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HomeMy WebLinkAboutPermit Electrical 2003-8-29 6 'dC' City Job Numb., , t _ _ Date tL ~ 1. . LOCATION OF IN~TALLATIOI( . 3. CaMPLETE FEE SCHEDULE 01 V lor)~ ~ \'\\1t'1'u ~0 ~EGAL DESCRIPTION l <6~ l.rY~ 34 -.; - JOB DESCRIPTION Pc~~~~tra~ not started within 180 Suspended for 180 days. DO\7J) '~lD bIe and e1..~re if work is s of issuance or if work is 2. CONTRACTOR INSTALLATION ONLY A. New Residential - Single or Multi-Family per dwelJing unit. 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 B. Services or Feeders - Installation, Alterations or Relocation: 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 Spr inqf ield Phone 736-1292 Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Over 600 Amps or 1 000 Volts see "B" above. Signature of Supervising Electrician D. 'Branch Circuits J~ I . J New Alteration or Extension Per Panel . \.~ YQ. ^" \ . One Circuit $ 43.00 =~~~ StLf;;~~~~:;:~:~~~n~i~U4C:):::~.~~11~no" City \(f(\~ ~ OOf.(2..- Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Expiration Date .Lll~4S 1 D II ell Supervisor License Number Constr. Contr. Number 20-474 C Expiration Date lO {'It)l{ OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~() .()\ ~~~.~ Inspection Request: 726-3769 '~, Temporary Services or Feeders ),0." Iqstalflti.lon, Alteration or Relocation ZOO Amps~rless 20L'AmPgito4(J() Amps ~_.' "" '~'" 401 Amps to'600 Amps $ 50.00 $ 69.00 $100.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnslElectrical Pennit Application 1-03.doc LICENSE NUMBER: ENTITY NAME: ADDRESS ONE: ADDRESS TWO: CITY: TELEPHONE: SECTION CODE: . LICENSE TYPE: ~ 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 ~ S$=40948 : CC HOURS TAKEN: 0 : . CR H,OURS TAKEN: 0 : NSF CHECK RISK: HU~-~~-~~~~ ~~.~( +- - +- :Window:Enter :Sv r'.\jl/\jl - - - - Entity/Address/License Screen - - - - - - _ + 20-474C THE MURPHY HARRIS COMPANY PO BOX 7632 COUNTY: LANE STATE: OR ZIPCODE: 97401- DATE: 09/23/02 PRINT FLAG (Y/N): N FIRST LICENSED: 11/08/01 EUGENE (541) 736-7292 PRINT EL ENTITY TYPE: DBA C ~ ELECTRICAL CONTRACTOR ACTIVE ISSUE DATE: 09/16/02 09/16/02 VALIDATION NO: 0137354 EXPIRATION DATE: 10/01/03 .: AMOUNT PAID: S125.00 . CERTIFICATION LEVEL: START: END: SUPERVSR .SIGN DATE: EXAM SCORE: DUE TO LACK OF S$; 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. - - - - - - - - - - + :SoftKeysl : Collector +-----~+------+---~------------------------------------------------------------: : Level 1: :Ed. Off: FILTER: : Daviscl :August 29. 2003 , . ~ TlftED TRUE coPYO. ~~~LD1NG CODES DiVISION UCENSE~OR~~~. _ . . a'f -.r: '.u ~~Q I ^ ~ . OATE....:- . ~." .~ ~ TOTAL P.01 CCB#142410 @ ^,,<.r~.,,~c-. ;/""IlfJ{] .~\ The Murphy Harris COlnpany PHONE (541) 736-1292 FAX (541) 736-1273 P.O. Box 7632 Eugene, OR. 97401 Building Codes Division Issue Date: 09t.t9/20Q1 Expire Date: 10/01/2004 License No:' .40945 :'-~'~ "~~\ 1, General SUf?~rvj.sor .,: .' ~ .. .;........" GEISLER STEVEN R 37026 Hl~LSCR RD SPRINGP'IELb, OR 97478. " ~.-. ... ".' l~. ...__. ,,-i .~~ ~I. " ~ , . . ",> l(~ Q ~. ~. SCOFIELD ELECTRIC Co Fax:5416868696 ** Transmit COnf.Report ** P. 1 ~ul 14 2003 12:46 Fax/Phone Number Start Mode Time Page Result Note 15033782322 14,12: 46 0' 29" NORMAL o K JUL-14-2Ge3 09:~0 1='.02 .. . . ,. . . ;, . ""~ ." .... . Signing Supervisor Registration .