HomeMy WebLinkAboutPermit Electrical 2002-12-27
'~;225 FIFTH ~TREET i': .~\ r, , 1,1 r ELctt-1CALPERMTT APPLICATION
\ . SPRINGFIELD, OREGON 97477 i ': .', .
, 'INSPECTIONREQ~ST 726.3(69', J 'i c-;:: :ciiYJohI';l,umher~2=~- 0,.017*0 .
\ , . :, I OFFICE: 726-3759. " Ii' ',. 'i . ,I I ,r, ' .
"".:'" ..>,'1 ,''. ii_,"" 11,'-- :3,'COMPLETEFEE'SCHEDULEBELOW' '
\ 'r. LOCATIONOF'lNSTALLATION : : r 'i:' I, '
:S..-7 ',~ "';;..z~hP~ '.to J. t,';';' 6~ ~ I l. - <- A: N~w'l\~inti;ll-Single or ~ ""- - -- - ~- -- .
'iqq.Z- rv,A/A/ STr-f!"r ...\~.\~Il<MUlti.Famil)'perd\\'ellingunit. ~' ;
LEGAL DESCRIPTION Sp~, (!!)R'1' 7't~~:c'\\C \..f< Service Included
, '7 (l 7 ~3.3> z... 0 II 0-0 ~Il Il". .9 A /' Items Cost Sum'
\0\0....:\.'(0<< ~...........
,,\\9 .,,0
JOB DESCRIPTION \O\\o"'~ 60.. '1/ less
/3,-a/VCh Cld":y!:,,,~t-PN"~o. ,1-"..0 Ea, dltlOnal500
..(I ~ S., ,..u' LI.. S ). ~2>0 I2I/Jj:f'I:'1 sq. ft or portion
Permits are li9n.transferable and expire I. thereof
if \\'ork is l1?t lstartcd within 18~~ay S\Q,(\0.\\>' Each Manufd Home or //
of issuance or if work is suspen'ded~~1-.6 Modular Dwelling ./
180 days. ' I'll Service or Feeder
,-
r,
, ~
.,:' "
~ .'
$106,00
.,. .
. .
$ 19.00
~. . ..
"
$ 50,00
;,
\.
. '
/ ,-.' .
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2, CONTRACTOR INSTALLATION ONLY
B. Services or Feeders .
"
Installation, Alterations or'
1 '
Relocation: ;' -. '.".~"
/ .: ... ','.. ::.'~:':\:'{>'?:;.'\ L~~:~,:'t~
200 amps or less $63,90 ~ ,
""" 201 amps to 400 amps ~ $ 75,09_
'.401 amps to, GOO'amps, ~'$125,Qq---,-i
601 amps t6 1000 amps ~ $163.00_\
Over 10QO amps/volts ---.:..... $375.qO ~~
, Reconnect Only all _ $ 50.00 '
. . ~Q""
c. TemjlOmry servil\'t~-"~~~~\)\,,
InstallatiOt~\~~~~ion
,,-\'\J::' 11\ ~~\,;~'\~~~"-'nti~t.'\) , ,
\\~\ t.\\~ ~,s ~I'\\-~, ' _
. -.- ,\\\\<0 \> '\)'i\\1-'t.% 6~ If., 400 amps .
Signature of .Supervising Electrician l><\)\~ -~\j~'O~~'\Iooo amps '
'?' ",,' ' "", c,'\)~~t: " \)~eHiJO, amps or,lOOO volts see
.' '.' ")-<2 ~\,,\'O\J "B"above ..--.-..,
, ~~ t:.1':'?n_~-'!. _ l><\-I' /' \
. '. D. Branch Circuits
Owners Name .5Q\AA <lit, i\ ~ L New Alteration or Extension Pe/Panel
, ,./ ' i &'lOU\O' .
Address Po 13 0,1< . \.( "t On'e Ci~&'\il.'l<Itet\U\te on\)\\\\\'J . / . $43,00 ~
f:r, ,L, IOI'l..Ote<.)O \heOte9 ee\~ .
Cit). <:?F0. Phone 'II{ 2 <;-~~1'l1 ~Wi~~~~~!:';'~~ice
~\o'l<ltU\eS ~e4d~\~"Ofl.~~& ~ $ 3.00 --C-
OWNER INSTALLATION t~\\\\ca\ionC ~.()O~O\ll'''~iesot\~ ~One '. . '
The installaJion is being made on ~OOj).,,~~al.~Sf.8l~({{~~~~I.I.Clllded) .'
properly I o,vn which is not intended ,n 090.~O~:~\li1I.l~~\\\'INo\\'I "
for sale, lease or rent 0 Ca\\\nO"'~I0t~~I.qll,'2.'~)' _ $50,00
u1l\~tt~ ~~~llll1g $50.00
Owners Signatnre: fI Cfl ed Enerb'Y/Res $25 00
, Liil1ited Energv/Comm $45.00
I\'1inimum ~lcct;.ic permit'lnSJlection Fcc ~urChargcS
. '
,
. i '.
