HomeMy WebLinkAboutPermit Electrical 2003-04-29Gity of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00r13
4129t2003
4t29t2003
t0129t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION
2417 16TH ST
1703243402000
Service change
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Residential
OWNER/APPLICANT:
SCOTT WILLIAMS
24I7 I6TH ST
SPRINGFIELD OR97477
54t-741-0836
ELECTRICAL CONTRACTOR:
JOSEPH AARON BUNCH 541-345-9808
2525 WILLONA DR
EUGENE OR 97408
CCB # 145024 Expiration Date: I lll2l2004
Description
+ l0% Administrative Fee
+ 7%o State Surcharge
Perm Serv/Fdr 200 amps or less
Amount Paid
6.30
4.41
63.00
Date Paid
0412912003
0412912003
0412912003
Receint Number
1200200000000001092
1200200000000001092
1200200000000001092
To Request an inspection call the 24hov recording at726-3769. All inspections requested before 7:00 a.m. will be made the same
working day, inspections requested after 7:00 a.m. will be made the following working day.
Required Inspections:
1 Electric Service: Approval required to utility company energizing service.
By Signature, I state and agree, that I examined the completed application and do certify that all
information hereon is true and certify that any and all work performed in accordance with
the Ordinances of the City of laws of the State of Oregon pertaining herein. I further
certify that only contractors are in compliance with ORS 701 I further agree
to ensure that all req requested at the proper time, that street, and that
the approved set of will remain on the site at all times
rt
Owner
Pase I of I
t*mnlK&
o\
\(\\5\
225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541\726-3689
ELEC:.RICAL .E,.MIT AppLICAfON . .,,_- irrj!e.+ es submitted has
'/ 'Aq:A 3 ,1..! irilil coes not require specific
the following
land use
$ 106.00
$ 19.00
$50.00
ciryJobNumber rc Z(::) 'lC'C I l3 nut"
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LEGAL DESCRIPTION
t7O'3 z\3q OZA&
JOB DESCRIPTION
Address
Permits are non-transferable and if work is not
started within 180 days of issuance or if work is
Suspended for 180
,
Electrical Contractor t'lC
/C-Z
2;2y Dr//ona br
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/Volts
Reconnect Only
B.
Services or Feeders * Installation, Alterations or }leioc:rtion:
$ 63.00
$ 75.00
$ 125.00
$ 163.00
$375.00
$ 50.00
a3
City 4t4
I
Supervisor License Number
Expiration Date lo-o('o3
Constr'. Contr. Number /qtos-y'
ExpirarionDate /0 - a { -'zl
Signature Electrician
Ph""" 3qq4 7/{
{zs ( -s ^ Tcrnnorarv Serviccs or Fccdcrs(..
Ins(allation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
n Branch ( ircuilst.
OWNERINST
The installation is being made on property I own
which is not intended for sale. lease or rent.
Owners Signature:
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
Serwice or Feeder Permit $ 3.00
- \liscellancous (servicc/lecder no( incluclcd)-F-ach lnsta!talionL.
egon iaw requtres to
Pump or
dbv the {eeo
ose a
rsrcs&'-
You maY obtain telephone
7o/o State
l0% Administrative Fee
TOTAL
F*
1$E
Owners Name
Address
City
7lInspection Request: 726-3769
Shated Drivc(T:)/Building Fonns/Electrical Pennit Application I -03.<1oc
COTTTRA CT O R. I N ST AL L AT I E N @ N I,Y
t. ;,i t ;i )t!i signature
A. Nerv Residential - Single or &{ulti-Family per
CO]UTPLETE FEE
trri.l
'l
Surcharge qql
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 1200200000000001092 Dutet oq29no03
ELE2003-001 13
ELE2003-001 l3
ELE2003-001 r3
Perm ServlFdr 200 amps or less
+ llYo Administrative Fee
+ 7Yo State Surcharge
63.00
6.30
4.41
Item Total:$73.71
P.ynmh:
Check JOSEPH BUNCH ELECTRIC djb In Person
Payment Total:
73.71
$73.71
4/29/2003 2:20:l4PM Page I of I cReceipt.rpt