---. _..;.. ~ De.p;anment or Consumer &. 8usiness Sef"icc:s BuUdb.g COllIes Division. / S3S E.dge"'alc( tfW. Salem, OR Mailing ufdreS$;P,O. 801 /4470..5al(",. OR. 9"1J(w . pOJ} J/J'J~,S(1j)"":t1tl-2JZ-2;''fT~(~1~7~13S8 '.... '., -.-- . \Il<ww.oregonbed.org ~'i~:~t~FIJ~.1~~~i~;(.:~~~~~if~~l;;1 ".::J::~~'};;itr~~r:~t{q;~~l~'i~1 ~~~~'';;2'~ .,.,,';: ~~~,~! ,~. ~~/*~~ ~(.u..:, ":;~ ::: :!~f .: :!;~J:!~E~~, ,;~il.: ~"''J.t:~: ~~ ~;..jfrJ ~~~:,Ct{~~j}~~~~ ~};'~~(. ~:;1~~::~~~;t:~;~t0~1:j};i}jt~; ~~~~{~~~~~ (, the undcrsignc4..~ of . . ..ill acNe 'Iii I ("II",e) (due) (Please check o"e): a licensed gen~1 supervisor c1ecuicjan o l.imited joumeyman .5ign electrician a Lill'lIted ~/I'Cy dectr!cian fOf (comp;jI"Y name) COMpany address: Cit y/St3.te/ZIP, Campa,,}' license no.: Phone: ( ) I ~jll sIgn a/llabel app.ic;uion:.s and countersign all labels. As supervisor, I ~ill be n::spolD5ible (or ensuring that all elcclriul installations meet minir1\um sa(ety standards and thai aU sDCh instllllations ",ill be 1Y1lsd!= in c;ompliance ....1It1 ORS 479510...8'0. ' SignalUrt: Qualifying signer's hcen1e no.: ]""OC,.. ~~k;-L-. '(Rame) . will not be signing .he l.IndcrsignCld. as of ") ~ / '4 ~ o.::.s. (dlle) rOt '"i1vt- vYlv~ -/ J.h".~ Co~pany address: P 0 ~ X City/SlaatJZIP:, .~~ (:) R _ r , . ((f") . " " ("'''''Uln)l" ".~) ?b 3 So. 7?<Jo l Company Ijct;~no.: S,.gnature' k~.- /' -. Phone: (S'lJ ) 7 J'1e. -/27> L Qualifying :signer's license no.: tJbbY.. s.. 4/~ -r-- J~~-14-2003 09:40 P.02 e. , . . . . . . . . . ~. .' . . Signing Supervisor Registration Depllrtment of Consumer &. Business Serriccs Building Codes DIvision . 1~35 Edge\bBter NW, Salem, OR Mailing address: P.O. Bo~ 14470, Salem. OR 97309 (S03) )7).1268. Fall.: (503) 378-2322. TTY: (S03) 373-13S8 Vlww.ore.gonbtd.org lr_l,..~~~~}:t;t~j~r.;;~~;l:;~.~~~:~ ~:;:~:~l~~~~};~~;~ ~~~~-?'~~;':~i~~t'JS~~~:~~~'$~:J ;~;~ .~~.l~~~~ .~,~;~ : !~~? ~!;~ti:Em~~~ .i}~(,. ~~~!.!~~~~~: ~:::\~::~; ~~ ~:~:;iS!;~i\~:~~~~~~~~~~7\:;;~~~~ ~~~~~:~~:~ll.f.t~7~ I, . the undersigned. as of ., wilt Bern:_, (11:1 me) (dale) (please check one): o licensed general supervisor electrician a Limiled journeyman sign electrician a Limited energy electrician 'fat' '.' _.,~-..:_- -- (company ftame) Company address: , Ci(yfStatelZ1P: Company license no.: . Phone: ( ) I will sign all label applicalions and countersign all labels. As sltpervisor.1 will be respOnsible for ensuring that all electrical installalions meet minimum Sarel)' standBl'ds and tnat all such instal1Jrions \lr'iU be made in compliance with ORS 419.510-.850. Signature: Qualifying signer's license no.: -?ffi t. ..., \) '\ . Jc~'J C~ :Yo~ &-o~..1ot: --L.. ("~c) the. undersigned, as of ) ~ III - !> ~ ((JIIIl:) . wil/not be signing for T"k-. Yl1~.J..; ~{~ (if). / .... -- (t.'Omp8ny name). Comp.anyaddress; P. (') ~)( ?b'3 z.. Cily/$rateiZIP; &:~ t:) I( :' 77 C/o J ;- , t...c-' Company liczns nO.: ,. "D \. . Q4 -1 _ ~'Signature" '. ..~ //~-;- Phone: ( S'J ] 7.:?k -I "2?2- Qu~lifying signer's license no.:Y6h 't.~ o Employernotified Date: . By Comment: (inJIiJ!.IS) ~.' ~5~~M€&' IM~t~~ o\4().U~~ (1fQVCOMI TOTAl P. Q;>