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Home My WebLink AboutPermit Electrical 2003-04-15Gity of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield, Oregon 91477 541-726-3759 Phone 541-726-3676Fax 541-7 26-3769 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00105 4nst2003 4n5t2003 10/15/2003 SITE ADDRESS: 165 33RD ST ASSESSOR'S PARCELNO.: 1702313102601 PROJECT DESCRIPTION: Service change and 5 OWNER/APPLICANT: VILLAruANJ&PETRA I65 33RD ST SPRINGFIELD OR 97478 Springfield TYPE OF WORK: coPies $bl?aenuat UtilitY Alteration v in by the Oregon settortt sby t-687-5770 the on Receipt Number 2200200000000000746 2200200000000000746 2200200000000000746 2200200000000000746 Description + l\Yo Administrative Fee + 7Yo State Surcharge Add, Alter. Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Amount Paid 7.80 5.46 15.00 63.00 Date Paid 0411s12003 04ns/2003 0411512003 04nst2003 To Request an inspection call the 24 hour recording at726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required Inspections: 1 Electric Service: Approval required prior to utility compar$ Strl$f;rg service. 2 Final Electric: When all electrical work is complete. THIS PER[4lT SHALL EXPIRE I AUIHOR|ZED UNDER THIS PEi F THE WORK MI ISN By Signature, I state and agree, that I have carefully examined that all information hereon is true and correct, and I further certify in accordance with the Ordinances of the City of Springfield and the laws of the 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 Page I of I arlfallD 4/1512003 l:24:46PM City of Springfield Development Services Department Public Works Department Official Receipt 225 Fifth Street Springfield, Oregon 97 477 541-7263759 Phone Items: Job/Journal Number Description Amount Paid ELE2003-00105 ELE2003-00105 ELE2003-00105 ELE2003-00105 Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + lUYo Administrative Fee + lYo Stale Surcharge Payments: 63.00 15.00 7.80 s.46 Line Item Total:$91.26 Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid Check JB ELECTRIC INC ddk In Person 91.26 Total: Page I of I cReceipt.rpt gFl*llrlsFr{t o Receipt #z 2200200000000 0007 46 Date: 0411512003 le ft, 22{.I;IFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-37 69 OFFICE: 726-3759 I. LOCATION OF INSTALLATION ELECTzuCALPERMI" )PLICATION 165 N. 33rd St. LEGAL DESCRIPTION City Job Number 3. COMPLETE FEE SCHEDULE BELOW A. New Residential-Single or Multi-FamilY Per dwelling unit' Service Included: Items additional500 Iure B. 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect OnlY C. Temporary Services or Feeders 200 amps or less 201 amps to 400 amps Over 401 to 600 amPs b-t05 Cost Sum $106.00 $ - $7s.00 $ $125.00 $ - $163.00 ..- $37s.00 $ $s0.00 $ $50.00 $69.00 $100.00 w0RK $ $43.00 $ $3.00 $ 15.00 ZL 2UOt11oL bt -'' t,rilrvrng p!'olecr as submitted has the tollowing. ,.rrj ano does nol requrr4@ddclterpf ilC$ - JOB DESCRIPTION branch gilggi(6';' rr t.rvaiService&5 Permits are non-transferable and expire ', if work is not started within 180 days . ... ,.i,,zeu t,ru.a of issuance or ifwork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor JB ELECTRIC. INC' Address 4685 st. City Eusene. OR 97402 Phone-@-ZQ.- Supervisor License N umber 3872S Expiration Date Constr Contr. Number 37s87C ccB 104929 Expiration Date 1Ol1l03 3114104 S Electrician Owners Juan Billa Address _same- City Sprinqfield. OR 97477 Phone 736-8400 --* OWNER INSTALLATION The installation is being made on properly I own which is not intended for sale, lease or rent, Owners Signature: IS NUI D.OR One Circuit Each Additional Circuit or with G*i* or Feeder Permit 5 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation S igrrlOutline Lighting Limited Energy/Res Limited Enerry/Comm 5. SUBTOTALOFABOVE ilrlrtuit 7%State Surcharge l0% Administrative Fee $4s.oo $ $ $ 1 $ $ $ $s0.00 $50.00 $25.00 $4s.00 $ $ $ 78.00 5.46 7.80 JB Job #034%TOTAL $ $ 91.26 Panel