HomeMy WebLinkAboutPermit Electrical 2003-1-21
OS/23/02 THU 08: 48,. FAX 5417'1 '89
CITY OF SPRINGFIELD
~001
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225 .r U' at STREET
SPRJNGFlELD, OREGON 97477
INSPECTION REQUEST: ,726-3769
OFFICE: 726':'3759'
1. LOCATlONOFINS'rALLATION
2355 YOLANDA AVE
ELECTRICAL PERMIT AF'PLlCATION
City Job Number I?l.-c2D03~ 0000 s;-
3. CO~LETEFEESCHEDULEBELOW
LEGAL DESCRIPTION
BRIGGS MIDDLE SCHOOL
; 703 ZY4'1
02200
A. New Residcutial.Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Swn
o'l'lW~
JOB DESCRIPTION \fU~(J)~~. or less
:':lIT<;''T'~_~~ mT'T'T l;''T' TlIT TH l;' ~.r"Ul;'P :o((\\\wo :~~acD~dditio~~l Soo
. ~s S\} '(e S~ sq. it Or po
. fi d' 'ee, ~\)\ th
PeJ1ll1[S are non-transtrable an expIrc, q ~(o~ (\0\ (e ,
if work is not started within 180 d~o'l'l\(\o ooes Q ch d Home OT
of issuance or if work is suspen1fe~\fIU ~\(\ . lar D g
, 1-0 \I~ ' 'q .
180 days. . e.~~(o -10(\\(\ e or Feeder
,.. ,-
2. CONTRACTOR INSTALLATIOtte 'q(\~\\)~' Services or Feeders
00. (\1-eo CO\ Installation, Alterations or
Electrical C~_ntrac::tor SCOFEILDf>..tl:.~CTRIC CO Relocation:
$106.00
$ 19.00
$ 50.00
Address PO BOX 2765
Expiration Dare --12 / ? 1 /0') .
:t'~..;-
200 amps or less $ 63.00
201 amps to 400 amps $ 75.00
401 amps to 600 amps $125.00
60 I amps to 1000 amps $163.00
Over 1000 amps/volts $375.00
Reconnect Only $ 50.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $50.00
201 amps to 400 amps $69.00
Over 401 to 600 amps $100.00
Over 600 an1ps or 1000 volts see
"B" above
D. Branch Circuits
" New Alteration or Extension Per Panel
One Circuit $43.00 43.00
Each AdditionalCircuit or with Service
or Feeder Permit $ 3.90
City EUGENE, OR Phone 686-8612
97402
Supervisor License Number '508-8
Expiration Dalc
10/1/04
Conslr Contr. Number 38702
Signature of Supervising Electrician
~
Owners Name~ SCHOOL DIST /I 19
Address ')?5 MILL STREET
City SPRINGFIELD Phone 747-3331
. ", OWNER INSTALLATION
TIle installation is being made on
property I own which is nor intended
for sale, lease or rent.
. U\O
tes'JO .'
. , Owners S~l{9.~Qe&\U\ 00 \l\\\\\'J
. N'.Utego \"e Qteg , set 10rtn
~n E.N \ \0 ,.... ..I')~\ed b'J _ J"J\A, sate orl')-f'lO'\-
r U\6S o.v 1'''o~~'' Op..t\ ~J-. W\./
\o\\O~ t. cent6t. tOU<}" tu\eS u,
NO\\\\Ca.~;_oo'\ _00'\ ~~"C09\es 01::9no~e .
\0 Op..f\ ~ou rna.'J ob\~. ~No\e'. ~~e NO\'\\Ca.\\OO
0090,. \"6 ceo\e nort \l\\\\\'J nA4).
. ca.\\\09 ,ot \ne Ote,=, OO-'3'32-Z,yr
ou~be{cen\eY\s ,\-8 ,
E. Misc.ellaneous (Service/feeder not included)
.Each installation ""
Pump or irrigation' ,t\~ 'NO\\ _ $50.00
i," SignlOUtlini' 'Ii' !ft'\~ \f :'\ \S ~IJ \ $50.00
l\O't\C ~~~ ~~~~~ rO~ $25.00
,\\\S ~t:~~';fO~~ ~~~O~t: $45.00
:\\\O~\l\.. I\S ~u
~IJ "F1~i6MU\iQ ~\~jc Permit Inspection Fcc is $45.00 +
CQ\'4\ ~f.
