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Home My WebLink AboutPermit Electrical 2003-3-17 ~ ~. . :,... CITY OF St _..NGFIELD, OREGON '~, '-' 9t. av"'> '7 'i- 225 !'ll' '" STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Joh Number i:LE200?~{'JOO 7 S- Date 1. !tiifO'(tj)1fI~iiiETiNsritJ.Wtf,N,T.ijJiNiitfi,fdjj~1il ~"*l''''''~''''''''M'~''.II'i'(''1I<\''''')''"'''~''Jii'ii-~",,''':~~~~~'<;I~~~ '5" 1 ~~ s. vi) Il\ vi <; t" ,LEGAL DESCRIPTION ~ IlJ4k ^'Y\' JOB DESCRIPTION +i.vll.<."ffmsJ Pt,..., 4 f ~ OY F/fl I Permits are non-trallllferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2 ~~~~&;~t;;;;:&i!&.~~~.r ' . .i!~~1ar;'''''''' ,," --. -':" ,- -'-~' Electrical Contractor (1,,..; <:t-t:lnppn Fl t=J.(" -t-rir db... J'" ~<-<,.-..J-<.J 1:1~Lr"'.~;<' '>-,,_. Address 1 ?qil Rpth"l nri"" ,City l':l1gpnp Phone ,~1-hilil-h12jL Supervisor License Number '17,qS Expiration Date . 10/01/04 ConsU. Contr. Number ....ooLt5)2 Expiration Date 10/01/03 Signature of Supervi,ingEleetrlci T ~~d"~Nn~n ~ U- Owners Name A-I huts IIVL S Address ~ 51) 'fJll-~~ ('e." rm-J&:.\~~ . ,\'(\1.- ~v' City F70\V_ iA) Ph~~P.~'t\"$(u..OO ~\. ~~ ~S ~'t.\"&.\) '( .- OWNE~~j~~S'\,." \~\>.~\)\)~ Th ''''~I '''~'''b~\S ~ . e m.s~~o';lS~~ ~ ~perty I own which IS not mten~@ ~ . nt , \>-\)\~~~ v\)~ Owners Si~~'O~ \>.~ Inspection Reque't: 726-3769- ?;: ... L. The following project 8S sUb.niftt~d-h'~.s'the following' 01/ :;03 zoning, and does not require spec,flc land use ~~' ,~.=.' ,'..". . '--"";;;,,~A" .. '-,- ".~, 3. .'€@MEIIEfJlFJ1liEEw',"', ,~,,",gllf~:,.., ,or" .,$$" " ',',: lI.~'t;~"'~.u:!,,;;....,....~.""""'lI.'\i,",'I"-';;:;.;;;;,;o.;!,..T.'J~'"',;.".,""'~~~' ',,' W :~ Date ~"""'r:'l'>"""-'''''''-''''''''''P''''''':::a'' ~~~. "1.......lfMj.....W.Jl;r. . ,. "'"''R"''' .. =... "~=," ~I'Ii.'''".'"."".I'-.. l'1t.o' e.~J:: ~~", ,," rp J }~Od ~ ~aDJI.ty.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 . , $106.00 ~ $ 19.00 $50.00 '~- """"",,~,.. '"""...."J"~'-'''''''.."'i~''.'''.B,' B. t :seiWic~'o .. ".;.~~""t?~!, 'eratib"nsfo ..; ocmo...1"'A . . r~f~''l~'1~!1!t,~~ae...'-i'.z::!!...~-wus;~'~;r:M::~,;'~~~'' .. .:.~~_ . 200 Amps or less 20 I Amps 10400 Amps ' 40 I Amps t0600 Amps 601 Amps to 1000 Amps Over 1000 Amps/V oIls Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 , $375.00 $ 50.00 l"f"".-""",,",.,~..M~"''''"''''~~~''E' "'Ifis"". C. '<J,em u_d~' !\3ltt.VlCOSlon,Eeeaers ~ '. .-" _;. '!'i" '~'r~ "........y.....I.;-"',_,J~""""......,___.r""'<.i.""',......_,....,, "~~.., , ' "'~.. '"^-.',~- ". , .:l' Installation, A1leration or Relocation 200 Amps or less 201 Amps t0400 Amps 40 I Amps to 600 Amps .. $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. ~~~il1~~~it~~~~ . New Alteration or Extellllion Per Panel One Circuit ,~.:. \'01.1 ~?$ 43.00 Each Additional Circuitorc.with)~I.I.. 0(\ u"':'~"'" Service or Feeder Peniiii I ",;'e Q(ag "~p.\ $)'3.:00 ..."v'" - "" >" 'A,~ ,,". . \\.)\..... _"o(\ul .....\\~S V' _ nr;...?_~V E. . ::'ti'-":' :.;~...... . . +;::'~"'';.ltU.it~''':'':'7;;~.~Jft~->'~-;;;--'jf , .'. "..".-, ",,11... ....".~ \o\\'-' . \\v- ",\J.... '''SU' ;{\U'- .',' r:il~\U ",,(\,\.\)v ; c09'" \e\s9 ..,~n ~,ploUtT!ganon 0:0\2>'(\ 'e..'lne ._,..~,$,50:00 r ',,-," ,,,,,, INO' .", ,~-- S!gD/0utlin.s,Ligliting,W(" \\.'\\h,. .,.$ 50.00 ~nf"\' ~~ ce.. <\'0\\ ., ' -. ". Liiilited Ener '/ResidentiaJl" ".?:,'2-''''Y $ 25.00 . . r.\:>''': ~,,,( '\" . _ i ..'000"" LUDltedEnergy/Commefl:i31 / $45.00 </S'OO (lV" ce...- Minimum Electric Permil Inspection Fee is $45.00 + Surcharges ~!,t<....~,,,,-, _~~q:,.,,~~'-:', ,nTl'('C':,' "?;t .' '.;:.. ,_" -0 '--," , 4 p'SI;r":~~j ." ' . ~~m~.r.N..