HomeMy WebLinkAboutPermit Electrical 2003-6-20
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City of Springfield
Electrical Permit Attachment
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541~ 726-3769.lnspe~tion!hine,:u" ,,<, ;L_
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PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00152
6/20/2003
6/19/2003
12/20/2003
,ill II,,; III SITE 'ADDRESS':") f1S'75S"'MAiN:ST Springfield
! it I:',:: !,,", pf' 1-\1U1f! I:-O:l',!' ,1"\, on,:-'" NOTICE: TYPE OF WORK: New
ASSESSOR'S PAR8EL.NO.: -i 1702334400800, , .
W". ,." '''' """; - ". .:' -' - '...Hd . THIS PERMIT SHALL~f\l~ WSlfIE wl9.QRlmerclal
, ,"!I'v i'l '''r'nlrr" If' ,'la: 1,,[" \eICOr,m;r. ^"Tl.IO<>'7cn ,,,,,,en. THIS PERMIT IS NO
rf.~~lr~T PE~~RIPTIPRi:rJtii~~?'."r~~~&~~IT. Power P~I~~ ~?~:!~~~~~~t~~O.Sl..... ..ro.~.,...... ......;- T
,,-~,"" . ....1/.' ..........".....,....,....., VII IV r\UIU1UV"L.LI I \..ill
OWNER/APPLICANT: - ,. ANY ~.E~1J~IJ?~~.CONTRACTOR:
JOSEPH AARON BUNCH
2525 WILLONA DR
EUGENE OR 97408
CCB # 145024 Expiration Date: 11/12/2004
ALBERTSONS INC #574
A TIN: PERSONAL PROP TAX DE
BOISE ID 83726
541-345-9808
Descriotion
Amount Paid
Dale Paid
Receiot Number
+ 10% Administrative Fee
+ 7% Stale Surcharge
Temp Power 200 amps or less
10.00
7.00
100.00
06/20/2003
06/20/2003
0612012003
2200200000000001100
2200200000000001100
2200200000000001100
To Requesl an inspection call1he 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. will be made the following working day.
Reouired Insoections:
1 Temporary Electric: Approval required prior to Utility Company energizing pole.
By Signature. I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is Irue 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 Ihe laws of the State of Oregon pertaining to the work described herein. I further
ce i that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I furtber agree
t len ure that 111 quired inspections a e requested at the proper time, that each address is readable from the street, and that
I e pproved set f PIa~s' pplicable ill remain on the site at all times during conslruction.
tU..t~' _ ("/
- ~
ner or ontractors Stgna re Dale
Page" 1 of I
~_....'
'" las submitted has the following
I require specific land use
225 FIFTH STREET' SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~p~I726-3689 C c..--
ELECTRICAL PERMIT APPLICATION lo In r..?.. z~nl'u~ r
City Job Number f.(!( ~r:lLDate 0 \~ O()0 Date '" ~ ,~
r:..:\IW'i~t"'~'_,~~'r;f;-:,~:..'t;;t:<~7(>..;.'trt:'il~:.' '!'!"'i~;::"~'~':':';'-"J1i~~_[" ~~"'~-'-""",~;:~!';"',"r:r.r~:~~J~.?r~~~2",-~~~J;!.~"t.!;I!~i.~'~ ''>' '1;Wi'~:;,-~\"m-"r~~~{i'f.7"'~
1. ttL,9""q.fH9!";Pk{l)';~l~~r!.gJX;!li~~~~ 3. tE2!'JF:U:TE.:f!Hr~,clJf,D(rr,IL#l~7.,;.9,.j~~~~;\)t.;;C:~\)i~~1&l
~f)7J~ ffill1D S\-ffrL
LEGAL DESCRIPTION A. r~~~~~~;'~;fJ~~~;~~!f\~~ni~!~J1~IlJ~~~~1iii~
\...., l) ry..:;?:f\4 rJ..JW() Service Included
JOB DESCPJPTlON 1000 sq. ft. or less $106.00
'l. ~N\() \)o\e~ ~t" 11 ll~~7:nd~~~~~~1500Sq. ft.or $19.00
Permit, are non~ransferable and expire if work is ~Each Manufact'd Home or '
not starled wilhin 180 days of issuance,or'if-work is ' Modular Dwelling Service or $50.00
Suspedded for.:180~da~s.pt~d bY the Or dgOIl uti, ., Feeder
IUIlUV\I I\.I.......::.......~...
