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Home My WebLink AboutPermit Electrical 2003-05-15Gity of Springfield Electrical Permit Attachment Status: Issued 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: ELE2003-00126 snst2003 snst2003 tut5l2003 SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCzuPTION 3815 E 14TH AVE 1703344312500 Rewire house Eugene TYPE OF WORK: TYPE OF USE: New Residential OWNER/APPLICANL TOM TALMAGE 3815 E I4TH AVE EUGENE OR 97403 541-942-7529 ELECTRICAL CONTRACTOR: OWNER CCB #Expiration Date: Description + l0o/o Administrative Fee + 1Yo State Surcharge Residence Wirine 1000 Sq Ft To Request an inspection call the 24 how recording at Receipt Number l 200200000000001222 l 200200000000001222 I 200200000000001222 requested before 7:00 a.m. will be made the same working day Amount Paid 10.60 7.42 106.00 Date Paid 0s11512003 0snst2003 s$5/200310 working day, inspections requested after 7:00 a.m. nrl Required Inspections: 1 Rough Electric: 2 Electric Service: 3 Final Electric: d$ servlce.(, -( By Signature, I state and the completed application and do hereby certify that all information hereon is true and certify that any and all work performed shall be done in accordance with the Ordinances of the City of 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 is readable from the street, and that the approved set of plans, if applicable, will remain on the site at all times \t \s No Owner or Contractors Signature Pase I of I lHlxlt*s 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department' Public Works Department Official Receipt , Receipt #: 12002000000000 01222 Date:05/15/2003 ELB2003-00t26 ELE2003-00126 ELE2003-00126 Residence Wiring 1000 Sq Ft + l0%o Administrative Fee + 7o/o State Surcharge 106.00 10.60 7.42 Item Total:$124.02 Prvm€n8:. Cash Change TOM TALMAGE TOM TALMAGE djb djb In Person In Person Payment Total:--wM 12s.00 (0.e8) ELE2003-00126 ELE2003-00126 ELE2003-00126 Cash Change Residence Wiring 1000 Sq Ft + l0o/o Administrative Fee + 7Yo State Surcharge 106.00 10.60 7.42 Item Total:$124.O2 Prvmert!: TOM TALMAGE TOM TALMAGE djb djb In Person In Person Payment Total: 125.00 (0.e8) $1"{JZ 51t512003 ll:12:03AM Page I of 1 cReccipt.rpt ) has the lollowing re sPecilic land use 225 FIFTH STREET . SPRINGFIELD, OR97477 o E LECTRICAL P ERM IT AP P LI CATI ON ciry.tob Number l7t-Zoo3-U)lZ(;- Date I. LOCATION OF INS'I'ALLATIAN 3. PIHz (5 4l)7 26-3 753 ."tffi Z,p Zoning 3srf E I ft/t|+l LEGAL DESCRIPTIONt)o33\tt3 lZ\oo JOB DESCRIPTION A*ro ?e t,n ae Permits are non-transferable and expire if work is not started lvithin 180 days of issuance or if work is Suspended for 180 days. 2. co^'rRAcrofi /NS7?TL4TION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date C Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Nr Address City Phone OWNER INSTALLATION The installation is being rnade on property I own which is not intended for sale, lease or rent. A. New Residential - Single or Multi-Farnily per drvelling unit. I $106oo /oeService Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps . Over 1000 Amps,A/ol1s Reconnect Only C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Arnps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits $ r9.00 $50.00 B.Services or Feeders - Installation, Alterations or Relocation: $ 63.00 $ 75.00 $ 12s.00 $ 163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $ 100.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit \t 43.00 3.00 E. Miscellaneous -Dach Installatiorr $ 50.00 $ s0.00 $ 25.00 s 45.00 Minimum Permit Inspection Fee is $45.00 * Surcharges 4. SLIBTOTAL OF ABOVE /a6 7qz /060 I 7L{ lYo State Surcharge l0% Administrative Fee TOTALInspection Request: 726-37 69 Shared Drive(T:)/Building FonnsiElectrical Pennit Application I -03.doc 9? milffiNCITY OF