HomeMy WebLinkAboutPermit Electrical 2003-02-03City of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
541-726-3676Rax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00024
2t3t2003
2t3t2003
8t3t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION
8OO 42ND ST
r702300002201
Relocate service pole
Springfield
OFWORK:TYPE
TYPE OF USE:
Alteration
Commercial
OWIYERYAPPLICA]TIT:
LANE FOREST PRODUCTS
8OO 42ND ST
SPRINGFIELD OR 97478
ELECTRICAL CONTRACTOR:
OLSSONINDUSTRIALELECTRIC 541.747-8460
PO BOX 70413
EUGENE OR 97401
CCB # 63473 Expiration Date 0112612005
Description
+ l0% Administrative Fee
+ 7oh State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
12.60
8.82
126.00
Date Paid
0210312003
0210312003 .1O
Receipt Number
1200200000000000643
1200200000000000643
1200200000000000643
will be made the same working day,
herein. I
project I
from the
To Request an inryection call the 24 hour recording at 726-37 69. All
inryections requested after 7:00 a.rn will be made the following
Required Inspections:
1 Electric Service: Approval required
ts.e
By Signature, I state and agree, that I have and do hereby certify that all
information hereon is true and correct, and I work performed shall be done
with the Ordinances of the City of Springfield Oregon pertaining to the
further certi$ that only contractors and with ORS 701.055 will
further agree to ensure that all required inspections at the proper time, that
street, and that the approved set of plans, if applicable, will remain on the site at all times
Owner or Contractors Signature t
lofl
213/2003
2:54:llPM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541:726-3759 Phone
Receipt #z 1200200000000000643
Date: 0210312003
.- Line Items:
Job/Journal Number Description Amount Paid
ELE2003-00024
ELE2003-00024
ELE2003-00024
Perm Serv/Fdr 200 amps or less
+ ljY, Adrninistrative Fee
+ 7Yo Slate Surcharge
Payments:
t26.00
12.60
8.82
Line Item Total:s147.42
Tlpe of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
Check OLSSON ELECTRIC djb In Person 147.42
Total:47.42
Page I of I cReceipt.rpt