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Permit Electrical 2003-8-29
I 'G~ 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3~689 6\, \ ~\ ,,'2-, ELECTRICAL It\F,lPlf.~~&19~1{ION '(} QJJJ City Job Number ~'~t1. ,lJ\[)~ Date ~ {h.1J 1. LOCATION OF INSTALLATION 3. COMPLETE FEE SCHEDULE V 1.Q\)C\C\ ~ ~ L\G~5~L33M ffi\3( ~~DESCRlPTI~NI c (\_ Permits ar on-tra s not started 'ithin 18 ays of issuance or if work is Suspended for 180 da s. A. New Residential- 'Single or Multi~Fa;nily'per d,~~iJingunit. Service Included 1000 sq, ft. or less Each additional 500 sq. ft, or portion thereof $106,00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 .CONTRACTOR llyS'rALLATION9~l! . 2. '.. ' '", " .. "";,,, " B. Services or ~eeders-Jn~.tallation, Alterations or:Relocat.ion: .. "" " ':_' " ,,:~. '.' ," . _,',,- . "::.",," ',' , ,- .', .' '.c", _" '.' Electrical Contractor The Murphv Harris CompanyOO Amps or less 4'Oh 201 Amps to ~OO Amps Address 149 9th street 0/_ '/,... 401 Amps to 600 Amps C', <1U;"0'"o;;'I:-.' 601 Amps to 1000 Amps City Springfield PhoJlq, 0t~!t~OA.>,~>>>- Over 1000 AmpsNolts r ;."Y/f'1;~<f'O' o~ Reconnect Only ~ff4~~~~<"~~~~",/!-";po~9:~~1~~~~E..ji;i:s. .. ( 191(;~ -<1& Zr A I"c- lG II nL\ ~ ~1;OQ <(D~~ton, Alteration or Relocation ~2 l({~~~ess $ 50,00 Constr. Contr. Number 20 - 4 7 4 C 2<0' f'~Pt~ ~O Amps $ 69,00 \ b 1,1 "I I /'li/l;18J.AinPst66OO Amps $100.00 \ 0'-1_ Oli() I ' 1/("\_, ft'vt!iiCc~v :~W~;-~~,:~ ;,~~ 1000 Volts see "B"above, Sig~nture s.u."pervfJ{}iSing Electrician il? OAt '''D~:fl;Br~~1CirrrU}t. 00 ,',' - '-I.V"~,~- ,t@(fJ.;,^' 90 . V..J,', _ .. (/fA I' '. (.Ill" GIlf.. . ~~'" NeW IVteratloJborIE~~sIO~-er.Panel Cq/.'. '" I'" Uf'):1,.., ,ge f'en YOu _ n A h. Ifile:., 0ite-CircuitJ In", tU/'e ~Of) I, to . '~' ~ ....'?b ...., ,- ,JO'~' fro. S'" UtI!" ^ >>1 $r,~ 'Eash,~aoiti.onal'G~~it-orwiths Ity I ~ \ ~.)-'ISe~i6~for/Ee~<fe'tiRenrii0iA 9./:' St In.., $ 3.00 Owners Nffle \ 'A \. '/\_ylJ~~ ~: (J;'0~ 1IOtt:). .:-' Df t. ..J<, Q,~'~" ,;--, -;'''::-,-;'''~''''",~s;.r';,-?':-:.;,,;\''Z Address 'L\al.l... r. V) 6.ro.i.D(L,~E(~~~ :~: ~:; '. t~fc~~~~)jI~~\l~~;~~;talla - P 1'\ 1 ~ nl\. "^ ' . -'2~ Ifle, City ~(, ^ \,( )l .Phone Pump or irrigation l 44). dtlOf) $ 50,00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 $ 63.00 $ 75,00 $125,00 $163,00 $375.00 $ 50,00 Supervisor License Number Expiration Date Expiration Date $ 43.00 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~kID 4. Inspeetiou Request: 726-3769 ~'t\. W ot Owners Signature: 7% State Surcharge 100/0' Administrative Fee TOTAL Shared Drive(T:)/Building FonnsIElectrical Permit Application l-03,doc NU~-~~-~~~~ ~~.