Electrical'Contractor M~i)I.4/Zm//) (oAJf/o2~
;'- :./. .,';;Y', (,,;..\.
Address r f5:ss79 N c.- 99 So /'"
" ' /
) I' /
Citv EL, <7C"/L'tF Phone 72~ -/677
.. I. 0 \ \::' ./'
Supervisor Lieense'Number :Z$Oo 5 .
~xPirati~uDate!lorl /e: i .
C;onslr Contr. Nm;,be;' 7 70'2'.3
-.
. c"~ E".piratiol1 Da~~-- /~~"L(
$50.00 ,
, ,.-)
$69,00 '----'-
$'100.00
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
80/0 Administrative Fce '
,-.
VI '
'311
:::lbO
-,71
:::, -
TOTAL
e
.
City of Springfield
Electrical Permit Attachment
..- ....,
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541.726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: ELE2002-00170
ISSUED:
APPLIED:
EXPIRES:
12/27/2002
12/27/2002
6/27/2003
SITE ADDRESS: 4992 MAIN ST
ASSESSOR'S PARCEL NO,: 1702333204000
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Commercial
PROJECT DESCRIPTION: Branch circuit extension
OWNERlAPPUCANT:
SQUARE DEAL LUMBER CO INC 541.746.2576
PO BOX 49
SPRINGFIELD OR 97477
ELECTRICAL CONTRACTOR:
MCDIARMID CONTROLS INC 541.726.1677
85579 HWY 99 S
EUGENE OR 97405
CCB # 77023 Expiration Date: 10/24/2004
Dese riotion
Amount Paid
Date Paid
Receint Num her
+ 7% State Surcharge 3.15 12/27/2002 1200200000000000469
+ 8% Administrative Fee 3,60 R-~ 12/27/2002 1200200000000000469
Add, Alter, Extend Circ 43,00 ~'\S 5:)'\ 12/27/2002 1200200000000000469
Minimum/Adjustment Electrical 2,00 ,.'\~~ ~ ~ 12/27/2002 1200200000000000469
. \'< ,~ ' <\
To Request an inspection call the 24 hour recor~~~~~~X)tinspections requested before 7:00 am. will be made the same working day, ,
inspections requested after 7:00 a,m, will b~~~~~~\i)lrg working day,
~. / c.,'X' ~y't- . Q,~ _
-<-'v" ~\ \ ~f.': \'0' 0\).':-
Reouired InsDectplllsl)~~,.,~\) ("\ \)~ ~\)\). .\\~e'l>'l ~~\~JI,,'{I
'-. \l.":)' ~".~(.'v ~' eA" ~ \Q"
1 RoughEleetriC\'1'l'~:~~~q . \e.'fl~ O~vJ8 e~~'" .
2 Final Electric: \\'\h~~~~~~al work is complete, .O~~~~'O'l\)\e~\eSe.~~~S ~9'b'fSl
CJ ,," ()~~. [1.0" ~0 ...'nOr 0~ 0
By Signature, I state and a~, that I have earefnlly examined ~~~X~~ I!W {l:llI~'b~m':~~t~';;fY that all
information hereon is true and correct, and I further eertify th$t'a'!i~q~ Ol~'all~~~in aeeordanee
with the Ordinanees of the City of Springfield and the laws Oft~lf~1t~&\~~ ~~\'- described hereilL I
fnrther certify that only contractors and employees who are in ~ de~~~O!;"~ 9.1z,'CI\lSed on this project. I
further agree to ensure that all required inspections are requeste,.\\lil ~lft6d111~, '!AA i1dress is readable from the
street, and that the approved set of plans, if applieable, will rema~ , ,~,itlIll~\~.'l(lli'ring eonstruetion.
~~e~ ~o(\~, .
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Owner or Contractors Signature Date
I of 1
'~,'" I CIJ!l8D,
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2002.00 170
ELE2002.00 I 70
ELE2002.00 170
ELE2002.00 I 70
Payments:
TWe of Payment
Cash
Paid By
Description
Add, Alter, Extend Circ
Receipt #: 1200200000000000469
Date: 12/27/2002
Minimum! Adjustment Eleetrical
+ 8% Administrative Fee
+ 7% State Surcharge
MCDIARMID CONTROLS
Received By
Check Number Confirm No
djb
Page I of I
12/2712002
.
1:13:27PM\
City of Springfield /'
Development Services Department
Public Works Department
Official Receipt
.
Amount Paid
43.00
2,00
3,60
3.15
Line Item Total:
$51.75
How Received
Amount Paid
In Person
.
Payment Total:
51.75
$51.75
cReceiptrpt