The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-4-10 ,'" CITY OF L.....tlNGFIELD, OREGON 0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . F'~~,b~4U726-3~89 10 mg proJect as submitted has the tollowin ELECTRICAL PER1U.IT APPLICATION zoning, and doas not raquire sp~nd u g . IS 9 3 approval. sa City Job Number Et.-<-ZCOj -00 101 Date 01..{ 0 0 Zoning I. LOCA110N OF INSTALLATION 3. ' COMPLETE Rm scummr F rmE.OW 1kK=~f)=({J) ~ Y 0 <r S- 1M A--/ ttI S T Authorizad Signature ~ . IYI l- A. New Residential - Singil' or Multi-Family per dwelling unit. ,0 -AO~ ~~ ~ '" .s \,0 ~ New Alteration or Extension I'cr Panel O'.~.::R. 0 . ~ n~~O~ 'b~J~ ~ One Circuit f $ 43,00 v ~:.~~ ~~(o.'" ~ EachAdditionalCircuitorwith ( ~ ",..'J ~1J!f 0'" 0 ~Q" /) Service or Feeder Permit $ 3.00 Owners Name \1C2;f,f,O~,!,~~_...~,tA~.,;P ~...... ~.. ~ &"", go ~ i:>""f# - ,'Q ~ . ~~ Address k 0 9 <f;J'-~o~~ ~"'- ~O \:\. .Eo' !\!isceUaneous (Service/feeder not in~llSo~ -Each Installation. JP;G;Y ~,j.' ~I,)- cY'~0' ~ rI' '\~~ S ~~ City S t" '$'''' ~~p~~.~~ -to ~~"I:.nfl; Pump or irrigation ~ ~ to<" '\ .150.00 ~ ~... ,,,O~ sfl ~~ ~",.... # ~"f? Sign/Outline Lighting y.,'{J.~ ~v~,s ~\) $ 50.00 OWNER INt~~l,p~ ~tt; c!'t::'",0'" ....~<;:s Limited Energy/Re1\d~ial,\~S ,~~'" $ 25,00 ~ ~ O~~'" ~ ,<0 . . ~;.. ~. (,~ o.,~' The instaUatiOn'l.q;~&&~~~~P!tdY I own which Llmlte~'v"""~~~~.~~~~V $ 45.00 is not intended foi-.~~~'i! ~'I00t::' Minimu~l\'~g'~fir~(.:bHl IlJ~\,\@i\i Fee is $45.00 + Surcharges ~{::' . . '\~ ~v..\::'<<;;' ,\C~~-.l <j,v,,'(' ... . . .. t::'. 4. . SUBWT~<O'F<(J'PUVE Lf b .. .' <J~W \'0(;) 7% State ~~harge 3 z2 10% Administrative Fee '1 b 0 53KJ LEGAL DESCRIPTION /70Z_ 'JILl / f)l( ~-oO JOB DESCRIPTION .A-'b\\ !t~\Crt~ i) Z L.' fLu.'- " i-", Permit{ are non.transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. .2. CONTRACTOR INSTALLATION ONLY EUGENE ELECTRIC Electrical Contractor Address 120 MONROE City EUGENE Phone 344-3561 Supervisor License Number 10925 Expiration Date 10/01/03 Constr. Contr. Number CC890200 Expiration Date 3/17/07 Signature of Supervising Electrician Owners Signature: Inspection Request: 726-3769 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 B. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsIV olts Reconnect Only $ 63.00 $ 75,00 $125.00 $163.00 $375.00 $ 50.00 c. . Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps $ 50,00 $ 69.00 $100.00 0:,e000 Ampsor.IOOO Volts see '.B'. above, . D, ' Branch Cireuits L(J $. TOTAL Shared Drivc(T:)/Building Fonns/Elcctlical Pennit Application 1-03.doc ~- . . City of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-37691nspection Line PERMIT NO.: ELE2003-00101 ISSUED: 4/9/2003 APPLIED: 4/9/2003 EXPIRES: 1019/2003 SITE ADDRESS: 4095 MAIN ST ASSESSOR'S PARCEL NO,: 1702314104500 Springfield TYPE OF WORK: New TYPE OF USE: Commercial PROJECT DESCRIPTION: Add extend 2 circuits OWNER/APPLICANT: PIZZA HUT INC #857 FG INC % SA V AGE SA V AGE & BROWN OKLAHOMA CITY OK 73123 ELECTRICAL CONTRACTOR: EUGENE ELECTRIC SERVICE INC 541-344-3561 120 MONROE ST EUGENE OR 97402 CCB # 90200 Expiration Date: 03/1712007 Descriotion Amount Paid Date Paid Reeeint Number + 10% Administrative Fee + 7% State Surcharge Add. Alter. Extend Cire Add. Alter. Extend Circ Ea Add 4.60 3.22 43.00 3.00 04/09/2003 04/09/2003 04/09/2003 04/09/2003 1200200000000000974 1200200000000000974 1200200000000000974 1200200000000000974 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. ReQuired InsDections: ....0 1 Rough Electric: Prior to Cover :,\0'> .#, i:? 2 Final Electric: When all electrical ,,:,Qfk ~~fllP.rretl:: " ~ ~ qj !If- ~'Q By Signature, I state and agree, that I If.l~.ei~reftfujl~~<<ti~~e completed application and do herehy certify that all information hereon is true and co~,,~ iif$~tr.f,,(!;~rt.!lY t!l8t any and all work performed shall be done In accordance with the Ordinances of the Cily of Spr' ~fl:!.ih!l!I.~s,~e1State of Oregon pertaining to the work described ~ll;cein. I further certify that only contracto~s p+ifl~[~e1bw<{leia\!9zln~. ~~!iance with ORS 701.055 will be used on this,~'1~c~i further agree to ensure that all required ~#0~)i~1emt'l;st~ ~)Jw.'llroper time, that each address is readableJr~t~'ilWeet, and that the approved set of plal1~ ~ii1js.ai\~'w!..II-~~~~e site at all limes during construction. R--~ ~ ~'\ <;)~ ~<v~ ,~:~~~~~i!>~0"~:'($"J~ .\" ~~;:S ~~~~~'V ~ ownerorContracto\~~r~.,r~~-0cl" 0J....;v Dat~. ;\S~~~~'<' ~'Q,?-\... ~~~;~$,t#~'~ ~~~~~~ <;)~~<;)'V. <:s ~,>{f- ,?-,:>'\ ~~~ 'V~ \J<;)~ '\ 'tJ<;) ,?-~-4" Page I of I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number ELE2003-00101 ELE2003-00101 ELE2003-00101 ELE2003-00 101 Payments: Type of Payment CreditCard Paid By Description Add, Alter, Extend Circ Receipt #: 1200200000000000974 Date: 04/09/2003 Add, Alter, Extend Circ Ea Add + 10% Administrative Fee + 7% Slate Surcharge EUGENE ELECTRIC Received By Check Number Confirm No djb 000040 009832 Page lofl 4/9/2003). 1O:1l:36AM " City of Springfield Development Services Department Public Works Department Official Receipt . Amount Paid 43.00 3.00 4.60 3.22 Line Item Total: $53.82 How Received Amount Paid In Person 53.82 $53.82 . Payment Total: cReceiptrpt