~( t-'.U1/U1 " 'i +- - - - - - ~ - - Entity/Address/License Screen LICENSE NUMBER: 20-474C ENTITY NAME: THE MURPHY HARRIS COMPANY ADDRESS ONE: PO BOX 7632 ADDRESS TWO: CITY: TELEPHONE: SECTION CODE: , LICENSE TYPE: -if> LICENSE STATUS: :VALIDATION DATE: ENDORSEMENTS: EMPLOYERS: RECIPROCAL LIC: CCB NO: 142410 AB EXAM DATE: EXAM DATE: : COMMENTS: INACTIVE FROM 7/14/03 TO 8/29/03 ~ 5S=4094S ; CC HOURS TAKEN: 0 : CR HOURS TAKEN: 0 , : NSF CHECK RISK: - - - - - - - - ,+ EUGENE (541) 736-7292 PRINT EL ENTITY TYPE: DBA C - ELECTRICAL CONTRACTOR ACTIVE ISSUE DATE: 09/16/02 09/16/02 VALIDATION NO: 0137354 COUNTY: LANE STATE: OR ZIPCOOE: 97401- DATE: 09/23/02 PRINT FLAG (Y/N) :'N FIRST LICENSED: 11/08/01 EXPIRATION DATE: 10/01/03 AMOUNT PAID: S125.00 CERTIFICATION LEVEL: START: END: SUPERVSR SIGN DATE: EXAM SCORE: DUE TO LACK OF 5S; , , ' I ,/ I , CC HOURS REQUIRED:" 0 CR HOURS REQUIRED: 0 MOLTI pMPLOYER? I " I . SENT TO PHOTO ID: LAST RENEWAL SENT: 08/09/03 LAST UPDATE: 06/29/03 - DAVI +- - -> - - - - - - -' - - - - - - - - - - - - + :WindowJEnter :Sv :SoftKeys: : Collector , +------+------+--------------~----~--------------------------------------------: :Ed Off: FILTER: : Daviscl :August 29, 2003 : Level 1: TRUE copy OF CERTtfllEO S DIVISION BUilDING CODE , LICENSE aECORD~kD BY (' _D0.'~ Q- . ~,. DATE. ,8 t .". . TOTAL P.Ol CCB#142410 @ ,.,,<,r~...,,~,. .-;..".~""'> ,':' rum '; T11e Murphy Harris COlnpany PHONE (541) 736-1292 FAX (541) 736-1273 P.O. Box 7632 Eugene, OR. 97401 Building Codes Division Issue Date: 09/19/2001 Expire Date:10/01J2004 license NC~<~094S Gene'ral Sup~n.;..sQr .,: ... . .- "i,.,,. ..': .-~ GEISLER STEVEN R 37026 HlhLSCR RD SPRINGFIELD, OR 97478 ~...., ,," ~-." " . ',--=-. - --:, ~(. ..~ , ~~~ o~ ~. SCOFIELD ELECT~IC Co Fax:541GS68696 ** Transmit Con~_Report ** P. i Jul 14 2003 12:46 Fax/Phone Number Start Mode ,Time Page Result ~lote 15033762322 14,12:46 0'29'" NORMAL o K JUL-14-20e3 09~~a P,B2 .' , . . . . . , . . :. "'~ .... Signing Supervisor Registration. Depilnment or Consumer It Business Sef"tCCS IIhaUdb.t Codes DI.ision . 1535 Edie...llc( t(W. S.lcm, OR , ftUiliflg addl1!S$: P,O. BOll 14470.511("" OR 9"1JCW ()U..!I' J1J.l~~,\~jt'3'1&-231'2;'TT~(~1>>7~llS8 '-, '. '. -.--. \If,,-,w.ore.gonbed.ofg _ u_____ __ _ _ _ I "~~~:~l;~:r.~~~r;:~f ~J~~~!;~;~~s;~y~J~~?