HomeMy WebLinkAboutPermit Electrical 2002-10-14
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'/ 225, FIFTH STREET: ' ' '\ : '
'"SPRINGFfELD, OREGON 97477 ;, ' ".J
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'C' I ,INSPECTION REQUEST: 726,3769 - I
" " ',I O}:FICE 726-375?" 'I : \ " i, ! i ,.: I
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\ "':' 'I. LOCt\TI~)NOF~S1;ALIlrION r ~ l:
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( PyOC;~'" i+i rl<.l:)t~ S:~Yu\~'<.C's L-L.q.
LEGl\L DESCRIPTIO~ 7.
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i, '.- ELEeCAL PERlVnT APPLICATION .'
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l. ; :Cl;y Joh ~u~lierei ~ :;i00 2.-1(-- {J~/13
, :3, .COMPLETE FEE SCHEDULE BELOW
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~': N~w'Rc;illeutial-Single or" -., - --,- -' ,
Multi-Family per dwelling unit, .
Sen'iee Included:
JOB DESCRIPTION " c' as submitted has l/1Jdel~iI',%r less
W', "'~'f'S.S "')ee"" '1~~~o~~e ".qUIte specificE:\l~~l ~flaitional 500
, approval. c..- (I sq, ft or pOI}lOn
Permits are non-transferable and expiz:Sning ~ ' l;tereOl
if work is not 'st"ncd within 180 days It,-It{-o Z. 5;IOL r.I.."urd Home or
of issuance or if work is susp~u ;VI , cK.J Modulor Ull:clling
180 days, Mthor/zed Signature Service or Feeder
Items Cost SUIll
$106,00
$ 19,00
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$ 50,00
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City!"
Phone
2, CONTAACTOR INST ALLA TION ONLY M B. Services or Feeders I
" Oriel Installation, Alterations or
Electrical Contracto~ f-I6b1J--( See. v....~"lNts p : Relocation: / " ,
) , /J A.tlii-t eRA/II,: "
Address..:.!j(-.,' Jr 1C.C..l2"... lln'fOA/ ORI2ErlrliJt.wl qr less' _ $ 63.00 ~
. ',I , (J / ,A:AtvlffNC 2f:1~/~pP1 ~1Iir',p.s _ $ 75.00 _ '
City'& *...",,;~ Phone L/Jd-q b~:7rlJOD E~iJ):,\ 2ll1jJ'S t~P,QOti)!.l#Srf!f w. _$12500 _'
~ \ \ / ',A.r-,LJl9) mn%W~IOOO,al1,Ijp,r OR/(_$163.00_'
Supervisor Licen~e,INumber, f ~::2.l,~.!L EA . t/ifiDlJl,go aK1!l~15 IS NOr _ $375,00 _'
I \, ., " Reconnect Onl)' FOil ,.' $ 50,00
Expiration Date /0 - c I - 'ZO'O , 50 '.,',' ':,,'
r.. , ".C" TertliioraQ' Servicesor Feeders .
'-Constr ,Contr. Number b q '7'~'l5r., /; \,." " ' Installation, Alteration or Relocation
"- -,~,-- J9I!o~-V/'Otv'0_ ",
: ....Expiration Dnte /6--- . 0~f/~~; 'I'" II..... ;4(:ir,;~I.JO(, 'q,~ ~qR amps or less .
I O~/.; ,''-'<.......'''' 13" ~r, '1'l2tJl1illnps to 400 amps
.:, ~Sign.~turCOfS pcrvisingElcct?Jtiall :I"~,.!,,/ 1.,;:<~----~I''''''''i06~&~j;~O%~9~0J3nips "
~ 'Illlm .., If) ~"tf(11 vert600,amp~ior 1000 volts see
, ""'- P {!''it- '-1.. JO~IB'" b )f!l '0 - -..... ~
" ' .. 7'Jbl'!rl ,~",,_' . '0'", a ove" rth --,-.
""11 "\ ,.... It i~..::Jc~001
~ "'0 "up' (hi::; tJ. \
A . V"'''I rsOo I"", ,r IIOSb )
, . 7)i '_ "~.!:' '_ D!j'~I'i"'clf/9t~f6"rs Y , '
Owners Name ~tfJ/ /VI (~ Jtl)t., h?,;~lotiHBIG~On or E~tension Per PalleI
"..........,.. .a44):.'1 i:illOn !
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Address On~,Circuil
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OWNER INSTALLATION
The installation is beip.g made on
propeny I own which is not intended
for sole, lease or rent. '
Owners Signature:
)t!f;tp~2 ~
$50,00
$6Q,OO
$100.00
$43,00
Ea6h Addition"1 Circu\t or with Service
or Feeder Permit $ 3,00
E. l\Iisccllancous (Sen'ice/feeder not included)
-Each instollation
Pump .or irrigation
Sign/Outline Lighting
Limited EnergyfRes
Limited Energ)'/Colllm
$50,00
$50,00 '
$25.00
I $45,00 f J~
I\'1inimulll Electric Permit Inspection Fec i~ S45,nO + Surcharges
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
80/0 Administrative Fce
4S"~
, 1/5
7{,'tJ
\/,7;-
TOTAL
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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 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2002-001l3
10/14/2002
10/14/2002
4/14/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO,:
2140 MAIN ST
t703364202700
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Commercial
PROJECT DESCRIPTION:
Wireless Security System
OWNER/AI' I' LI CANT:
PARAMOUNT CENTER LLc
PO BOX 26125
EUGENE OR 97402
ELECTRICAL CONTRACTOR:
GLOBAL SECURITY 541-461-9657
46 IRVING ROAD
EUGENE OR 97404
cCB # 69705 Expiration Dale: 10/01/2003
,Descrintion Amount Paid Date Paid Receint Num her Cashier
+ 7% State Surcharge 3.15 10/14/2002 2200200000000000057 dim
+ 8% Adlllinistrali\'e Fee 3.60 10/14/2002 2200200000000000057 dim
Low Voltage - Commercial Indus 45.00 10/14/2002 2200200000000000057 dim
To Request an iospeclion call the 24 hour reoording al726-3769. 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 Insncctions:
1 Low Voltage: Prior to cover.
By Signature, I state and agree, that I have carefully exalllined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Onlillanrrs of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certify that fIllly contractors and employees who are in compliance with ORS 701.055 will be used on this project I
further agn'e to en,ure that all required inspections are requested at the proper time, that each address is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction,
Owner or Contrnctors Signature
Dale
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