HomeMy WebLinkAboutPermit Electrical 2003-5-14
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225 FJFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPUCATION
City Job Number ~zco"3 -00 il '-I Date
Electdcal Contractor 11, 'LJ 8/' J,- ~ ( .:J'",c. 200 Amps or Jess $ 63.00
201 Amps to 400 Amps $ 75.00
401 Amps 10 600 Amps $125.00
601 Amps to 1000 Amps . S16~.QO
Over 1000 AmpstVolts $375.00
.'.Reconnect Only . ". '0" ,'. . t.. . .., .." $ 50.00'- ..
,," J?~'~~~;~~.i~~~~is;;~1~~~i~;.fi,:t~~~l~;;k ':::\' ;:'::.-'." :...'
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Installatio'1f.4I~ratioD:or Relo~tlOn 0.9"::J'2.: '.;::"
.........~~)..:.-."'aO\"';'"t\\Osel~. Op..,. I"'C;"'" -.
2QO,Allj:psJlf;JeSS -'el. ....IOIJ.9'" .......,IBO.OIl
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2QJI~!,lPs.:t9(4oo J\n;!~J. o~ieS . _1"~S\69\:qs>,,
~b~fs,IO:6W~S)\e.\{\ ~'O\6" \"''' :'~,,\\$160~00
OIXI"' w ......e.'i ~ ~. ,\... ....1\1'1 ' .
cAAr 600 fl~s'oi-,1000~Vol~ 5lle \.'B" aboVe").)'
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Onecirc~HIS ptRMIT SHALL ~~~~ IF.TJ:le..wGl~_ eS--
EacbAddA\ili!~~tUmlER 1M!;' FE~~'S1(e-:'
V OwnersNam:s~&A~ J~, ~(\o)l. S~:~~M~~.OR IS AR.~~.~~~Ll~~.m
t ...... .....ANY1~'(PERlQO.."C...... "" ". ................, .
Address JI~ '7 r -'7;l' -... s r- E. ':~~~~~~~!I,~~;~;?~:,....:):.:~~t~;#t~~Hiif1~~~iQ:~~~;~;~fu~~~~i:
C. v. ~ ~/..-./J Phon6''I / - 7'3?- ') H J Pump or irrigation S 50.00 .
~ Sign/Outline Lighting S 50.00
OWNERlNSTALLATION _~._.._ ..._ _._..' Limited Ene:gylR.esidential . $25.00
The ;;";6Iiati~;'i.< being made on,properiy I own which' u.:mted Energy/Com'mci-bi'aJ-,' ,-'. '. $ 45.00
is not intended for sale. lease or rent,--.--'-.-. ----
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1. iiUJCA1'lOivOJiiNSTA.LLATION' ... . ....
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r.EGIA7LODE;C~Z~N.L.. I
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JOB DEsc:B.IfnoN
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Permits are non-transfera bIe and ~pire if woek is
not started within 180 days otlssuance or if work is
Suspended for 180 days.
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Address ;< 9?R9 H w,- -:J c.j S ~
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Cirj AI h;;. IA ci Phor$t//~ 7S''I-~/1 /
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~'tP".rvi~~ L~cens: ~'-"'r~5ri ,~.Io_ 04 - .s
ExPfralio;Dai"/jf5' :.:.{jy;:5:.."O''I':'" '--.;
Conslr. Comr. Number Cc?'3 b 1..-
Expiration Date 0 to -} 9 - 0 "3
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Signature of Supervis'
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Owners Signature:
Inspection Request: 726-3769 .
5;/1(/03
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Service Included
1000 sq. ft. or Jess
Each additiona1500 sq. ft. Or
portion thereof
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
Minimum Electric.PenniUilSp'ection.Fee.is S4S.00'+Snrchargcs '.';.- .
4. ;i,~~~~t~:~f~~~lli~~~0:,r;~;~II~ij1L4:l~~.~
;% Slaie SUrcharge '. .. - 37'5";, .. ';'0 r
10% Administrative Fee ~ tt ."30
TOTAL ~ ....so-3.1
Shared Dri,o(T:YBuilding FoiinslElcctriCiil Pcmrit AJlPlication l-03.doc
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SPRINGFIELD
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225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726,3753
FAX (541) 726,3689
www.ci.springfield.or.us
May 16, 2003
David McFarland
M & W Electric
29889 Hwy 34 SW
Albany, OR 97321
Dear Mr. McFarland:
Yesterday, May 15, 2003, our office issued two electrical permits to M & W Electric.
