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HomeMy WebLinkAboutPermit Electrical 2003-9-8 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-36 ELEt;l.KICAL1{l}I?-'!!F(fNPLICATION f) Il.rv/J.-.... City Job Number -\:.~..!1l!l J Date vt rJ V-"""'; 1. LOCATION OF INSTALLATION V:O \ ~ \\U1'fu LEGAL DESCRIPTION \ ~ O'LO'3?f\ 00\% JOB DESCRIPTION ~ ~ermits are non-tr erable and ex not started within 180 days of issuanc Suspended for 180 days. 2.S9NTR:1~OR m:STAUATION ONLY ~~ e if work is or if work is 3. COMPLl:-ll:- FEE SCHEbiJLE BELOIV A. New Residential-Single or Mu1ti-F~1Il1i1y.perd'~eIlfug.~niC, Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. S~r~'icesor Feeders - Installation, Alterations ri~.Reloca'ik,it:. . .;- i" ,c. '-'-' ,-.--.. - ,,:., -;,,,.->< _:":--?~~":.~~': '. Electrical Contractor The Murphv Harris CompanyOO Amps or less 20 I Amps to 400 Amps Address 149 9th street 401 Amps to 600 Amps 601 Amps to 1000 Amps City Springfield Phone 736-1292 Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges . ~i\J 4. ~'-~ · I\"'~ . 'fy~ 7% Slalt Swdwge ~ (01)..: 10%' Administrative Fee Inspection Request: 726-3769 P\'\. TOTAL Supervisor License Number 4 0 9 4 S Expiration Date 10/1/04 \ \ Constr. Contr. Number 20-474 C Expiration Date 10/1/04 Sign~ture fSupervising Electrician . /~~' ~---- - '-... ~ ~~ .. . Phone 13\0 .l\B2- ~;~ ~~ Ci)\-t:t~ - OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: C. .,~~f~~~l8Jl~~L_Y~~'d'~<- Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. sr5~E~' - New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 l'J!:-"","/""'C",,"_c..1t.'>n~C "c.".,.~~"",,,,.<~,,,,,,,,.,,c'~'''''=''''''''''''''~~_c ~'c.< }!_~~f(~::~-~~:----~T~'7_~'!'!-- -~'6_ ~-;~-- ~I:4{,,-",,'~-:~~r~-!.'~'-~~~~A;~~~'~~~~,~~~~1f~-~-' ~'~~i, E. ~'~~~!!c~~~~l~~iJi~z!~~!~aJl-ac!i..... . , ~':' " :f.,~~ _{~:~'}>_' Shared Drive(T:)lBuilding FormslE1-h:...J Permit Applicalion i.()JJ!oC1~:':;: " t".\:jl/l:::Jl v +- - - - - - - - - Entity/Address/License LICENSE NUMBER: 20-474C ENTITY NAME; 'THE MU~PHY HARRIS COMPANY ADDRESS ONE: PO BOX 7632 ADDRESS TWO: .CITY: TELEPHONE: SECTION CODE: , . LICENSE TYPE: ~ LICENSE STATOS~. :VALIDATION DATE: ENDORSEMENTS: EMPLOYERS: . RECIPROCAL tIC: CCB NO: 142410. AB EXAM DATE: EXAM DATE;. : COMMENTS: INACTIVE FROM 7/14/03 TO 8/29/03 P:~ 55=4094S : CC HOURS TAKEN: 0 : CR HOURS TAKEN: 0 : NSF CHECK RISK: Screen - - - - - - - - + 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 : ~'l'ATE: OR ZIPCOPE: 97401- DATE: 09/23/02 PRINT FLAG (Y/N): N FIRST LICENSED: 11/08/01 EXPIRATI9N DATE: 10/01/03 AMOUNT PAID: $125.00 CERTIFICATION LEVEL: START: END: SOPERVSR SIGN DATE: EXAM SCORE: DUE TO LACK OF 5S: I . , ., CC HOURS REQUIRED: CR HOURS REQUIRED: MULTI EMPLOYER? o o SENT TO PHOTO ID: LAST RENEWAL SENT: 08/09/03 LAST UPDATE: 06/29/03 - OAVI +- - - - - - :WindowlEnter :Sv : - - - - - - +------+------+-'----------------------.-----------------------------~---~______I , :S.oftKeys : - - - - '- - - - .- - + : Collector :Ed Off: FILTER: : Daviscl :A~gust 291 2003 : Level ' 1: ~ .-= ERTtflED TRUE COpy. O. ~UILD1NG CODES DIVISION UCENSE ~OR~~0 _ BV]:\,-, ~.. .lD. ()~ .OATE-. . ^ ~> TOTAL P. 01 CCB#14241O @~' .,"'\.........'...."J^'r-'. d-;"'.JUlll'''\. T11e Murphy Han'"is COlnpany PHONE (541) 736-1292 FAX (541) 736-1273 P.O. Box 7632 Eugene, OR. 97401 Building Codes Division Issue Date: 09/19/2001 Expire Date: 1.010112004 license No-;:~94S . .