HomeMy WebLinkAboutPermit Electrical 2003-01-08City of Springfield
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
541-726-367 6Fax
541-7 26-3769 Inspection Line
PERMITNO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00010
u8t2003
u8t2003
7t8t2003
SITE ADDRESS:
ASSESSOR'S PARCELNO.:
PROJECT DESCRIPTION
347 S 43RD ST
t702323403700
200 amp service
Springfield
OF WORK:TYPE
TYPE OF USE
Alteration
Residential
OWNER/APPLICANT:
EARL YARNAL
40143 DEERHORN RD
SPRINGFIELD OR 97478
541-741-3834
ELECTRICAL CONTRACTOR:
BURRELL BROS ENTERPRISES INC 541-741.2724
40159 BOOTH KELLY ROAD
SPRINGFIELD OR 97478
CCB # 136446 Expiration Date: 0812012003
Descrintion
+ l0%o Administrative Fee
+ 7Yo State Surcharge
Perm ServiTdr 200 amps or less
Amount Paid
6.30
4.41
63.00
Date Paid
01/08/2003
0l/08/2003
0r/08/2003
Receipt Number
r200200000000000s1 I
12002000000000005 l 1
l 2002000000000005 l l
To Request an inqpection call the 24 hour recording at'726-3769. All inspections requested before 7:00 a-m. will be made the same working day,
inspections requested after 7:00 a.m. willbe made ttre following working day.
Required Inspections:
1 Electric Service: Approval
By Signature, I state and
information hereon is true
with the Ordinances of
further certify that
further agree to
street, and
Owner or
\o(,.€
company energizing service.
the completed application and do hereby certify that all
certify that any and all work performed shall be done in accordance
of the State of Oregon pertaining to the work described herein I
are in complhnce with ORS 701.055 will be used on this projecL I
are requested at the proper time, that each is readable from the
will remain on the site at all times
\t \t
lofl
Date
t/8/2003
l:54:02PM
City of Springfield
Development Seruices Department
Public Works Department
Official Receipt
225Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 12002000000000005 1 1
Date: 01/08/2003
Line Items:
Job/Journal Number Amount Paid
ELE2003-00010
ELE2003-00010
ELE2003-00010
Perm Serv/Fdr 200 amps or less
+ lUYo Administrative Fee
+ 7Yo State Surcharge
Payments:
63.00
6.30
4.41
Line Item Total:$73.71
Type ofPayment Paid By Received By Check Number Confirm No lfow Received Amount Paid
Check BURRELL BROS djb In Person 73.71
Total:$73.71
Page I of I cReceipt.rpt
225 FIFTH STREET
SPzuNGFIELD. OREGON 97177
INSPECTION REQUEST
"
7 26 -37 69
OFFICE: 726-3159
LEG N 03 7oo
I LOCATION OF INSTALLATION3ql l.{B- >r .-)
L, ]TRICAL PERIVIIT APPLICATION
City Job Pr*1,.,' €a€Zc:OJ -(ioO/O
3. CONSLETE FEE SCFIEDL]LE BELO\\/
A. Nen Rc.sidcntial-Singlc or
Multi-Farnily pcr dl'clling unit.
Sen'ice Included:
Items Cost Sum
sq.ft. or less _ $ 106.00
ilional 500
I
JOB DESCRIPTION
Perrrits arc non-lransferable artd expirc ,*
rl'*'ork is rtot started rvithin 180 dttvs
of issuance or if u'ork is str
ItiO days.
2 CONTRACTOR INSI'
Burrelt Bros. Electric Qo"'
40159 Booth Kelly Road
Springfield, Oregon 97 478
\\i_N._:r\
Strpcn'isor Licertsc NLrrttbe '&:s_
Exp iration Dtite
Constr Contr. Number \h\.oA+\. c
Expinrtiou Drte
Si gn rrtul'c o1' Str ltcrli.si ng Electric i irrr
Mnnul'd Horuc or
ular Drvclling
Sen'ice or Feeder
B. Scn'iccs or Fecdcrs
Instullirtion, Altcrations or
Relocrttion:
200 anrps or less
201 anrps to 4t)0 arnps
.l()l anips to 600 amps
60 I unrps to 1000 arttps
Oi,er 1000 amps/r,olts
Reconnect Only
10
Insta
or n
_. $19.00 -.
a
.$ 50.00
--
$ 63.00
$ 75.00
$125.00
$ l6i.00
j;3 75.00
$ 50.00
$50.00
$69.00
$ 100.00
tt:
ation
voits see
teration or Extension Per Panelers Na,ni \(\'-to$
I
ao,r,..rrr LlOIu{3_'Dtttheur.:'Z d
citr tPtid Phone ") ttl-383q
OWNER INSTALLATION
The installation is being ttiade on
propertl I ort'n u'hich is ttot intended
lor sale. lease or rent.
Each Additional Circuit or tt itlt Sen'ice
or Feccler Perrnit
E. I\Iiscellrncous n clu detl)
One Circuit _ $43.00
$ 3.oo
-_
r0s
Itg
r,/Comm
nr Elcctric Pernrit Insllcction Iee i.r S15
$50.00 _
550.00 _
s2_5.00 _
$+5.00 _
,00 * $u1'qh11Y-c.5
]. SUBTOTAL OFABOVE
7'X, State Surcharge
8'1, AdministI'lttilc Fce o
7l
Orvncrs Signlture
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