HomeMy WebLinkAboutPermit Electrical 2003-7-28
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F,A.,\:~(~I'jIMJlrpl~.\iII; submill~i:1~as the fOllowing
WH'l"y,,~{t6I;JS"'rV6YreqUlre specific land' ..
ELECTRICAL PERMIT APPliCATION approval. '.. .' usa.
City Job Number ELC7J::.<;3 --00 1]3 Date 7 h s- ;';:r . Zonin^' '. L:\)fL- .
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72 Y ( DA-l So
LEGAL DESCRIPTION I
, 702 553v
0370-0
JOB DESCRIPTION
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor IZohS t:lu-fh~
Address 2 I ) S- OJ/, 0 S I.
City (;"'10-.(..
Phone bft- r'/,-/V
Supervisor License Number
Expiration Date
Constr. Contr. Number ~
Expiration Date
Signature of Supervising Electrician
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Owners Name :;) c) IV
72'1 '1
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Address
City
Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature,
Inspection Request: 726-3769
A. ~~~~~:~R~iiiI.~ii~!:~~ij{gJ;. ~r~hitU~,~~~~ti~;~p~r;.:(JW~ir~~g~~fi!~t:;;~
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~~ti~!~~:;5it:f~~d~~~~&t'il.l~yrrn'i ti'~'f~{~Yt~~~ ti6l1~;~oifi(R~'15ca ifo~: .-:J ~
~"~~"~" "..~..',..,f>::'.'*'..v.,'.-_...: .1>:'<1.. '!f~~".lo .. .....,:... ',-'. -~ ~~-r. ,''''I~>>.'' ~~. ",' I.. 1."_'" ,,-,..J
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200 Amps or less ,\0-.}8~"'\' $ 63.00
0"" \),. ~,
201 Amps to 400 Amps ~,~ O~ ~'O~. $ 75.00
401 Amps to 600 ~~~\0~ ~e 'b:f)J:l~ "- $125.00
\.'3' ~e ",0' ~-' 'Io.e"'-
601 Amps to~U ~p~~0 O~<?- ../oS ,'" $163.00
Over I,g,~~~~!p ~c;,~ 0' ~ ;.,,!~Q S\C€375.00
R~'i;innecl:Pm~:<-~ >1$',0 ',e'" e\.0'J"\\c,v $ 50.00
y~ ",Y>' ?~e_ ,() c,o~ r'~ ~:
~^ '. ~-',W'cd"";~'"I"'4>.""""' '7i1'''i.,a..W2).';;;;~' ',E~- '11, "!I;';l<"".,..'....i<'..~
~"C~ Te~p'oJ: S"ir.s, te ~nl'. ters,: ,_~-! ._,"'_'.t~.> "'0 d(r\~>:i uc., ". '.~" \ '. ," t-:!l:
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~~~~~wm~~f~~~~<~location
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~l ~~~~ps
401 A7t\~s to 600 Amps
$ 50.00
$ 69.00
$100.00
Over 600 Amps or 1000 Volts see "B" above.
I!li:t"'~#r.'c.:,~"'~ ,~.~ ~l;t:..~-t;i.J.f;'{:".~~:;."'iWi\\,f.\-:~'.;,"'f,..~::r- ,,-,:...It,'-~, y,,~...,~..l'i~
D.. ~.rfll!l;,h,_,q_lro,~1}},t..~~~'~t~~':~~ ~ ..~ .!',.;....~~t~~ _.~.1"::, .;~~\,.\'~ _t'~';-'::.~.,.~:'z'w~t.~~~:.~l
New Alteration or Extension Per P~~~,\
One Circuit l( '\~'i:: \~~ $ 43.00 Lf'1
Ea-oh Mditional Circuit o~~ ~~" ~\)~
Service or Feeder Pe~ S <:(~ ,('\, $ 3.00
_M"~!_.",,,, ~~~\'\~~h,;Q~~~:".",~",..~ ..., ,.,~ _.\~
E. '7' \.'WHa ~~~.\~~~~'~.9!t5~~~"t~!~'q,I~~e~ri~~~~h~P!~).f1~~.~i?r~~Jl
\\\)~:< v ~ ,..J
~'i> '? '-~l~'PO IJ ~~\)"J' $ 50.00
SI~~t{eW~~ $ 50.00
Limlltd" ~~/ReSidential $ 25.00
Limite'iPEnergy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee ~ Surcharges
4. lSL'liTOTA;f;'~OE:4.BO.VE' :';, k::::::" ~j,4:~":~~'j
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5l-(,~
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:}lBuilding FormslElectrical Permit Application 1-03.doc
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
OWNER/APPLICANT:
HERSCHEL D L & TRYHORN K E
7249 DAISY ST
SPRINGFIELD OR 97478
Descrintion
+ 10% Administrative Fee
+ 7% State Surcharge
Add. Alter. Extend Circ
Minimum/Adiustment Electrical
.
.
City of Springfield
Electrical Permit Attachment
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
ELE2003-00 178
7/25/2003
7/25/2003
1/25/2004
7249 DAISY ST
1702353403900
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
ResIdential
Add 1 circuit
ELECTRICAL CONTRACTOR:
ROB'S ELECTRIC 541-686.5444
2155 OHIO STREET
EUGENE OR 97402
CCB # 146149 Expiration Date: 09/25/2004
Amount Paid
Date Paid
Beceiot Number
4.50
3.15
43.00
2.00
07/25/2003
07/25/2003
07/25/2003
07/25/2003
1200200000000001827
1200200000000001827
1200200000000001827
1200200000000001827
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same
working day, inspections requested after 7:00 a.m. will be made the following working day.
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Reouired Insoections: ~0'i> o~.;;s i;-'~~
oY ~ 'Ii!); '\.
1 Rough Electric: Prior to Cover ..0 0..0 ~0 1:11':> ~~''ll
2 Final Electric: When all electricll{j'i\l!lls.~.9nip%i:e'0 \~~o~ . o~
o~ ;\~ ",...;s ",V ~'$< ,,0Q ~
By Signature, I state and agree, th"l)'Dhlt~ EJlrefgni',sxan!Ji'ledJtlie completed application and do hereby certify that all
information hereon is true and ccl;i-ed;0an'ii'~u9tlief cdtif~~\l1\any and all work performed shall be done in accordance with
the Ordinances of the City of~ig~ficllraQ~ .iIte>lJ'~rti'~r,iii"'i~iliie of Oregon pertaining to the work descrihed herein. I further
certify that only contract\!.~')~cI>'e~P~Y,~1,!h'o'~[Il~9!!1p'fiance with ORS 701.055 will be nsed on this ~Ject. I further agree
to ensure that all requ~"d'~ns~ef,tio~ars~q~_kt~l~~ proper time, that each address is readable~~~~e street, and that
the approved set of pla'lis,'\lr~RPiie!IJl~)wiU~II\!!I'il ~the site at all times during construction. -<y,.'I:- c. ~\)
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Owner or Contractors SignifUi@V!r,,1t''SJ0' v'll' . Date ':0~\)"'~ ,\y,.\-;,~\)\)'\\"'"
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