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Home My WebLink AboutPermit Electrical 2003-02-19City of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield Oregon 97 477 541-726-3759 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00046 2n9t2003 2n8t2003 811912003 SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION 1160 32ND ST 1702303404601 Change electrical service Springfield TYPE OF WORK: New . T\?E OF USE: Residential ATT follow Notiltca 952-001-0010 througt OWI\'ERYAPPLICANT: VICKIE ROMAN I I60 32ND ST SPRINGFIELD OR 97478 541-736-3430 OAR c&s rthe Oregon Utilitl 541-741-2236 P.O. Date: 0910112004 Description + l\Yo Administrative Fee + 7oh State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid 6.30 4.41 63.00 Date Paid 0211912003 0211912003 02/19t2003 Receipt Number l 200200000000000720 I 200200000000000720 1200200000000000720 To Request an inryection call tre 24 hour recording at 726-37 69. All inspections reque$ed before 7:00 am. will be nrade the same working day, inryectionsrequested after 7:00 a.rn will be made the following working da$l$TICE: THIS PFR[4[T SHALL EXPIRE IF THE WORK 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 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 projecl 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 lofl tFtlxltrLll 2/1912003 8:28:48AM City of Springfield Development Services Department Public Works llepartment Official Receipt 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone Receipt #: 1200200000000000720 Date: 0211912003 Items: Job/Journal Number Description Amount Paid ELE2003-00046 ELE2003-00046 ELE2003-00046 Perm ServlFdr 200 amps or less + l0%o Administrative Fee + 7%o State Surcharge Payments: 63.00 6.30 4.41 Line ltem Total:$73.71 Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid Check C & S ELECTzuC ddk In Person 73.7 I Total:$73.7r Page I of I cReceipt.rpt clrY oF SfthrcFIELD, oREGoN o? 225 FIFTH STREET o SPRINGFIELD, ORg7477 o pH:(S4l E L E CTRI CAL P E RM IT AP P L I CATTON ,726-37s3 r FAX: (s4l)726-3fEifnq ec! as submitted has the lollowing not require sPecific land use IJ)(L $106.00 $ 19.00 $50.00 City Job Number €t-fZC<_,3 CrCrC96, oate Z- tV -ot l.3. Oate Autrronzed Signature /l o 3z*L sf JOB DESCRIPTION SCOtt,-<-ef CL,p- LEGAL DESCRIPTION l7D z 3o3Y ct{ &l 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 Installation, Alteratlon or Relocatlon 200 Amps or less 201 Amps ro 400 Amps 401 Amps to 600 Amps Over 600 or 1000 Volts see'r" "*r" { A. B. D. E. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor 1S Address P O Ror l'\(z City J. ,non" -l Ll I -)zzL 4<qqs C.Supervisor License Number Expiration Date lD-ot-oll Constr. Contr. Number 3K.l,l Expiration Date Signature of Supervising Electrician V, -l-tt ?.''q.*(tco 3Z*f, sf City S l-Phone 86 3fio OWNER INSTAILATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Sigaature: Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surchrrges a 7Yo State Surcharge l0% Administrative Fee v/ 7 3=L $ 50.00 $ 69.00 $100.00 XiI#hTf8ei' Extension Per Panel Owners Name Address I Each Pump or irrigation Sign/Outline Lighting Limited Energy/Residential TOTAL Ftt1fueRr rHrs PERMII l$doT FOR $ s0.00 $ s0.00 $ 2s.00 o<) )o Inspection Request: 726-3769 4. Shared Driv(T:/Building Forms/Elechical pctmit Application l -03.doc $ 63.00 $ 75.00 200 201 601 Amps to 1000 Amps Over 1000 AmpsA/olts Reconnect Only (t' \ q-l-otl t {)