-' . Generalsup~~or .......... ....: .... GEISLER STEVEN R 37026 HlhLSCR RD SPRINGi=IELb, OR 97478 -- ~- .... ,'--0 . ..~__... 0". .- -.- ' .- ~ ~I. " . \:\ . , ~ ~~ ~. .: SCOFIELD ELECTRIC CO fax:~4'68S8696 ** Transmit Conf.Report ** P.1 Jul 14 2003 12:46 .Fax/Phone Number Start Mode Time Page Result Note 15033782322 14,12:46 0'29'" NORMAL o K JUL-14-20e3 09:A0 Signing Supervisor Registration P.02 Deplnmcnl of Consumer &. Business Sel"'fCCS IIhdldb,g Cedes Division. J Sl$ Edge....ak:(.NW. S.lcm, OR Mailing Z.dt!RS$; P.O. 80.1 14470..Salcm. OR. 9~)CW ()U~' J"'I~\~jt'3"18-2J2"2;''I'T~(5e3>>7~llSS '-... '. -.-- . . \II,",,,., .Ortgonbc:d.ofC "----- -- - - -. ~ -. 1~:;~::t:~~j~;'i~~:~~~;~j(~~~~!r~~~~~~~t'~;I~;t~,'i3~~:,~~:f ~~:~:~~Z~( k~3t~~~~!:~:.!,\.;~ .~~ml J<~fj' ~ I~~~ t~(:: ~dJ:~ ~', 1". ~}, ,'l ~.~;; ,~.z\~~ "1~}~:?~~~ ~~~{~~i~{'~~;~~:~~~J:~;:t~~~~~~1.~ ~~f:1!'~~;::1<~:~-! (, dle undcrsigne4.u 01' . ~in acNe 116 (PI~ase che.ck ofle): ( "lime:) (Clue) a licensed general supervisor cloct~cjan o Limited joumeyman sign electrician a Llrrllied t:M:'CY electric ian (Of (comp;jlny ft:lmc) Company address: Cit}'/St3.1e1ZIP: Cornpa"y license no.: _ Phone: ( ) I ~i11 sIgn all label applications and counltnign alllabelli. As supervisor. I ~ill ben'3ponsible for ensuring Ihat all e.Je.clric.rd inslallations mee.r minil1\bm safelY St&l"Idards and Ihara1J $DCh installations ""m be rnl5dr: in r;:ompliance \&olth ORS 479510..8'0.. . Signature: Qualif>:ine signer's hcense no.~ . Toc'- '-5&:..1...' ...IL- (nal'll!:) . uh.e undersigned. as of ') ~ 1"#. f) ~ (diu:) . will not be ~igni"B for ~ VV/......J-; J.h".~ .; ';. (b)( ?b '3 '<.. Ci,y/SlatelZ1P;, b:,~ ;' (C) ~ '. ((0. (I."OmJlllll)' "11I\c) Company address: P. 0 77tJo l . Phone: ( S\I 7 ) 73k. -J27>2- J!:I~1. ., ) QtliJifying signer's license no.:Jbt, 'lS. ~~.i~~~.~~;~r:I:.~7'1~'~f~~t~~i1~;;~(l~j:;~~t~'~~~:?i~'.~4~~ ~~;~, J~~-14-2003 09:40 P,02 .' . . . . . . . . . . . . ~. .' . . Signing Supervisor Registration D~r~,",".ent of COnsumer &. Business Serrices Building Codes DJvision . 1~3S Edgclbatcr NW. Salem, OR Mailing adcbess: P.O. Box 14470. Salem. OR 91309 (S03) 37).1268, Fax: (503) 378-2322. TTY: (503) 373-llS8 www .o~gonbcd.org :t~~~:;~~:f~i:' ;~::~;.r;~l1/~~:~:::~~C:~~'7~.'i~~:~'I~:?t~:l:~~~~~~~r;~1~.~: i! ~~- fl~~-.~~.:\~ ,~.~;, l..~t:/l~rtltl~~.~~ /~ ,~: ~'~,~~.:' '~~.~~, u:~ ~:;~~~{~!~~f~l~:!;$~~~~~:~:~*~~~~;;"tg~~ti~~~ ~~~~~~~:t~7~~!~?,:: . f. (~me) the unde~igned. as of . will &eM 4' (dale) (Please <:heck.one): Q Licensed general super-..isor electrician o Limiled journeyman sign eleclrician a Limited energy eleclrician "for' '.' -.... -0-"-- - _. . ..- -'.. (company name) Company address: Cil)'fStatelZlP: . Company license no.: . Phone: ( ) J will sign all label applicalions and cDuntersign a/l1abel$. As sllpervisor,l will be: respOnsible for ensuring that all electrical inslallalions met:! minimum safely St8fldlll'd$ and that all such inslallalions ""ill be made in compliance with ORS 479.510-.850. Signature: . Qualifying signer's license no.:. ~l, ...,~ " . .l(~'J C~ :Toe- ~~_ 'l:..iL- (n_c) . the undersigned. as of ), I '-I- t> ~._ . willllot be signing (dllll:) for T"k.. Yl1~.J.y , .. ~.~[(f). t'hx ?b '3 Z. - (:) fl.. . , - (comp8ny nlime) Comp~ny address; .to C;ly/SlatelZ[P; G:f~ . . r.r Company :Z::' ,.-, . ~u4-; ) '\. . - ~' Signature' . ~ ... .) 77 fJo { _ Phone: ( S'/ 1 .) 7.fk - I ;;? ? 2- Qu~lifying signer's license no.: Y6b'l S. o Employer norified Date: By Comment: (indiaIS) 1m' lI4().2S~~ (7f02ICOMI TOTAL p.ra;>