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HomeMy WebLinkAboutPermit Electrical 2003-5-21 . ..\;." , CITY OF f-'~INGFJELD, OREGON. '. . '. ~ :=:=: (\~'. O~. ;:;:; 225 FIFTH STREET 0 SPRlNGFIRLD. OR 97477 0 PR:(S4I)726-37S3 0 FAX: (541)726-3689 W~i \. n :.,:; ,.:, . ELELTJtlCAL PERMIT APPLICATION / '7 ' '" , Cil}'JobNumber aEiX:c}, 00 (y) Date s;l ,5/03 ) ;;;.r..v,~";~';-~':iT.'~-M"~_\l!U\" -'_!!i'~'"'' :~'oU';' '~::!!"'"T'i;;:i't.:-.AC4t-~"11~~~~g~;l!.r~~ I ,,'" " . '" , ,,-n, " . ;;;;.."""'",.!.J]ii'.,.....,..,.., . -.;&:I \7. . :r..: ,'l:::LJ,XL.V~~.~'''''':'''~'' _......., ;\"......~~.;'''''.;,:....,'''''''i:.....;.....'M.'', "'..-:...~._."',jl;"<:"',..:I~;;u",,.,,...i',"....., ..."r,;;...-.-.~~'._..,c..;1:r... _ ...=.. ,....~. ,,~...__~~= ......".......... I gOY Pi<:>.IIu/t Plc.-vv E LEGAL DESCRlP110N nOJZbZ3 02001 JOB DESCRIPTION P05 Cl:1..h/IA, Permits are non-transferable aDd ~ire if work Is not started within 180 days ofiSsuance or irwork is Suspended for 180 days. 2. ~~C;~1i~llif!1l1 Electrical Contractor Vy",.1 >(cft'L.'c ~Nv~ Address ~'iOY 5uJ f:fUt Auf. City P<H1.H"",,\ Ol'l. '11iNl Phone $"'<>) - ~-(,771 Supervisor License Number ;)s())' L~p Expiration Date 10 --OJ -(),J Constr. Contr, Number 6G7ql Expiration Date 65'-;;),/- 06 Signature of Supervising Electrician ~~ 'r r Owners Name ~l>A-1I4 ~1l.Y Address \=>0 &l}C 9~ '3 City ~0',4{) - /72.\..LS\ Cl4-Phone OWNER INSTALLATION The installation is being made on property I Own which is not intended for sale, lease or relit. Owners Signature: Inspection Request: 726-3769 . ""! ',,, ",' 3. ~i~1aZ~~~~i;:4?Jf!i!~f~~2i~~~i!:~~ri~1~~!\. - ~'-:lI:&~'--r.:r.;:::.::l~~ . '10:1..._....................,,;;.... A. .!lli,;;ii'i.',......., 'ia1i:i~:t.'(ii'i(-!M~t'""l!lll'i:l.~'t~:.iil,;~jj'ii:~i;';!',: ,~~~.-."::"~.~~~;.~4"~~:.~4~!f~:.~~o;:I~._-c ..i~~:l~1ft~; Service Included 1000 sq. fl or less $106.00 Each additional 500 sq. ft. or portion thC!rCof $ 19.00 Each Mauufact'd Home or Modular Dwelling Service or Feeder $50.00 B. ~~~~~l~~~W;Z'~l~~~~~@rl~!i.fi;~~;i;~~~~~&~~i{~ :w.-.!";;;::;:!..io~......t,:;~.HA't~.;:'..;"".~.,"~'''';:~l:.;.." ..";,~~~~,,~,~R~.~,, ~"~I'...,:..;;.Jt.;'1',...,., -~~''''''''''''''_'_'''=;___'''''''H' "'__..... . ___, ...._._ ~ .................... 200 Amps or less $ 63.00 20 I Amps to 400 Amps $ 75.00 401 Amps to 600 Amps S125,OO 60 I Amps to 1000 Amps $163,00 Over 1000 AmpsIVolrs ~(\~~ $375.00 Reconnect Only ~ '\~\ ,S ~I,)' S 50.00 c. F~lffirl!;:~q~~~:;...;r.