Unfortunately, the permits that were issued did not have your original signature on them
as required by Oregon Administrative Rule 918-309-000. Each electrical permit is
required to have the signature of the signing supervising electrician. We cannot accept a
stamp facsimile of your signature for permitting purposes.
Please sign each of the enclosed permits and return them to me in the self addressed,
prestamped envelopes at your earliest convenience.
If you have any questions, please feel free to contact me at 541-726-3790.
Sincerely,
.
Lisa Hopper
Building Safety Supervisor
cc: Dave Gadomski, Electrical Inspector
David Bowlsby, Building Permit Review Technician
Dave Puent, Building Official
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To Requesl an inspeclion call1he 24 hour recor<Un~~7~46~'1~2<.\\\1l inspections requesled before 7:00 a.m. will be made the same
working day, inspeclions requested afterYJOO\;;'m,\wilrbe\]l1~de.the following working day.
0\' X\e~ ~\'O ~Al~
,,(e~ . "'~ "I .\",S..., 0.'3 . ~ '0>
~\O\"'" ~W~ ose" X\ or' e 1\)'- 13
Reuuired InsJ?ectiohs:,c, ~oO\el.~~ \X\\olJ.~ ~ 0\ \~ <lX\0~. O~
1>,1'- -W' ,..~r>' ,\0' 0\13" \13\0.... e.\\
1 Rough Elec~ls:t-IPneNo,eO{.e!';) . r> cO... . \X\e .,:;"O\\\\C
2 F. lEI \(\ ..,,,,\\ all"\ll '~'l:(l.\ -",..\13, "I't
lOa ecthc:~\nuen:.'e ectnca wo,..,\s'comp e e" 11,').
~o' F>-W"w ll'e.~ ~~\el-'': o{\ V"'1.7..?>or
By Signature, I state.Pnd.agr' "j;~ ,tha(.r'have:c~refullY;€xamined the completed application and do hereby certify that all
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information hereon ul"triIeo.8ni\t.corre'ct, and'l'further certify that any and all work performed shall be done in accordance with
the Ordinances of the Ci!j. ~f;Sp~fuglieid hnd the laws of the State of Oregon pertaining to the work described herein, I further
certify that only contracto'irand imployees 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, that each address is readable from t~~~t, and that
the approved set of plans, if applicable, will remain on the site at all times during construction. ,0'" W i\'\f. ~'Oi
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
4175 MAIN ST
1702323202500
PROJECT DESCRIPTION:
Add 1 circuit
OWNER/APPLICANT:
GABRIEL HERBERT F TE
1023 LEONARD AVE
OCEANSIDE CA 92054
Descrintion
Amount Paid
+ 10% Administrative Fee
+ 7% State Surcharge
Add. Alter. Extend Circ
Minimum! Adjustment Electrical
4.50
3.15
43.00
2.00
Owner or Contractors Signature
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City of Springfield
Electrical Permit Attachment
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00124
5/14/2003
5/14/2003
11/14/2003
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Commercial
ELECTRICAL CONTRACTOR:
M & W ELECTRIC INCORPORATED 541-754.6171
29889 HWY 34SW
ALBANY OR 97321
CCB # 67362 Expiralion Date: 06/19/2003
Date Paid
Receint Number
05/14/2003
05/1 412003
05/14/2003
05/14/2003
1200200000000001190
1200200000000001190
1200200000000001190
1200200000000001190
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
ELE2003-00 124
ELE2003-00124
ELE2003-00124
ELE2003.00124
Payments:
rype of Payment
Check
5/14/2003
SPRt~'~~F.!.~'___._.'I'
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City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 1200200000000001190
Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum! Adjustment Electrical
Paid 8y
M & W ELECTRIC INC
2:37:36PM
Received By
djb
Date: 05/1412003
~
Amount Paid
Item Total:
4.50
3.15
43.00
2.00
$52.65
t:heck Number Confirm 1'lo
.
How Received
In Person
Payment Total:
Amount Paid
52.65
$52.65
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cReccipt.rpt