HomeMy WebLinkAboutPermit Electrical 2003-03-10Gity of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield Oregon 97 477
541-726-3759 Phone
541-726-3676Fax
541-7 26-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00065
3tr0t2003
3n012003
911012003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION
215 38THST
1702314200701
Service change
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Residential
OWNERYAPPLICANT:
OSBORN BELINDA
215 38TH ST
SPRINGFIELD OR 97478
ELECTRICAL C ONTRACTOR:
NEAL INVESTMENTS LTD 541-485.2472
4715 FOX HOLLOW RD
EUGENE OR 97405CtR# 93953 Expiration Date: 1012212004
Description
+ l0o/o Administrative Fee
+ 7%o State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
6.30
4.41
63.00
Date Paid
03t10/2003
03/1012003
03n012003
Receipt Number
I 200200000000000800
1 200200000000000800
1200200000000000800
To Request an inpection call ttre 24 hour recording at726-37 69.
inryections requested after 7:00 a.m. will be made the day.
requested before 7:00 a"m. will be made the same working day,
<)
Required Inspections:
1 Electric Service: Approval
By Signature, I state and agree, that
information hereon is true and
with the Ordinances of the
further certiff that only
Owner or Contractors Signature
.D.$
I
and do hereby certify that all
any and all work performed shall be done in accordance
the of the State of Oregon pertaining to the work described herein I
in compliance with ORS 701.055 will be this projecl I
requested at the proper time, that each from the
will remain on the site at all times
"$'Date
^\}
lofl
TI|I';IAD
further agree to ensure
street, and that the
1$
serylce.
31r012003
1:49:40PM
CitY of SPringfield
DeveloPment Services Department
Public Works DePartment
Official ReceiPt
225 Fifth Street
Springfield, Oregon 97 47 7
541:726-3759 Phone
ReceiPt #z 1200200000000000800
Date:03/10/2003
Line ltems:
Job/Journal Number
ELE2003-0006s
ELE2003-00065
ELE2003-0006s
Perm Serv/Fdr 200 amPs or less
+ l0%o Administrative Fee
+ 7Yo State Surcharge
Line ltem Total:
Amount Paid
63.00
6.30
4.41
$73.7r
Payments:
How Received
In Person
Amount Paid
73.71
$73.71
Tlpe of Payment Paid By
Check NEAL INVESTMENTS
Received BY Check Number ConlirmNo
djb
Total:
Page I of I
cReceipt.rPt
spltlr{GFrgr-a
225 FIFTH STREET . SPRINGFIELD, OR-97477 o PH:(541)726-3753 o FAX: (541\726-3689
ELECTRICAL I}ERI${IT APPLICATTONT
City Job Number @ZCO) : P co6Soate o l1/c)Os,
1. LOCA?TON #]" mrSrSir-4?I{}N A{}]MT'LE?'E I;E E SCi{,ET} III,E tr} E tr-O I,II3
LEGAL DESCRIPTION :,, r.-,rll,uinq proldtjt * J[g$rflmiflg8ti+! m riitfl frB or M ulf i-Farrrily per du.elling unit.
7oZ IL{ L oo70t ,, ,i.. and does
JOB DESCRIPTION
_Seca_v r( c:,ci*/(G( "'
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
use
500 or
ta
Each Manufact'd Home or
Modular Du.elling Service or
Feeder
Zoning $106.00
$ 19.00
$50.00
,,ur.r Signatu
7
Electrical
Address
Phone /Fr-"742_
z4aF
Supervisor License Number 7.*s
B. Sen,ices or Feeders - Installation, Alteratierts or Relocittion:
6-s
J
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
$ 63.00
$ 7s.00
$ 125.00
$ 163.00
s375.00
$ 50.00
Over 1000 olts
\f,r
$J\{
Expiration Date /A - zz-Lr4 I'.------------7-
Constr. Contr. Number
Electrician
Owners Name
Address Zt 9 3 S+v' sf
City sPr\Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
7%o State Surcharge
10%o Adminisfative Fee
TOTAL
$ s0.00
$ 69.00
$ 100.00
olts see "B" above.
$ 43.00
$ 3.00
?jq s
\\U o hS..{O\)
Expiration Date //'- / -)y'$,e
101
\ne
;D.
or 1000 V
CEF
E.
ER
\S
1H\S PER
$ 2s.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
L3
7q/
3a
7/
Inspection Request: 72G376g
Shared Dive(T:)/B uilding For:ns/Elerrrical pennit Application l_03.doc
W reffiffi's;ffi
,'(
(u'-
Feeders
\S
Installation
50.00
4. SLIBTOTALOFAEOI.E