-~,. '-'''\'''~~'~' ).;u '~';~~i€&~]:~~~~lH!~[&f.S;f;&fi~~ .\ll:iit!..,~.lI. ~'~"~~" ._.:.&:.:,: '",., . ;.\-I!....-..:.:....~.:\!.......ni:.~'.:lt~"'.~. "~""'I~-""~."'~'''.'' 1ns~~~~O~~A~~~~)I~eloca~o:- . .--'" - "-,.-.",-". <. ,~'O .~'(.. .A~ ~\l"J60~ps ot1ess{:> ~ S 50.00 ~~ ~'i'~~40~ ~'s' S 69.00 '\~ OFAr~;~lo,,~\1Ilps SIOO.OO '" ,,,,'f,'<; <;)r r ver6W?Amps or 1000 Volts see "B" above. D. : . ..~)J.-~";~~~~~~~~~~~ErJ~~;g~~~~~~~;~t~1t~~~~~t~~~fr~ 4. ,. '~'''''''~~~'.'!!I:l ..~'.,..I,"~'....~'",;Il;:.-"~"W...1?J;~...~.,.".,~..,',..-..,~~,,,..:li;;,,...,.,_.._..~...,""!'''.'...r.'...,.. -..... --......,,";;;j\ -.;..,....."'),~........-..,--~.,::- _.:'.,;I....._".....,...~.."."._,.."....,U"..R ". New AlteratioD or ExteDsion Per Panel One Circuit ~ 43.00 Each Additional Circuit or wi1h IOU': _,I Service or Feeder Permit . <>." 'l ,,~~3.00 1,\\)0' :\,\..) 1'(1" f~V\ ..t'\O ~\ \ _. ~'.""':"i5.;-..""~~".,.~..'l'~~1ii;""."~""~~,;~"~."=:~iiJi:f;;"'" E, fi!r:'~kl~~~~~~~~J!.~1..~g~~~K~~~,mJ~J~~ ,.v\~- 0 v' e ~\)' ()\" . ~ t\}\~ " Pump or irriglltion'" oo~\e "i,V,ps ~,,(O.'<;o _\ \'I"S'50,06'. ~(\ SignlOutIfu~ugI{'~S(\\et. ~ Cl \'<;o~ ~"Ie" - n \'sq'iJ:oo>\~ . p..' f\>'\V \....... f\() .~\.!_.. '_\'" ..'''\.'' Limil~~pner~~es!3~nrl~I~\\'-I \.,,\e: '::''1 ~l~'?O L.rnited ,,~,G /,,/]. .. Q, t.~ 'I' '"$'4-500 1 ....,ergy.'-Ummerc....,\e ,,,{\ _","" . ~..... n!':'" '.JOU \" ce\ ~,~\.2J !'\':"-' MInimum Eled:rie-Pcrmit'IDs~on Feiill 545.00 + SurchargC.9 . _('\v'l''''' ..'.(\\". ~ ,~\.\" ".. .\.. ~1l!'1il1tr.;;'j,;~ .~"" ,,?,~,~;;. 4 "N,j~~" .. . c, ,',., ""~~.' .... . ~~f:1F~q,,:~{f.1""'... ~.;,~.;;":'~.... I..{S-~ :w::,. '-t f.:L . 52. 6'~ 7% Stale Surcharge 10% Administrative Fee TOTAL Slwed Drivt(I':)IBuildiDg FormsIElc:ctricaI PcnnIt AppliCHrloo I.()JAoc .. '''''', ~- '- Status: Issued 225 Fifth Street Springfield,Oregort 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION: OWNER! APPLICANT: TABATA FAMILY TRUST PO BOX 943 CARLSBAD CA 92018 Descrintion, + 10% Administrative Fee + 7% State Surcharge Low Voltage - Commercial Indus . . City of Springfield Electrical Permit Attachment PERMIT NO,: ISSUED: APPLIED: EXPIRES: ELE2003-00130 5/20/2003 5/19/2003 11/20/2003 1805 PIONEER P ARKW A YEAST 1703262302001 Springfield TYPE OF WORK: TYPE OF USE: New Commercial POS cabling ELECTRICAL