HomeMy WebLinkAboutPermit Electrical 2003-06-18City 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:
ELE2003-00150
6n8t2003
6118t2003
12tr8t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
3230 PARTRIDGE WAY
1703221309000
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION: Add I circuit
OWNER/APPLICANT:
YAGERDORIS MARIE
3230 PARTzuDGE WAY
SPRINGFIELD OP.97477
ELECTRICAL CONTRACTOR:
ROB'S ELECTRTC 541-686-5444
2155 OHIO STREET
EUGENE OR 97402
CCB # 146149 Expiration Date: 09125/2004
Description
+ l0% Administrative Fee
+ 1Yo State Surcharge
Add. Alter. Extend Circ
Minimum/Adiustment Electrical
Amount Paid
4.50
3.15
43.00
2.00
Date Paid
06/18t2003
06/t8/2003
06n8/2003
061t8/2003
Receipt Number
l 20020000000000 I 5 87
I 20020000000000 I 5 87
I 20020000000000 I 587
I 200200000000001 587
To Request an inspection call the 24 hour requested before 7:00 a.m. will be made the same
working day, inspections requested after 7:00 following working day
1 Rough
2 FinalElectric:
By Signature,I state and I have carefully examined the completed application and do hereby certify that all
information hereon is true correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfietd 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 Conkactors Signature
Paee I of I
anrrlatljB
-
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date:
ELE2003-00150
ELE2003-00150
ELE2003-00150
ELE2003-00150
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
Item Total:$s2.65
4.50
3.15
43.00
2.00
Payments:
Type of Payment Paid By Received By
ehec-kNum5er
Batch Number AuthorizationNumber lfowReceived Amount Paid
CreditCard ROBS ELECTRIC djb 000099 In Person
Payment Total:
$s2.65
-$fr5-
018039
itted has the tollowing
225FIFTHSTREET . SPRINGFIELD, OF.g7477 o PH:(541)726-3753 etrEKl
E LE CTRI CAL P ERMIT AP P LI CATT O N
City Job Number €L€Zoaj -oC: I ;O Date L I d ) Date
1
230 {
LEGAL DESCRIPTION A.
f7o3Zzt3 O ?ooa
Signature
re sPecilic I
$)L
and use
-o?
s 106.00
s 19.00
s50.00
3.
JOB DESCRIPTION
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular
Feeder
z4\ I -7- c-t {zcu;. I
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
\sE.
H\s
Electrical Contractor ,%trS E/.-/r,L N\)1
Address Zr t S' CSil,b S /.
City E*7et^e Phone lsg ryqy
Supervisor License Number 1) V'-t S C.
Expiration Date o
Constr. Contr. Number %-tq(, /qq
Expiration Date ?-zf- o?
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps S100.00
Over 600 or 1000 Volts see "B" above.
to 400 Amps
I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsAr'olts
Reconnect Only
New Alteration or Extension Per Panel
Cne Circuit
Eaeh Additional Circuit or with
Service or Feeder Permit
Pump or irrigation $ s0.00
7Yo State Surcharge
l0% Adminisffative Fee
TOTAL
$,1'
\S
ORK
Signature of Supervising Electrician D.
E.
$ 63.00
$ 7s.00
s125.00
s 163.00
$37s.00
$ 50.00
$ 43.00
$ 3.00
vltuzI
Owners Narne \oa*s
Address 230
City SftA Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Ow:rers Signature:
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial S 45'00
Minimum Electric Permit Inspection r;@> ro."or.*,
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Inspection Request: 726-37 69
4.
Shared Driv{T:/Building Forms/Electrical Permit Application 1{3'doc
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