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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) ) 5<)__T--