HomeMy WebLinkAboutPermit Electrical 2003-03-25SPBII'IGFIELD
Gity of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97 477
541-726-3159 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00088
3t2st2003
312512003
9tzst2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCzuPTION
tl18u2 8TH ST I
1703264313200
Service change
TYPE
Springlield
OFWORK:
TYPE OF USE
Alteration
Residential
OWNERYAPPLICANT:
LYNCH SCHLEY D
24OO G ST
SPRINGFIELD OP.97477
ELECTRICAL C ONTRACTOR:
DAVID R KIDD s4t-726-9303
PO BOX 1637
Description
+ l0% Administrative Fee
+ 7Yo State Surcharge
Perm ServiFdr 200 amps or less
Amount Paid
6.30
4.41
63.00
Date Paid
03t25/2003
03/2s/2003
03/25/2003
Receipt Number
220020000000000064 l
220020000000000064 I
2200200000000000641
To Request an inspection call the 24 hour recording at 726-37 69. 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 Electric Service: Approval required prior to utility company energizing service.
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
with the Ordinances of the City of Springfield and the Iaws of the State of Oregon
further certiS that only contractors and employees who are in compliance with ORS'
further agree to ensure that all required inspections are requested at the proper time,
used on this project I
street, and that the approved set of plans, if applicable, will remain on the site at all construction.
Owner or Contractors Sigrature
be done in accordance
work described herein I
is readable from the
Date
lofl
SPRINGFIELD OR 97477
CCB # 35651 ExpirationDate: 05105/2006
312512003
l:20:56PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #: 220020000000000064 1
Date: 0312512003
ne ltems:
Job/Journal Number Description Amount Paid
ELE2003-00088
ELE2003-00088
ELE2003-00088
Perm Serv/Fdr 200 amps or less
+ l0%o Adminishative Fee
+ 7oh State Surcharge
Payments
63.00
6.30
4.41
Line Item Total:$73.71
Type ofPayment PaidBy Received By Check Number Confirm No How Received Amount Paid
Check SCHLEYD LYNCH djb In Person 73.71
Total:$73.7r
Page I of I cRceipt.rpt
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