HomeMy WebLinkAboutPermit Electrical 2003-02-20AtrNTH6FITLD
Gity of Springfield
Electrical Permit Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
541-726-3676Fax
541,-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00050
2t20t2003
2t20t2003
8t20t2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION
1650 CENTENNIAL BLVD
17032s3403900
Security System
Springfield
OF WORK:
TYPE OF USE
TYPE New
Public
OWNERYAPPLICANT:
WAREMART INC #35
33368,32ND ST STE 2I7
TULSA OK 74135
ELE CTRICAL C ONTRACTOR:
sEcuREcoM INC s4l-988-358s
1940 DON ST #100
SPRINGFIELD OR 97477
CCB # 117195 Expiration Date: 0912912004
Descrintion
+ l0o/o Adminishative Fee
+ 7Yo State Surcharge
Low Voltage - Commercial Indus
Amount Paid
4.50
3. l5
45.00
Date Paid
02t20t2003
02t20t2003
02120/2003
Receipt Number
2200200000000000506
2200200000000000s06
2200200000000000s06
To Request an inryection call the 24 hour recording at 726-37 69. All inspections requested before 7:00 am. will be made ttre same working day,
inryections requested after 7:00 a.rn will be made ttre following working day.
Required Inspections:
1 Low Voltage: Prior to cover.
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 certiff that orily 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 time, that each address is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction.
Owner or Contractors Signature Date
NOTICE:
lnii'prrirtnlT sHALL EXPIRE-IF T-tE IvgRK
oii"Hoiiiiio ur'rorn THts PERMIT ls^NoT
t6i,aitlri'riio on rs ABANDoNED FoR
ANY 1BO DAY PERIOD.
lofl
l
^ .rot
tow ru r *i uurp,rX'#rH'3ilffi ii,iiNotifrcation Cerrter fhobe rrl., u?r.iioi
t1l OAR 952-00 i -001 0 through Onn-d#oo0090.,you may obtain copiJ. J ft,e"rils tcalling the center. (Note: tfre tetepninenumber for- the oregon Utitity rvofiiiciiion(*rnre. r,c .l-gnn_o c-i,trtl
LEGAL DES
2
Electrical'
Address
Date
,tk SCr )/ t (t S
)rtc
Multi-Family pcr drvelling unit.
Service Included:
Items Cost
sq.ft. or less
additional 500
or portion
d Home or
Du,elling
or Feeder $ s0.00
l/0
ervising Electrician
B. Services or Feeders
InstaIIation,
Relocation:
200 amps or
201 amps to
401 amps
1 amps
Ot er
D. Branch
4.s
1o/o
8%
or r,vith
ction Fee is $45.00 +
rs/?S
TOTAL
Permits are
if r,vork is
of issuance
180 days.
1-0010
IHIS
$ 106.00
$ 19.00
ISA
2120/2003
ll:29:43ANl
City of Springfield
Development Services Deparfinent
Public Works l)epartment
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 2200200000000000506
Date: 02120/2003
,ne Items:
Job/Journal Number Description Amount Paid
ELE2003-000s0
ELE2003-000s0
ELE2003-00050
Low Voltage - Commercial Indus
+ l0Yo Administrative Fee
+ 7Yo State Surcharge
Payments:
45.00
4.50
3.1 5
Line ltem Total:$s2.6s
Tlpe ofPayment Paid By Received By Check Number Confirm No How Received Amount Paid
Check SECURE COM lkw 34201 In Person 52.65
Total:$52.6s
Page I ofl cReceipt.rpt