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HomeMy WebLinkAboutPermit Electrical 2003-2-18 1. LOCATIO!,! OF INSTALLATION ,"II /8791 flOV/(t' Y fk !UIA F-. _ A: New R~il1e'ift1'lll-Slngle or ) .\\.0 "",s'c MilI'if-Family per dwelling unit. :o1fl' eC\\ . eS s\} "le!;oQ Service o z.. '?ot ~~\~~a\ ,.<I"' \o\\O~'(:;; OOl:P ~"e e.{\ J~ DESCJUPTION vp'''\,,\ -/jJ 1 ~ I a.Y mum a~~,a 1-0","11 Permits are non-transferable and exIW.!\. '=>'11"0"". if work is not started within 180 days """,e" of issuance or if work is suspended fof"< 180 days. ~~A.AA~ Owners Nam; YA,-y ~'c.,~' '-- ~;wB;~::a~;~r:ru~~tension Per Panel Address /63 I IJIIJt"Z5r ~<L . rE~'\'1Gjr.Rl!i~e90n law reqUires ~~~i~i~y1i43.00 _ V / C A AT ul s adopted by the Ore~o~ c::p.llortl' City I c;.tr>. IJ.. Phon~c5fo\lOWHacW Adffitwnal'~uit'o~3NithfServit'bn.1 . NotiIiC!l1l<F?e'dff llWih through OAR 952- -$ 3.00 OWNER INSTALLATION inOAR952-~ 1- ~~incopieso1thermesO"Y - The installation is being made on 0090. \E)llVli~~lilI!,e~us (Ser.v!!,\~r!lid~i'hio'ilfneluded) I hi h. . d d \I'~"""''''~ ~"r.IIP, ""'\"0. '1' t',on property own w c IS not mten e ca h~n:msta atlOn Utility Nott Ica for sale. lease or renl. numl!/!J1$Jor.'iiTirafi~~0~332_2344). _ $50.00_ Sig@'~tline:'L1glililig _ $50.00_ Limited EnergylRes $25.00 Limited Energy/Comm I $45.00 45 00 . 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 LEGAL DESCRIPTION _i70'3 Z6Z:s 2. CONTRACTOR INST ALLA nON ONLY Electrical Contractor ADT Su.ur- .. ty Address 2~ I ~ SIJI?~!:! Of". City. Bl!/lIle.dOl/\ PholleS03. Ii"- 7/00 Supervisor License Nwnber :zgq Lx A- Expiration Date It) ~ 1- O~..- Constr Contr. Nwnber S't 4f 4'1 Expiration Date 5- 7- 05 Signature or Supervising Electrician Owners Signature: .v~+OlV\er# 2-83-035oo-01/CZ ELECTRICAL PERMIT APPLICATION City Job Number..E:u;.~ZOO3. ...0'00 Z b 3. COMPLETE FEE SCHEDULE BELOW Items Cost Sum sq.ft. s ac ItionaI 500 sq. ft or portion thereof Each Manllf'd Horne or Modular Dwelling Service or Feeder $106.00 $ 19.00 $ 50.00 B. Servlees or Feeders Installation, Alterations or Relocation: 200 amps or less $ 63,00 201 amps to 400 amps $ 75.00 401 amps to 600 amps $125,00 601 amps to 1000 amps $163.00 Over 1000 amps/volts $375.00 Reconnect Only woAA- $ 50.00 I-\OilCE' ~~IRE IF 'THE,. - S pt.~lA\I[e/il\l~a~y: e ~1~\qrJN'i<Wet~O 1\1\ o~nft'Ultfjjl,!1fJiJ ,t1\l!l)~~~~lon p,\)1\1 \ 1=1 OR IS ABM~UU COMME2llO~~~~\\<;1~ I\N'i 1MDij)~~0 Ji'Oo~mps - Over 401 to 600 amps Over 600 amps or 1000 volts see "Btt above $50.00 $69.00 $100.00 Minimum Electric Perlnlt Inspection Fee Is $45.00 + Surcharges 4. SUBTOTAL O~' ABOVE 7% State Surcharge (01'. Administrative Fee 4S.00 ~ 5 a.bS TOTAL . . 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: ELE2003-00026 2/4/2003 2/4/2003 8/4/2003 SITE ADDRESS: 1829 PIONEER P ARKW A YEAST ASSESSOR'S PARCEL NO.: 1703262302301 Springfield TYPE OF WORK: Addition TYPE OF USE: Commercial PROJECT DESCRIPTION: Security system OWNER! APPLICANT: PAN PACIFIC RETAIL PROP INC 1631-B S MELROSE DR VISTA CA 92083 ELECTRICAL CONTRAcrOR: ADT SECURITY SERVICES INC 541-736.4973 PO BOX 5035 BOCA RATON FL33431 CCB # 59944 Expiration Date: 05/07/2005 Descriotion Amount Paid Date Paid Receiot Number + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus 4.50 3,15 45.00 02/04/2003 02/04/2003 02/04/2003 1200200000000000648 1200200000000000648 1200200000000000648 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 Low Voltage: Prior to cover. By Signature, I slate and agree, that I have carefully examined the completed applieation and do hereby certify that all information hereon is true and correct, and I further certify that any and an 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 ouly contractors and employees who are in compliance with ORS 701.055 will be1used on this project I further agree to ensure that an required inspections are requested at the proll.lllJtime,'tIiallea'Cii lilllir8s is readable from the dh h cd fl 'f I' bl .11......""'ulli".J!o1:j.aI..;.. ...,..._~I'~lIli"I\l . street, an t at t e approv set 0 pans, I app Ica e, WI 'remam on !lSlte!!'t . "mes.uur.ng construction. 10\loW rules a "I." U ~ lS~'r'U\eS are set fortr Notification cent~~.:.h.~__..~h nAR 952-001' Owner or Contractor.; Signature O'r-'t.. in OAR 952-ul[jai'e'~' ': '~;pies 01 the rules Oy ,\,\t. 'l'l ~ 0090. you may 00 alO te' the telephone ~. \. t.'1-'i'\'r-t. ~'r-~\' \S ~O calling the cen6r. ~~~ Utility Notilication ~Q1\~t.~~\' S\'\~\'r- '\'\\~~o~t.\) ~Q'r- number~~~~:~iS ~~800-332-2344). ,\,\\S \'\O'r-\lt.O \) O'r- \S t>.'O~ t>.\)i ~'t.~c,'t.\) 't.'r-\O\)' c,O\-l\ '00 Ot>.'l 'i' t>.~'l \ 1 of 1 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number ELE2003-00026 ELE2003-00026 ELE2003-00026 Payments: Tl1'e of Payment Check Paid By ADT Description Receipt #: 1200200000000000648 Date: 02/04/2003 Low Voltage - Commercial Indus + 10% Administrative Fee + 7% State Surcharge Received By Cheek Number ContirmNo djb Page 1 of I 2/4/2003 \ I :50:25PM City of Springfield Development Services Department Public Works Department Official Receipt . Amount Paid 45.00 4.50 3.15 Line Item Total: $52.65 How Received Amount Paid In Person 52.65 $52.65 . Payment Total: cRccciplrpt