v.~'\i~:)l.r;J~r,~~:o'rUi-!t-eP':1:i1~~r~~;Mi\~:5'e-;~~1 g;::~7 ;rt, ,'V,; _~ . ,r~.::''::7-::~:::(::.:':-"::',i~ ',_'.'--":p" _ .'." ~'(.':, ,1~'"
2. ~~~&Jf~~;t~Ml'!:f~~if11'{lL~. B. !L~_ff:~j~.~~~'o~~lte:~t~t:~:~;l1;~}!~~~9~;~~~!~t~J!Op.~![. R~~.~~~.~~2. \:J
EI ','.f1lj"C: v"" m,1II c.-()5-~'~;"p~t~('~MI'-(lJ&~T. 20<t!'@iji'I>~te i3 O~
ectnca ontractor ~ ".. ~V(..,_ ",P-.,h_ _ 6 i)\9f 5S r- .
c,~lIinf1 th'J C",nu.. I"V.;:.....- .--- '". ,~ . . EXPlk" -Fh: Oh"
, ~~ ',iJr"l~ Ornr.r'ln' !"Jil~",,,t.H:C2tl ; 201~mpS:I5.~OOILllpsi\LL t Irln_ ,5,QQ
Addres,rulI~;2 ~ --lvl " ~.~,~" .ur:: 401 ~;;'~'l'.~~q~t\rhpSDER 1HIS t'tn~v~', ~~':bb
, '601 OOi.p#HiloolA,G8s IS i\Bi\NUUNtU r 163.00
City ell1A Phone 3lfL1. ';j'7L/-~ Ove~lQ\lrwnPM%1?sERIOD.,' ' $375.00
I Reconnecl Only $ 50.00
, Supervisor License Number '-f 73 Lt-s
Expiration Date I () - 6 t./
c. ~~tiili'po;arV.siH.ices;or;F e~~'deis,,'.::~-' i~,.~, :f;~~~'~,..r-~~
~,,..,~......~~....~~---~~ " " ',', ~"..,.~', '-- ,'~
~n; -I;t~'c'.a
u".'~ ^ '.
Expiration D.te
10 -04
Install,'ion, A11eration or Relocatio'lil "
200 Amps or less ' " 'L.-.
20 I Amps to 400 Amps
40 I Amps to 600 Amps
\Oo.aJ
Constr. Contr. Numbe; J.O - 4 (; 3 t.
$ 50.00
$ 69.00
$100.00
S2Z:/iS~:/
i ~ ,
Owners Name AtN> it~ '-
Addre\,- ~S~ ~ ' (l---z~eet
CIty 2'l~~~eUPh;ne ,
OWNER INSTALLATION
Over 600 Amps or 1000 Volts see "B" above.
D . r'wB" ". ?~h'J.'C' .: --:-::,----:-t'" ';J,-:-~i>>':.:E-~""~,,~~;?;. "Of! <\-':'." ~";:~r;: " 'l~~..--p,,::; ~.:I
. t ,!~'!E, 1 ~!:5~I.~\<;;;:\>.~c<{t;-v;~",,>.-t'Y,.}-1,\..,.j....H J-'<~.-,Jt.. ,il ~'i ~
- ~ - ','" " '", , " , -, "-'
New A1teralion or Extension Per Panel
" One Circuit
Each Additional Circuit or with
Service or Feeder Peffilit
$ 43.00
$ 3.00
l~~'_r""':"".. '."','..: ,''-<1 _-;",.:...- .~:i.." ~.jI"-<t;.-:\.< ";.~<"?-',~1:';:r:--'1
E. itMiscellaneous.(Service/feeder'nol illcluded).~Each:Iristallatio,i ;
\" ,'-','C'" J."',."-' _; ~'-_>",.".,- " '-'.,~. ""'_';"',:~ '-'. ' ,'"'' ,
The installation is being made on property 1 own which
is not intended for sale, lease or rent.
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Inspeclion Request: 726-3769
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. ~i:r1ii6fALOFAhOVE,,7 "3-'" 2 _)~'l.;-; , N\ 00
ti '''''~>:- ':\J~"':"'~' .::-,,.~ "t;." ~ .~'._.""'i ~;.....\J.A).
..b... ~~ State Surcharge '70 OQ
I\"n...~ ~:\) ~O%Administrative Fee \ D.V((
~bt>~ ~ TOTAL l \ f\.{XJ
'{ ~~l.'~ Shared Dnve(T.)IBUllding FonnslElectrical Pennit Application I-OJ.doc
Owners Signature:
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
ELE2003-00 152
ELE2003-00 152
ELE2003-00 152
Payments:
Type of Payment
Cash
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Receipt #: 2200200000000001100
Description
Temp Power 200 amps or less
+ 10% Administrative Fee
+ 7% Stale Surcharge
Paid By
JOSEPH BUNCH ELECTRIC
Rec:eived By
NJM
(:heck Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 06/20/2003
1:39:31PM
Amount Paid
Item Total:
100.00
10.00
7.00
$117.00
How Received
In Person
Payment Total:
Amount Paid
$117.00
$117.00