HomeMy WebLinkAboutPermit Electrical 2003-01-14City of Springfietd
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
541-726-367 6FaY'
541-7 26-3769 InsPection Line
SITE ADDRESS:
ASSESSOR'S PARCELNO.:
PROJECT DESCRIPTION
OWNER/APPLICANT:
MAXWELL JOHN S & ruLIA A
3205 PHEASANT BLVD
SPRINGFIELD OP.97477
Descrintion
+ 10% Administrative Fee
+ 7oh State Surcharge
Service Reconnect
PERMITNO,:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00012
U1412003
u1412003
7t1412003
3205 PHEASANT BLVI)
1703221301000
Relocate meter base
Amount Paid
5.00
3.50
TYPE Repair
ResidentialTYPE OF USE
ELECTRICAL CONTRACTOR:
BUILDERS ELECTRIC INC s4t-48s-0922
195 MADISON ST
EU
Expiration Date:t211012003CCB
.\,J
Receint Number
1200200000000000542
I 200200000000000542
1200200000000000542
7:00 am. will be made the same working day,
Springlietd
OF WORK:
To Reque$ an inspection call the 24 hour
inspections reque$ed after 7:00 a'm' will be
\e
Required InsPections:
1 Electric Service: Approval required prior utility company energizing service.
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 work described herein. I
further certifY that only contractors and employees who are in comPliance with ORS 70 be used on this Project I
further agree to ensure that all req uired insPections are req uested at the ProPer ress is readabh from the
street, and that the aPProved set of plans, if aPPlicable, will remain on construction.
O*n.r or Contractors Sigrature
o N
\(\'
to
1of I
225 Fifth Street
;f,?,%:,T;rT;:H s7477
t/14/2013
8:39:26AM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 1200200000000000542
Date: 0111412003
Line ftems:
Number
ELE2003-00012
ELE2003_00012
ELE2003_00012
Service Reconnect
+ l0Yo Administrative Fee
+ 7o/o State Surcharge
Paid By
BUILDERS ELECTRIC djb
Amount Paid
s0.00
5.00
3.s0
Payments:
Typ.
Check
ofPayment
Line Item Total:
How Received
In Person
Total:
$s8.s0
Amount Paid
58.50
Received By Check Number Confirm No
$s8.s0 a
Page I of I cReceipt.rpt
F
OREGON
1. LO CATION
LE TIONt3 OI ooo
JVIulti-Farnily per du.elling rrnit.
Suvice Inclurled:
J D
Pernrits are ilon-transferable an dif rvork is not startecl rvithin I 80
of issuance or if work is
I80 days.
2. CONTRACTOR INST
Electrical Contractor
Address
Ci Phone
ration Date
ervising Electrician
less
tional 500
sq ft or
I{ome or
arD
S Feeder
Scrvices or Feetlers
In.stall ation, Alterations or
Rclocation:
200 anrps or less
20 I amps to 400 amps
I la nlps to 600 amps
'Fceders
Alteration or
Iterns Cost Sum
$ r 06.00
$ 63.00
$100.00 _
and
6\
Zodng
n'c
201 amps to 400 amps l
Over 401 to 600 aurps
Over 600 arnps or 1000 volts see
"8" abo\.c
.$43.00
$ 3.00
for sale, lease or rent.
Orvncrs Signature:
Pump or irrigation
S igr/Outlinc Liglrting
Linrited Euergr,/ltes
Li nrited Euergr'/Cornnr
4. SUBTOTAL OF ABOVE
?Yo St'.rtc Surchirrge
8Yo At\ministtntirc Fce
$50.00
$-50,00
$25.00
$45.00
i\'Iinimunr Electric Permit Ins;rcction Fce i.s S{5.00 * Sur.chirrgcs
\-3
TOTNL hgz
ZZ
125:00
IF THE
&YN D. Branch Circuits
ENI
tollow
in OAR
You
callir€UtilitY
inclu ded)
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