HomeMy WebLinkAboutPermit Electrical 1982-10-31225 FIFTH STREET
SPzuNGFIELD, OREGON 974
T'. 72
LEGAL DES
ELE :CAL PERMIT APPLICATION
Residentiu I-SingIe or
Multi-Fnmily per drrelling unit.
Ser-vice Includetl:
Items Cost Sum
7
AutlionzeO
c )ffT'g* " 5
ure
l tul\
w rules adoDt€dbvth
JOB DESCRTPTION
'. !..,) i ' , ii I c i'
Notification Cenler Thos
rn oAFl 952-001-onl n ihr
i000 sq.ft. or less
Each additional -500
sq. ft or portion
thereof
Each Manufd Honle or
tu-lodular DrvelIing
Senice or Feeder
$ 19.00Pernri1s llre noll-transf,erlblc IItd e.rpire
if u'ork is not stirrtcd riitltin 180 davs
of issuancc or if u'ork is suspended for
180 da1's.
Electrical
OWNER INSTALLATI
SHA Stlfl $itS,N0T
Address
2. CONTRACTOR INSTALLATION ONLY B. Service.s or Feeders
Installation,
Relocittion:
Over 600 a
"8" aboYe
D. Brirnch Circuits
Name N,
r(_
20GJ a0 mps lessor
C,
$50.00
$69.00
$ 100.00
nlps seevolts1or
LL EXPIRE
IHIS P
e."r'Alteration
THE WOIi(
t0R
Additional
rt
ABANDONIEP Circuit or r itli Sen ice_+D.or Feeder Pennit
The installation is being tttade on
propcrtv I orvn rvltich is not irttended
for sale. lease or rent.
E. Ntisccllaneous (Scrrice/leeder not inclutled)
-Eirch instlllltion
Putttp or irrigirtion
SigilOLrtl i ne Ligltting
Liruited Elergl'/l{es
Limited Energl'/Comm
4. SUBTOTALOFABOVE
7oh Stirtr: Surcharge
87n Administrative Fee
Orvncrs Signature:
$50.00
$50.00
$2s.00
$15.00
^lU'
-cy
I\Iinimum Electric Permit Inspection Fcc is S15.00 * Surchargcs
# /,,c
64.0)=.)\
flv"-*TOTAL 7i, 7a
1 TION OF2
eq
BELOW
$ 50.00
\./ $ 63.00
$ 75.00
$ 125.00
_- $163 oo=
s375.00
--s 50.00
$43.00
s 3.00
obtain copie
Conta"to@)
Yttone 49id47L
Strpervisor Licensc Number J 578 5
Expiration
Constr Contr. Nnmb *---93f8 3-
Expiration Date /c , RA-T; tl
Signrturc of Supen'ising Electrician
Orvne rs
7
NU I llrE.
IS
180 DAY
City of Springfield
Electrical Perm it Attachment
Status: lssued
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
541-726-367 6Fax
541-726-3769 Inspection Line
PERMITNO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2002-00132
10t3U2002
10t3U2002
4t30t2002
SITEADDRESS: 280 21ST ST
ASSESSOR'S PARCELNO.: 1703361306500
PROJECT DESCRIPTION: New Service
Springfield
OF WORK:TYPE
ryPE OF USE
New
Residential
OWNER/APPLICANT:
CABELL J NORTON & HOLLY H
PO BOX 2370r
EUGENE OR 97402
ELECTRICAL CONTRACTOR:
NEAL INVESTMENTS LTD 541-485.2472
4715FOX HOLLOW RD
EUGENE OR 97405
CCB # 93953 Expiration Date: 1012212004
Description
+ 1oh Slate Surcharge
+ 8% Administrative Fee
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
4.62
5.28
3.00
63.00
Date Paid
10131/2002
10131/2002
10131/2002
t013U2002
Receint Number
1 200200000000000 l 72
1 200200000000000 I 72
I 200200000000000 l 72
l 200200000000000 I 72
Cashier
4368
4368
4368
4368
To Request an inspection call the 24 hour recording at726-3769. All inspections requested before 7:00 a-m. will be made the same working day,
inspections reque$ed after 7:00 a.m. will be made the following working day.
Required Inspections:
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 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 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
Al I trl\ I ilJt'r.'rl'eut
follow rules adopted bYthe
rlotification Centet. Those i't
n OAR 952-001-0010 tnroug
)090. You may obtain copre
calling the center. (Note:1
nurnber for the Orecon l.Jiil
equrres you ta
rOregon Utility
iles are set for
thoAR 952-00
rs of th€ rules t NOTICE:
THIS PERM]T SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
I of I