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Home My WebLink AboutPermit Electrical 2003-02-18City of Springfield E lectrical Perm it Attachment Status: Issued 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone 541,-726-367 6 Fax 541-7 26-37 69 Inspection Lin e PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00043 211812003 2fi4t2003 8/18/2003 SITE ADDRESS: ASSESSOR'S PARCELNO.: PROJECT DESCRIPTION 1544 sTH ST 1703263102200 Lighting Upgrade Springfield TYPE OF WORK: TYPE OF USE: Repair Public OWI\ERYAPPLICANT: SCHOOL DISTRICT #I9 525 MILL ST SPRINGFIELD OP.91477 EI,E CTRICAL CONTRACTOR: BRIAN DAY ELECTRIC 298 ORCHARD VIEW TERRACE MEDFORD 97504 CCB # 81081 Expiration Date: 0ll0l/2004 Description + l0%o Administrative Fee + 7%o State Surcharge Add. Alter. Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid 6. l0 4.27 43.00 18.00 Date Paid 02n8t2003 02n812003 0211812003 0211812003 Receint Number 2200200000000000487 2200200000000000487 2200200000000000487 2200200000000000487 ToReque$aninryectioncallttre24hourrecordingatT26-3769. AllrnspectionsrequestedbeforeT:00am.willbemadethesameworkingday, inspections reque$ed after 7:00 a.m. will be made the following workrng 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 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 70f .055 will be used on this project 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 Srgnature Date lofl WW* 2/r8/2003 10:19:l7AM City of Springfield Development Services Department Public Works l)epartment Official Receipt 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone Receipt #: 2200200000000000487 Date: 0211812003 Line ltems: Job/JournaI Number Description Amount Paid ELE2003-00043 ELE2003-00043 ELE2003-00043 ELE2003-00043 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + l}Yo Administrative Fee + 7Yo State Surcharge Payments: 43.00 18.00 6.10 4.27 Line Item Total:s71.37 Type ofPayment Paid By Received By Check Number Confirm No How Received Amount Paid Check BRIAN DAY ELECTRIC 1640 lkw In Person 71.37 Total:$71.37 Page I of I cReceipt.rpt *F HNl3F,tSt-t} 225 FIFTH STREET ' SPRINGFIELD, OF.97477 o E LE CT RT C AL P E P.lI{ IT AP P LI CATTON City Job Number EIE }W> - OOOtt Date I. LOCAT'IONOT'INS'I'ALIAT'ION Y l\oFF 7T- LEGAL DESCRIPTIONT,( JOB DESCRIPTION,a (2-<-- PH:(541)726-3'1 53 o F AX: (541)726-3689 The lollowing proiect as submitted has the following zoning. and does not require specific land use &- 15- o3 approval Zoning 3. CO]VTPLEl'E ) Aurhonzed signature A. Neu' Ilesidcntial - Single or Multi-I aruill' pcr drvelling unit. Service Included Permits are non-transferable and expire if work is not started t'ithin 180 davs of issuance or if work is Suspended for 180 days..: c o NT r*4croR rNsryI raT I o N a NLY Electrical Contractor BruMUL ;\, SZi ,',*r t LL > h Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Antps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only Installation, Alteration or Relocation Each Additional Circuit or with Serrrice or Feeder Permit Pump or irrigation Sign/Outline Lighting $ 106.00 $ 19.00 ss0.00 $ 63.00 $.75.00 $ I 25.00 $ 163.00 $375.00 $ 50.00 $ 3.00 $ 50.00 $ 50.00 Address 7?{oRatt&D / Arj 7Pq Ciry 14 rpBc-l '*.*""Slg ?2? L Supervisor License Number 3 ? {1s Expiration Date /o- oLl Consff. Contr. Number ? I a I Expiration Date ct- oL Signature of Supervising Elecnician MENUEtrOH lBO DAY PER /- ownersName -31)/-) SCrfu-ce \rsi- 200 Amps or less $ 50.00 201 Amps to 400 Amps S 69.00 llr .I-n ffit?&&l its,i""q [ooo uo,,, ,.. '*oou.- .,* 06.'n,#JlHil cllt,,o t,;,, New Alteration or Extension Per Panel oneCircuit I So:.oo Ll 3 iS Nliscellaneous (Sen'iceifeeder uor included) -[:tclt InstallationE.Address Cify ll -.; r'l- N 7#'637s^Phone OWNER INSTALLATION The installation is being made on properly I own which is not intended for sale, lease or rent. Owners Signature: Lirnited EnergyrResidential $ 25.00 Limited Energy/Commercial $ 45.00 Nlinimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. STJBTOTAL OFABO\.E 6t Yzl L,to 7t\7 7o/o State Surcharge 10% Administrative Fee TOTALInspection Request: 726-3769 -o.(-@J. Shaled Drive(T:)/Building Fonns/Electrical Perrnit Application l-03.doc ?ro -oq{ 0090. you may obtain calling theceffsr.500 sq. ft. or Service or Relocation; or C. Ternporarl' Services or Feeders