HomeMy WebLinkAboutPermit Miscellaneous 2002-10-21
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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:
ELE2002-00121
10/2112002
10/2112002
4/2112003
SITE ADDRESS: 40th Olympic
ASSESSOR'S PARCEL NO.: 0000000000000
TYPE OF WORK:
TYPE OF USE:
New
Public
PROJECT DESCRIPTION: Traffic Signal
OWNER/APPLICANT:
CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD OR 97477
541-726-3753
ELECTRICAL CONTRACTOR:
LANTZ ELECTRIC 541-726-0659
4131 E STREET
SPRINGFIELD OR 97478
CCB # 84679 Expiration Date: 07/14/2004
DescriDtion
Amount Paid
Date Paid
ReceiDt Number
Cashier
+ 7% State Surcharge
+ 8% Administrative Fee
Perm ServlFdr 200 amps or less
4.41
5.04
63.00
10/21/2002
1012112002
10/21/2002
1200200000000000110
1200200000000000110
1200200000000000110
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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.
Reouired Insoections:
1 Electric Service: Approval required prior 10 utility company energizing service.
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 he 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 lhe 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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