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HomeMy WebLinkAboutPermit Electrical 2005-3-28 EC 00 0 1 Job NumberCll/7?;;)(e- '" 3 7S ELECTRICAL PERMIT - CONTRACTOR INSPECTION LINE: 726-3769 City of Springfield Fax Line 541-726-3676 225 Fifth Street Electrical Inspector 541.726-3663 Springtield, OR 974n General intormation 541-726-3759 [I] Job Address: d J 'Ill rrllLin sr. Owners Name: ~/7 lfd+- Oat'.. 3-;:1i?'-oS Pescription otwork:~ ;nh'j I COMMERCIAL)al RESIPENTlAL a INOUSTRIAL a PUBLIC a [g] Electrical Contractor: C-'!: ~ f;t~tJ;::'e-~. Supervising Electrician Signature: \ .'~~" .J2--- Supervisors License #: lft3(lfl S Expirea: } 0 -} -0 7_ Construction Contractors Board #: 7K1.f 1 Expires: _If - / - CIa THIS PERMIT IS NOT VALID UNTIL SECTIONS I & 2 ABOVE HAVE BEEN COMPLETED AND SIGNED BY THE SUPERVISING ELECTRICIAN PRIOR TO AN INSPECTION BEING REQUESTED I INSPECTION TVPE I TEMPORARY I UNDERGROUND IUNDERSLAB I ROUGH I SERVICE I lOW VOLT.&(jf I MANUF HOME SEIMCE' I MANUF HOME CONNECTION I SIGN I I FINAL ApPROVAL DATE INSPECTOR yo. T /- ty;:;'- .P kL ~'f'_. I I I TO BE REMOVED ONLY BY BUILDING OFFICIAL r, ~ I 0 SENDER: Co~1~;J2. 3~ ~ 4. ;.' 3 Add your address in the "RETURN TO" space ~ I on reverse. ~ (CONSULT POSTMASTER FOR FEES) l!J I" The following service is requested (check one). O)Q(ow to whom and date delivered .................... _t o Show to whom, date, and address of delivery" --J 12.0 RESTRICTED DELIVERY -J , ) (The restn"cted dt!li~ry f~ is cluJrgcd in addition lD the ntum rruipt I~) TOTAL n 1 ARTICLE AQDD~~ TQ Mr. John Akin 4982 Jasper Road Springfield, Oregon 97478 iii .0 TYPE OF SERvtCE: ARTICLE NUMBER g 0 REGISTERED 0 INSURED _:!i D-~.~~ 0 coo I o EXPRESS "".. '" S I (Amayo obtain u1gnature 01 add_ or agent) I ~ I have received the article described above. ~ ~ SIGNAT'W~ 0 A~dressee, ,0 AUlhO~ed agent . XL rA~~ /~ I DATE Of;;;;;' 6 I!IQA /;(:,;-:\ "I. ~ "AD_~.'DDRESS(~....",oI) (( I.l: toQ;')' I '" \. ""'I' g ,\.': "', ~ ,; : "" 7. UH~ TO DEUYER BECAUSE: IrA. Et:CPLOYEE'S m IN~ '" 0: ~I OI.ru~~ '" ~ '" z UNITED STATES POSTAL SERVICE OFFICiAL BUSINESS SENPER INSTRUCTIONS PrInt your name, address.ancl ZIP Code in the space below. . Compltlt Items 1, 2, 3. and 4 on the reverie. lltIdItofrontofartldtltapaClpennlts, othn!II aflll to back of article. Endllno tItIcIe "ReIlJm R"'~t Requested" adjaceot to number. RETURN ..-. TO T PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE. 1300 ~~J . '" ..... (Name of Sender) CITY OF SPRINGFIELn :;~r-"... M"'-l\{I;t$Jl'oF>f/l'!l.'lt!!'lwoRKS 225 NORTH 5'h STREET $PR'NG"IFI" _,..,c<,:~.) ~-"'77-(City. State. ana ZIP Cooer