The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-06-26City of Springfield Electrical Perm it Attachment Status: Issued 225Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676Fax 541-7 26-3769 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00159 6t26t2003 6t26t2003 12t26t2003 SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION: 1042 3RD PL 1703352105200 Add 1 circuit for gas furnace Springfield TYPE OF WORK: TYPE OF USE: Addition Public OWNER/APPLICANT: EWING CLAUDE RJR IO42 N 3RD PL SPRINGFIELD OR97477 ELECTRICAL CONTRACTOR: KS ELECTRIC s4t-686-6236 PO BOX 24933 EUGENE OR 97440 CCB # 70889 Expiration Date: 12/3012004 Description + llYo Administrative Fee + 7o/o State Surcharge Add. Alter. Extend Circ Minimum/Adiustment Electrical Amount Paid 4.s0 3. l5 43.00 2.00 Date Paid 06t26t2003 06/26/2003 06t2612003 0612612003 Receipt Number 1200200000000001649 1200200000000001649 1200200000000001649 1200200000000001649 To Request an inspection call the 24hour 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 elechical work is complete. 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 atl 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. \.11$t Owner or Contractors Signature t0R Page I of I &l}nlHaFlSLo 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000001649 Date: 0612612003 l:19:31PM ELE2003-00159 ELE2003-00159 ELE2003-00159 ELE2003-00159 + lUYo Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical 4.50 3. l5 43.00 2.00 Item Total:$s2.6s Payments: Type ofPayment Paid Bv Received By Batch Number Authorization Number How Received Amount Paid Check KS ELECTRIC djb ( In Person Payment Total: $52.65 $52.6s 225 FIFTH STREET . SPRINGFIELI), OR97477 o pH:(541)7tG37St r FAX: (S4l ,ST.TC?i TCAT .p&R}frr AP T} LT C,LffON Date City Job Number d."fzoiD<__1a6 IS ? ou," D6 Z 6 03 Aurnorzeo r,ocAlIOlYOp ., jl as submitted hasrequire specific the lollowino land use Ala -o3 $ 50.00 $ 50.00 s 25.00 $ 4s.00 tlSr> a7 6f b I Srgnature :] . ... 3. CO}fPI.E?E I;EE SCHET}ULE BELOW2,+ LEGAL DESCRIPTION 7 5Z SZOC) .IOB Permits are non-transferable and expire if r*,ork is not started rvithin 180 days of issuance or ifrtork is Suspended for 180 days. z. co.i\1rfiAc?oR r:YSfAI-r-ATraN oNLy B. Services or Fcerrers Electrical conrracror k S gu.frr.',:6rrr/t1t"200 Amps or ress Address 201 Anrps to 400 Amps 401 Amps to 600 Amps 601 Arnps to 10ffi Amps Over 1000 AmpsA/olts Reconnect Only Supervisor License Number J Vg ZS C. . Temporary.. Sentces ar Feecters Expiration Date City Phone 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 One Circuit Each Additional Circuit or with Service or Feeder Pennit lYo State Surcharge l0% Administrative Fee TOTAL Installation, Atteration or Relocation 200 Amps or less 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see..B" above. D. Branch Circuits $106.00 $ 19.00 $50.00 - Installation, Alterations or Relocation: $ 63.00 $ 75.00 $t25.00 $ r 63.00 $375.00 $ 50.00 $ s0.00 $ 69.00 $r00.00 Constr. Contr. Number Expiration Date Signature of Supervising Electrician Orvners Name Address oYz City OWNER ra 86 New Alteration or Extension per panel / $ 43.00 $ 3.00 E. $'Iiseellaulous (serr.ice/feeder not inclutled) -Each rnstalla tion' Pump or irrigation Sigrloutline Lighting Lim ited Energy/Residential Limited Energy/Comrnercial Minimum Electric Permit Inspection nee i{Sfr0El Surcharges 4: SUBrOryr OF,{tsOtrt ,(5 3/f The is on property I own which or rent" Inspection Requesfi 7L6-37 69 Shared Driv{T:)iBuilding Fonns/Electrical pcnnit Applicarion I _03.<i<rc F,, _ A. New Residential - tiingle or l!,Iulti-F*mily per rtwelling unit. q> il. a \