~~'{ '\ J1 >'. 0 C>
~. SUBTOTAL OF ABOVE -4-3"":"00
7% State Surcharge 3 . 15
)" ...w7o" Administrative Fee .,..-. 9'e ~ l.{.5""t:>
TOTAL
--5-l-;-7-S-
~~.br
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.: ELE2003-00005
ISSUED: 1115/2003
APPLIED: 1/6/2003
EXPIRES: 7/15/2003
SITE ADDRESS: 2355 YOLANDA AVE
ASSESSOR'S PARCEL NO.: 1703244402200
Springfield
TYPE OF WORK: Addition
TYPE OF USE: Public
PROJECT DESCRIPTION:
Install outlet in bleacher
OWNER! APPLICANT:
SCHOOL DISTRICT #19
525 MILL ST
SPRINGFIELD OR 97477
ELECTRICAL CONTRACTOR:
SCOFIELD ELECTRIC 541-686-8612
PO BOX 2765
EUGENE OR 97402
CCB # 38702 Expiration Date: 12/21/2005
Desc riotion
Amount Paid
Date Paid
Receiot Number
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum! Adjustment Electrical
4.50
3.15
43.00
2.00
01/15/2003
01/15/2003
01/15/2003
01/15/2003
1200200000000000557
1200200000000000557
1200200000000000557
1200200000000000557
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 am. will be made the same working day,
inspections requested after 7 :00 a.m. will be made the following working day.
~ '
Reouired Insoections: ~\'(eS 'l0~\~\\'l ~'\'
1 Rough Electric: Prior to Cover 'O-~ '(e6'(e~0~ se\ \0 r:J'\'
2 Final Electric: When all electric~e~~~~%1R~~'(: 9~?;fJ S 'Q'J
, , ~~ ~eO e '(\)\ O~,"' (\)\'0
By Signature, I state and al;;!~ ~a~()~'<j} v~~~~x~~n%d~~Pleted application and do hereby certify that all
information hereon is tfiil~~'\~~~R~t <:. ~~~l~~and all work performed shall be done in accordance
with the Ordinances of(e~~:~\~~~~~ .~~\Yle State of Oregon pertaining to the wo!:.ih~scribed herein. I
further certify that onl~~~~~a~~f~~~'P~\)\~~Qompliance with ORS 701.055 wi~~s~'d'N1 this project I
further agree to ensure't~'f'~(b\ti~~~~~q-iiested at the proper time, thatdVtcJi ,~~~~~eadable from the
street, and that the appr~~~~~~I\.~)5'~~te, will remain on t~e site at a~\!.iW~~d~~~ction.
C'lJ. 'f;)e(\O ~\e('\ ~\),,\\C't:. "t..\' S\\~ x..~ ,\\\S r;Jr:S~t..'0
o(\\)~ era . ~. ,?r~\'1\ '0 \~~'0 _ I\~~~
Owner or Contractors Signature ,\\\S \\(J~\ll.t '0 (J~ \~ ~
\\'0' ~t..~~t: ,?t..~\\) .
~(J~ CO\) '0\\'{
\\~'{ '\
1 of 1
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2003-00005
ELE2003-00005
ELE2003-00005
ELE2003-00005
Payments:
Type of Payment
Check
Paid By
Description
Add, Alter, Extend Circ
Receipt #: 1200200000000000557
Date: 01/15/2003
Minimum/Adjustment Electrical
+ 10% Administrative Fee
+ 7% State Surcharge
SCOFIELD ELECTRIC
Received By
Check Number Confirm No
djb
Page I of I
1/15/2003
2:30:44PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Amount Paid
43.00
2.00
4.50
3.15
Line Item Total:
$52.65
How Received
Amount Paid
In Person
52.65
$52.65
Payment Total:
..
cReceipt.rpt