HomeMy WebLinkAboutPermit Electrical 2003-3-18
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CITY OF Sl _.INGFIELD, OREGON .
hmltted has tha tollowlng
. . Ire spaclfic land usa
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ~ FA1{: (5~..)m~6~qu
ELECTRICAL PERMIT APPliCATION approval. I ~(L.
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City Job Number c/ E,.).m) '3 -OOD 7.J...- Date ~ - I Lf - 0 ?,..~ _ ~_('$",o cr:;0
l. :'ioCATIONOF INSTALlATION --.--: 3, L C~JM~LETFA;:EES(]~ED'~HJ;~OW ~ __ .
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LEGAL DESCRIPTION
17. 03'..2.(., . J I . ,.". qJi)
JOB DESCRlPTION
f ~ . C 0>111. c:: <.__.,.~--
A. New Resi~e.nti~ -:- ~in,I!Ieor Multi-Fanlily.per dwelling unit.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Permits 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" INSTALu.iJ(iN!:,!~Ly'~
Electrical Contractor a~" ;{)rPa! ddJ (""
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder
$50.00
B. Services or Feedcrs - Installation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps.to'IOOOAmps
~d"-J- .2Jfn ..", 'v', , ,\. Itl" -
Phone '72f'J" ",lvyu"2mJ0.90,.A:i1iPs!y'o\ts
" ,,'.'~' "teO \Reconnect-Only ~V' 'J
1"" - I.11e5 adO" ,\1U5'- \u.'.' , ,',', -JS'.1.-\, .
J.9\IU~"1 G,"\ltel.,~~~),\, ',c"
Supervisor License Number ,3 f) 7 ~.tlt5~t\O~. ')"'\-00 G!j2"~~~~~~~eedersu_
hr\~""''''' n"'~h'\"-\' ....-~el--\....
in 0... I 1113.)' 0 \, 'Mf)\~'. '.'. I:; \. ';"r.~\\C'-.
/ tfJ - 2 2-- o.\~O. 'i OU ,~., center .InstaI'~1i~~; Alteration or Relocation
calll\ 1\0'. 'I' : t\'l2 O!l2o~).;;;ps o'rle~'\"
3 belO. ..' ",,".-
Constr. Contr. Number ;13'9' 1) flU'" ~~r\f'\ I? '201 Amps 10 400 Amps
40 I Amps to 600 Amps
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
.........-- $ 50.00
."n .VU
Address pJ;:;- Fox JIn (hw I> 1
City ~..,-c
Expiralion Date
Expiration Date
)0 - (/ I - 0 '7
$ 50.00
$ 69.00
$100.00
Over 600 Am~s or 1000 Volts see"B" ab"-,,e,~
Sign/atU1;1ve 0 ..u'M-7Pervisinpvg Ele?fClrirg:.C~ian D, i Branch Circuits ... ,._.
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuil or wilh
I I I Service or Feeder Penn it $ 3.00
Owners Name 5t-~f/u--. hf()I/S~
Ad~~\~~. [)\\1p" ~I( ~ E. , Mi;;~llan~ous (Servic~/feeder not included) -Each Installation
City ~_~'CIO'!"P;:' Pump or irri~lion $ 50.00
THI~ PERMIT SHAll EXPIRE lligbMfi1l1ilJ;Jl~ting $ 50.00
OWNER INSTALLATION AUTHORIZED UNDER THIS Plil~MIJdl~WNlResidenlial $ 25.00
The installalion is being made ~[j)MPA&YlC6,Q,QJi\i~ ABANDQ!~Re5~\krgy/Commercial $ 45.00
is not intended for sale, lease or Am 160 DAY PERIOD. Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
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ef).. ex)
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r;;~
56.~
Owners Signalure:
4, . SUBTOTAL OF ABOVE
7% Stale Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(f:)lBuilding FonnslElectrical Permit Application I-03.doc
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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.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00072
3/14/2003
3/14/2003
9/14/2003
SITE ADDRESS: 1278 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703264113500
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Residential
PROJECT DESCRlPTION:
Reconnect
OWNER! APPLICANT:
HOUSER STEVEN B & DENISE A
11640LYMPICST
SPRlNGFIELD OR 97477
ELECTRICAL CONTRACfOR:
NEAL INVESTMENTS L TD 541-485-2472
4715 FOX HOLLOW RD
EUGENE OR 97405
CCB # 93953 Expiration Date: 10/22/2004
Descriotion
Amount Paid
Date Paid
ReeeiDt Number
+ 10% Administrative Fee
+ 7% State Surcharge
Service Reconnect
5.00
3.50
50.00
03114/2003
03/14/2003
03/14/2003
2200200000000000595
2200200000000000595
2200200000000000595
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.
,Reauired I nSDections:
1 Final Eleclric: When all electrical work is complete.
By Signature, I state and agree, that I have carefully examined 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 Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certify that only contractors and employees 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 the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction,
Owner or Contractors Signature
Date
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1 of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.e Items:
Job/Journal Number
ELE2003-000n
ELE2003-000n
ELE2003-000n
Payments:
TWe orPayment
Check
.
.
,
Paid By
Description
Service Reconnect
+ 10% Administrative Fee
+ 7% Slate Surcharge
GLEN NEAL ELECTRIC
Receipt #: 2200200000000000595
Date: 03/1412003
Received By
Oleck Number Confirm No
lkw
4495
Page I of 1
3/14/2003
9:15:39AM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Amount Paid
50.00
5.00
3.50
Line Item Total:
558,50
How Received
Amount Paid
In Person
58.50
558.50
Payment Total:
cReceiptrpt