-O4 Consk. Contr. Number 63473 Expiration Date t-2@5 Signature of Electrician Owuers Name Walt Chaney Address 39535 Road City Marc-oLa Phone Installation, Alteration or Relocation 200 Amps br less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see..B,'above. New Alteration or Extension per panel One Circuit Each Additional Circuit or with $ 43'00 Service or Feederpermit lO $ 3.00 30.@ E. $ 50.00 $ 50.00 $ 25.00 $ 45.00 Fee is $45.00 + Surcharges 93.00 6.51 4. 108.81 Inspection Request: 726_3769 shared Driv{T:)/Building Forms/Electrical permit Application l {3.doc ( or Services: or' Feetieri - sIiii.eS or per dwellihg irnit. tollow 952-001 numberfor Center Branch OWNER INSTALLATION The installation is being-made on property I own whichis not intended for sale, lease o. ,*,. ' -- 'J ' v rt Owners Signature: not -.--.9.30-_--