CONTRACTOR: DYNALECTRIC COMPANY 503-226-6771 2904 SW 1ST AVE PORTLAND OR 97201 CCB # 66793 Expiration Date: OS/21/2006 Amount Paid Date Paid Receiot Number 4.50 3.15 45.00 05120/2003 OS/2012003 OS/20/2003 1200200000000001270 1200200000000001270 . ~'i'200200000000001270 .,,'''' c\. v . \~~~ f.: I.A~ ,;\V 1...1" ',J To Request an inspection call the 24 hour recording at 726-3769. All inspections requeste<!\b~f<ge-7:0Q'a~.~.Ji'I!,be made the same working day, inspections requested after 7:00 a.m. will be made the following working;d;fy.\I'e. '0)'0" ~:' .,' ,,~;Y I) . ,,~~,...o'()i fOe' ",",,~~\ ,~~; '_\:\C~'..r"\~ ..),"'. .\.o~... .,\\'. ,0", .1'"1' ,. ~('~ ':'\t;,')-" Reoul'red Insuections'. " ,,}u ~,\, ",.....' ", '~,' ~ c'"=' \'-v \\.' 0\ ~v' "r, . ,\. JI C},' ~~{',r. -~;, ."" ,.~. 1 Low Voltage: Pnor to cover. \A' d~\"\ ,u\' :,\\' \" ~.:::.\ ~'t'\. ,,\~'~~ '~<~,:-'l' \O~ ,~.,x,,,,~ 0 ..,-:(. r'\":' ."'1,, By Signature, I state and agree, that I have carefully examined the cC!niji!t,ti'd ap'pilca.!ion',~na'~o.liereby certify that all information hereon is true and correct, and I further certify that"a~~@nd alnv'o~l<-~~r(oh~e!fshall be done in accordance with the Ordinances of the City of Springfield and the laws of the State ofOr.egon,pertahii.tg.tolhe work described herein. I further "'I .~"" ."'" ,'. certify that only contractors and employees who are in compliance with OR~,\7.ot055:Will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, th!lt~e~ch ~dress 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 ~o.'l-- Date '0Y.. ~v~\::,"\ ~-<.: ~{o Y..~~\Y..<?-t Y,\::'<?- ~\.\. \~S RJ\::'~ ~\rv~' ~\ S~~\::,Y..~ 'r~'r~ ,,'~ <?Y..~ 't,\::' C)<?- '\ RJ. ,.... '0\S RJ~\: x.\::' Y..~\S -<.: ':0\~ .\"y"~\J ~ <? ~ \)~'''' CO\) \::, \J 'r~..J.. '\ Page I of I 225 Fifth Street Spriogfield, Oregon 97477 541-726-3759 Phone Job/Journal Number ELE2003-00 130 ELE2003-00 130 ELE2003-00 130 Payments: Type of Payment Check 512012003 City of Springfield Developmeot Services Department Public Works Department ~ Official Receipt 'r- Receipt #: 1200200000000001270 Description Low Voltage - Commercial Indus + 10% Administrative Fee + 7% State Surcharge Paid 8y DYNALECTRIC 3:24:09PM Received Dy djb Date: OS/20/2003 Item Total: Amount Paid 45.00 4.50 3.15 $52.65 Check Number Confirm No How Received In Person Payment Total: Amount Paid . 52.65 $52.65 . Pagelofl cReceipt.rpt