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HomeMy WebLinkAboutPermit Electrical 2003-03-24Gity of Springfield Electrical Permit Attachment Status: missing from list 225 Fifth Street Springfield, Oregon 97 477 541-126-37 59 Phone 541-726-3676Fax 541-7 26-3769 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00085 3t2412003 SITE ADDRESS: ASSESSORS PARCEL NO.: PROJECT DESCRIPTION: 505 18TH ST 1703362400500 200 Amp Service Springfield TYPE OF WORK: TYPE OF USE: OWNERYAPPLICAIIT: GALLIHER zuCHARD V & ROSAI 505 N I8TH ST SPRINGFIELD OR97477 ELECTRIC AL CONTRACTOR: CHRIS MILLERS ELECTRIC INC 54I-895-3660 33338 IDYLLWILD RD CRESWELL OR 97426trBtt0t17 ExpirationDate:rzt2y2006 Description + lOoh Administrative Fee + 7Yo State Surcharge Perm ServlFdr 200 amps or less EDORISA AY PERIOD.2200200000000000633 To Request an inryection call the 24 hour recording at726-37 69. All inspections reque$ed before 7:00 am. willbe made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required Inspections: 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I further certiff that only contractors and employees who are in compliance with ORS 701.055 will be used on this project I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, and that the approved set of plans, if applicable, will remain on the site at all times during construction.fu- k-v/{--ZE /44 d4-Z z-aa) Owner or Contractors Signature Date Amount Paid 6.30 4.41 63.00 *#?sHiI IT SHALL EXPI D UNDER THI Mli2A/?fr03. HBfl}$tr lofl BPBIIIIoFIEID 't-rs CITY O NGFIELD, ORECON 225 FIFTH STREET . SPRINGFIELD, OR97477 o E LECTRICAL P ERNI IT AP PLI CATI ON Date pHz(541)726-371f, e?J'&Yis(Fde3f,3ffi '$::f i:""f i".:'"n zonlng' rova 2 2 .L\ I. I.OCA'TIONOiTIjVS?H,I,TATION 2Vf tttYsf -/d /A/> LEGAL DESCRIPTION o 5oo JOB DESCRIPTION Za6 t+ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ) Electrical ci@ Phone tr- 3d /a Supervisor LicenseNumber 4 3z>F 5 UF g.o /Expiration Date Constr. Contr.Number A Z? 77 Expiration Date -z Signature of Supervising Electrician Owners Name Address Phone Authorrzed sign ure /z 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amf3 o"#Q60ilH06iuuav lzutoShddlUn$d SrHI :: C. D. lYo State Surcharge l0% Administrative Fee TOTAL A. New Residential - Single or Multi-Family per drvelling unit. 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 3. $106.00 $ 19.00 $s0.00 COIrrfRACfOfi INS?XJ I-A'[ION OIYL!' B. Services or Fecders - lnstallation, Alterations or llclocation: / 1 ,.1'l) s 63.00 G 5." OM l $ 7s.00 $12s.00 $163.00 $375.00 $ s0.00 Installation, 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. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E.Miscellaneous (Service/feeder not included) -Each Installation City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Sigrrature Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surcharges suBT'otrAL op- enove $ s0.00 $ s0.00 $ 25.00 $ 45.00 4.6Db 1t fi;*6'WMu Shared Drive(T:)/Building Forms/Electrical Permit Application l-03.doc City Job Number 3G 2v ti ra at ).a 4/ K $ 43.00 s 3.00