~~ ~~~1ri' :i1?1IS';{~~~;:~~?itl~~~~,~~:~~l!:~\?1~,~~,~Jt ~:~. .:~;~: f~~:~i:~",~ ~ \ ;~~~ ~~r (l ~ ~ ~i'11}~~~~.~ (~: ~!~~':~'~!;;':f:~S. ~;;~~~~~!~t~f.i;~~k:5t(7/~~;1~tlp~:'~; ~t~~jtf ;::~c] (, lhe undersigncd.u of . "Ifin acNe q6 (ft,,,n:) (due) (Please check ol'e): a licensed genenl supervisOr e'ecl~cjan o Limited journeyman .sign e:leccrician. a Limited energy electriciAn fOf (CO~IN'''Y n~n!C) Comp~ny address: Cit>-/Sl:lle/ZIP: COrl'lt>2lny license no.: Phone: ( ) I will sIgn all label applicinion,s and countersign ail labels. A.s supervisor. I will be n:spO~iblt:for ensuring that all eleC:lriul'l'lslalla\ions meet minimum safet)' standards and thai all s~h installetions,--.m be made in t;ompliance \Iouh ORS 479510..8'0. Signarurt: . Qualif)'ing, signers hce"leftO.: Toe.- c:..o~'k; -'L- (n~",c) lhe undersigned. as of "] - / "I. 0 S _ . will nD' be Jigning (dell:) for ~ JIYly.-.{y J.k,..~ Company .\ddves.s: P. 0 (.:b X Ci,y/SI3relZrp: ~ ,I' (C) ~ .. ((t') , ; ". '(l."O"'flIlIlY ".one) ?b3Z i 7'1.-0 l Pbone: ($\11 ) 7.fk. -/2 fj> L Qualifying signer's license no.: tJ6f2. ~ So compan1';lictnS no.: :-'~~ V'f ~ ./ Slgna(u~' ';.P" - 4A~~ ~l. ..., \) \ . Jc~' a~ ~ Jl.?_ -14-2003 139: 413 Signing Supervisor Registration Dcpircment of Consumer &. Business Serrices BuUcUng Cedes Division ~ 1~3S Edgelb8tef NW, Sale:m, OR Mailing addre~s: P.O. 80.. 14470. Salem. OR 97309 (S03) 373-1268. Fu.: (503) 378-2322, TTY: ($03) 373-1358 VlWW ,orc.gon~d.org P.132 I. the undersigned. as of , will serve_, , (name) (dale) (Please (;heck ooe): o Licensed general supervisor electrician' o Limited journeyman sign electrician a Limited energ)' electrician 'for:"'-"'~-":'-- -'-, "..- -'.. (comJ)3ny name:) Company address: Ci(yfS(atelZIP: , Company license no.: , Phone: ( ) . I.will sign all label applicalions and cDuntersign al1 labels. As supervisor, I will be respOnsible for ensuring thaI all , electrical installations meet mil1imum safel)' StBfld8l'ds and that all such install"ions ~i11 be made in compliance v"j(h , ORS 479.510..850, Signature: : Qualifying signer's license no.:, J()L ~~l.t: -L- (",""c) the undet$igned. &S of ) ~ J 1I- (> ~~ . will not be signing (dim:) for iJvL- Yi1 vrJ..;I J.k#,,~ , , Company address: P 0 _ ~ X Cily/$latelZrp: G::~ _' ~ {( . ~ '" Crt") . ------ (company name) /bJ '<... i 7 '10 { comp.nY~'_ .. Signature' ~Aj;-- . . --. ,. , Phone: ( S'I] 7 .fk - J "2 'T L Qualifying signer's license no.: lJ6b y, s. o Employer nOtified Date: By Comment: (iMiAIS) ~~~~~eg< :IM~~as ""o.25~.e 17r'02ICOMI TOTAL P, 9.7