HomeMy WebLinkAboutPermit Electrical 2003-03-20&FnrlrGTrat,o
Gity of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfrel( Oregon 97 477
541-726-3759 Phone
541-726-3676Fax
541-7 26-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00082
3t20t2003
3t20t2003
9t20t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCzuPTION
305 S 4TH ST
1703353407700
Add 6 circuits for server racks
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Commercial
OWNERYAPPLICANT:
TIMBER PRODUCTS CO
PO BOX 269
SPRINGFIELD OR97477
ELECTRICAL CONTRACTOR:
LR BRABHAM 541-747-6638
68 WEST Q STREET
SPRINGFIELD OR 97477
CCB # 8699 Expiration Date: 1211812004
Description
+ 10% Administrative Fee
+ 7%o State Surcharge
Add. Alter. Extend Circ
Add, Alter. Extend Circ Ea Add
Amount Paid
5.80
4.06
43.00
15.00
Date Paid
03120/2003
0312012003
03120/2003
0312012003
Receint Number
I 200200000000000859
r 2002000000000008s9
l 2002000000000008s9
1 2002000000000008s9
To Request an inspection call ilre 24 hour recording at726-37 69. All inspections requested before 7:00 a"m. will be made the mme 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 certi$ 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 from the
street, and that the approved set of plans, if applicable, will remain on the site at**xE:sls"
Owner or Signature
lofl
"lr.Iq;S;
3/20/2003
2:38:3lPM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 1200200000000000859
Date: 0312012003
Line ltems:
Job/Journal Number Description Amount Paid
ELE2003-00082
ELE2003-00082
ELE2003-00082
ELE2003-00082
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ l0o/o Administrative Fee
+ 7o/o State Surcharge
Payments:
43.00
15.00
5.80
4.06
Line Item Total:$67.86
Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
Check LR BRABHAM INC djb In Person 67.86
Total $67.86
Page I ofl cReceipt.rpt
.tLF|*lHaiFtEt-Il
225 FIFTH STREET ,:.
SPzuNGFIELD, OREGON 971'17 , ' .......
EL RICAL PERMIT APPLICATION
c8L7Cit)'Job Numl)
1 LOCA
LE
for sale, lease or rent.
O*'ncrs Signature:
0 Y 7 700
3. COMPLETEFEE SCI{EDULE BELOW
l-Single or
Multi-Family per dl'elling unit.
Sen'ice Included:
77o St.rte Surchirrgc
I a.yt Administrativc Fec
Items Cost Sum
$50,00
$50.00
$25.00 _
$15.00
Permit Inspcction Fec is S{5.00 * Sut'chirt'gcs
F ABOVE
*
TOTAL 61,8b
JOA DESCRIPTION 1\;r tf fitii" *, ruod* ,rn /Ms.1000 sq.ft. or less $ r06.00
Each
$ 19.00
Manufd or
$ 50.00
rr Q, Street
Electrician
Installation,
Relocation:
200 anrps or less ,
201 aurps to
Over
One Circuit
Each Additional Circuit
or Feeder Perurit
E. l\'Iiscellaneous
-Eaclr
O}VNER INSTALLATION