HomeMy WebLinkAboutPermit Electrical 2003-07-22City of Springfield
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00175
712212003
7t22t2003
y22t2004
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
1038 TTHST
17033s1203300
Service and feeder
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Residential
OWNER/APPLICANT:
LAND MICHAEL R & SANDRA J
1038 7TH ST
SPRINGFIELD OR97477
ELECTRICAL CONTRACTOR:
EASTSIDE ELECTRIC INC 541-741-1499
38253 BOSCAGE LN
SPRINGFIELD OR 97478
CCB # 117770 Expiration Date: 10/04/2003
Description
+ l0%o Administrative Fee
+ 7%o State Surcharge
Perm Serv/Fdr 200 amps or less
\o
1292
To Request an inspection call the 24 how recording at726-3 a.m. will be made the same
working day, inspections requested after 7:00 a.m.
Required Inspections:$e
1 Electric Service: Approval required prior to
2 Electric Service: Approval required prior to
\s
By Signature, I state and agree, that I have carefully 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 701.055 will be used on this project. I further agree
to ensure that all required inspections are requested at the street, and that
the approved set of plans, if applicable, will remain on
Owner or Contractors Signature
Amount Paid
12.60
8.82
126.00
Date Paid
07 t22t2003
01t2212003
Receipt Number
2200200000000001292
2200200000000001292
Paee I of I
artHA'|f.C
\
the proper time, that each address is
the site during
IS NOl
IS
ANY 180 DAY
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
:05PM
ELE2003-00175
ELE2003-00175
+ 7%o State Surcharge
Perm Serv/Fdr 200 amps or less
Item Total:$147.42
8.82
t26.00
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
CreditCard ROGERKING djb 000125 0t 5 l6l In Person
Payment Total:
s147.42
-
LEGAL DES
i7 0_\035oo
Multi-Family per drvelling unit.
Sen'ice Includetl:
Items Cost
or less
Horne or
D'welling
Service or Feeder $ 50.00
JOB DESCRIPTION
the
Permits are
if work is rvithin
of issutrnce work is suspended for
180 days
Electrical'
Address
Zorl\rrg
3f5 iD€ €LqqRIC
B. Ser-vices or Feeders
Institllirtion, A
Relocation:
200 amps or
201 amps to
401 amps to
rBI 4
D. Branch
Date
Super-vising
\{\S
h\)1
er-yice/teeder not in clu
$50.00 -
$15.00
ection Fee is S-15.00 * Surchilrges
6bL
iq7 L/Z
5tz
Signature
$ 106.00
$ 19.00
or u,ith
4. SUBTOTAI. OF ABOVE
7%o State Surchtrge
C /o..*1, A tl m in i st r at ive f ee
TOTAL