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Home My WebLink AboutPermit Electrical 2003-03-173T}ElXGTIEID Gity of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00073 3117t2003 3n7t2003 9n7t2003 SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION: 1491 5TH ST APT 13 1703264200800 Add 2 circuits Springfield TYPE OF WORK: TYPE OF USE: Addition Residential OWNERYAPPLICANT: MAINSTREAM HOUSING INC 433 W 8TH AVE APT OOI EUGENE OR 9740I CHRISTENSON ELECTRIC INC 1631 NWTHURMAN 2ND FLR PORTLAND OR 97209 CCB # 458 Expiration Date: 541-688-6121 543-419-3600 05/01/2003 Description + l0%o Administrative Fee + 7Yo State Surcharge Add. Alter. Extend Circ Add, Alter. Extend Circ Ea Add Amount Paid 4.60 3.22 43.00 3.00 Date Paid 03117t2003 0311712003 0311712003 031t7/2003 Receipt Number I 200200000000000832 l 200200000000000832 I 200200000000000832 I 200200000000000832 To Request an inspection call *re 24 hour recording at726-3'169. All inspections requested before 7:00 a.m. will be made the same working day, inryections 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 electrical 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 certiff that any and all work performed shall be done in accordance with the Ordinances of the City of Springlield and the laws of the State of Oregon pertaining to the work described herein. I further certiff that only contractors and employees who are in compliance with ORS 701.055 will be used on this projecl I further agree to ensure that all 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. Owner or Contractors Signature S No't lofl OR ELECTRICAL CONTRACTOR: 3/1712003 l0:00:2lAM City of Springfietd Development Services Department Public Works Department Official Receipt 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Receipt #: 1200200000000000832 Date: 0311712003 Line ltems: Job/Journal Number Description Amount Paid ELE2003-00073 ELE2003-00073 ELEz003-00073 ELE2003-00073 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + l0%o Administrative Fee + 7Yo State Surcharge Payments: 43.00 3.00 4.60 3.22 Line ltem Total:$53.82 Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid Check PHILIPS ELECTzuC djb In Person 53.82 Total:$s3.82 Page I of I cReceipt.rpt miited has the lollowing land use225 FIF'TII STREET r SPRINGFIELD, OR97477 . PH:(541)726-3753 . E L E CTRI CAL PERMTT AP P LI CATI O N City Job Number Eltarti *OOo 73 Date O 1. Permits are non-transferable and expire if work is not started within 1E0 days of issuance or if work is Suspended for 180 days. Electrical Contractor Chri stenson El ee-fri c Address 1 298 Bethel Dri rzo Cify F', 'go.,o Phone 541 -688-6121 Supervisor License Number 3759S Expiration Date f0/0L/01+ Constr. Contr. Number ?6-3/+C Expiration Date t0/0t/03 Signature of Supervising Owners Name llAAir^ 5C+Q,Y\ l-\oursin Address L{ %B t ' k {H r)n Tv I City Phone '.l (Q -q q tu OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature Inspection Request:'126-3769 Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsiVolts Recorurect Only One Circuit Each Additional Circuit or with Service or Feeder Permit Pump or irrigatiou Sign/Outline Lighting Limited Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps S 69.00 401 Amps to 600 Amps $100.00 Over or 1000 Volts see "B" above. New Alteration or Extension Per Panel JOB DESCRTPTION ql ftl LEGAL DESCRIPTION i7c s ZLcr Z *,3 OOrcO A. B. C. D. E. Minimum TOTAL s106.00 $ 19.004i\h Z C- a-r -^1 + $50.00 $ 63.00 $ 7s.00 $125.00 $163.00 s375.00 $ s0.00 $ 43.00 $ 3.00 ul3, oo 3- o r'r 3 $45.00 * Surcharges Q Lo 'oo 7o/o State 3. aa. 10% Administrative Fee L{(o 1) 3 Sob ooc>ltDg 4. Shared Driv{T:)/Building FormsuElectrical Permit Application l-03.doc 3. 1 \St' $ , ?a