~ .... . _ ;0;-:..< if ~ 0() 3./< Jj.~ S) "'~ 7% State. Surcharge' 10% Administrative Fee- TOTAL SIwod Drivc(T.}'BuiIding FonmlEloctrical Pcnmt Application 1-ll3.doc , . . . City of Springfield Electrical Permit Attachment I' ,I 1; H i' ji Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-37691nspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00075 3/17/2003 3/1712003 9/17/2003 SITE ADDRESS: 5755 MAIN ST ASSESSOR'S PARCEL NO.: 1702334400800 Springfield TYPE OF WORK: Addition TYPE OF USE: Commercial PROJECT DESCRIPTION: Limiled energy for alarm syslem OWNER! APPLICANT: ALBERTSONS INC #574 ATTN: PERSONAL PROP TAX DE BOISE ID 83726 ELECTRICAL CONTRACfOR: CHRISTENSON ELECTRIC INC 541-688-6121 1631 NW THURMAN 2ND FLR 543-419-3600 PORTLAND OR 97209 CCB # 458 Expiration Date: 05/01/2003 ,DescriDtion + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus Amount Paid Date Paid .Receint Number 4.50 3.15 45.00 03/17/2003 03/17/2003 03/17/2003 1200200000000000834 1200200000000000834 1200200000000000834 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 am. will be made the same working day, inspeclions requested after 7:00 a.m. will be made the following working day. Reouired I nsoections: 1 Low Voltage: Prior to cover. By Signalure, I slate and agree, that I have carefully examined the completed application and do hereby certify thai all information hereon is true and correct, and I further certify Ihat any and all work performed shall be done in accordance wilh the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to Ihe 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, thai each address is readable from the slreet, and Ihat the approved set of plans, if applicable, will remain on the site at all times during construction. .!,o.~ Owner or Contractors Signature '\'(\t. 'l~ ~I;}\ X. \~ :\ \S i-'?\~ t."~\ I;}" \>.,-,- ~ '(\\S '? ~t.1;) ~ o.\\)"\\C~~~\\ ~~\\I;}t." ~'O\>.\\I;}\l \' c. '?'- ",I;} \) n \S ,,<--\'" '(\CI\\\t x.\) CI'" \\\CI\)' \,-\~;'\~~",\\\~ '?\:: C}::i 1{ \'O~ \>.~ Date .01.1 '.,u . ,eo.l.llteS ~ \)\1\\') ,,0(\ \<3-" Ota90 e\ \O~ "Ule", ,.\\le _teS a" \ IV\ " :teo'O' l.I\eS 0. 52-0' ,,\ \\.01" \es\:1.00\) \\lOsel \lOJ:\y\9 l.I\es\:. \ ~\0'IN tl.l cel\\e\. 0\\\-01.1<.' _ d \'r,c t "e ~~\i\IC~~0~2_\)a' -~~~il\ cOi~~~ne \e\~r;~o.\iO-' ill O~ ,/01.1 \"lI3.~el\\et. ~~~ 0\\\\\\j ~~\'. 009 ~\\il\9 \ne \ne Ote9~(\_?:,,'?-'l~ - . c :oet\ot "'c, ~-~ '(\l.IifI cel'.\e\ 1- I of 1 3/17/2003 \] 10:16:44AM r- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 1200200000000000834 Date: 03/1712003 . Line Items: Job/Journal Number Description Amount Paid ELE2003-00075 ELE2003-00075 ELE2003-00075 Low Voltage - Commercial Indus 45.00 4.50 3.15 + 10% Administrative Fee + 7% Stale Surcharge Line Item Total: $52.65 Payments: T)pe of Pay men I Paid By Rtccived By Check Numher Confirm No How Received Amount Paid djh In Person 51.75 djb In Person 0.90 . Paymenl Total: $52.65 Check Cash PHILIPS ELECTRIC PHILIPS ELECTRIC Line Items: Job/Journal Number Descriotion Amount Paid ELE2003-00075 ELE2003-00075 ELE2003-00075 Low Voltage - Commercial Indus 45.00 4.50 + 10% Administralive Fee + 7% State Surcharge 3.15 Line Item Total: $52.65 Page I of2 cReceiplrpl 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Payments: Type oePayment Check Cash Receipt #: 1200200000000000834 Date: 03/17/2003 Paid By ChetkNumber Confirm No Reteived By PHILIPS ELECTRIC PHILIPS ELECTRIC djb djb Page2of2 3/17/2003 \! 10:I6:44AM , " City of Springfield Development Services Department Public Works Department Official Receipt . How Received Amount Paid In Person In Person 51.75 0.90 $52.65 Payment Tolal: . cReceipupt