HomeMy WebLinkAboutPermit Electrical 2003-4-2
City of Springfield
Electrical Permit Attachment
Status: missing from list
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: ELE2003-00098
ISSUED:
APPLIED: 4/2/2003
EXPIRES:
SITE ADDRESS: 1324 MODOC ST
ASSESSOR'S PARCEL NO.: 1703253314800
Springfield
TYPE OF WORK:
TYPE OF USE: Residential
. ' .... - .
PROJECT.R~SS~~JJ9N:;, \~'\Replace~ub Panel
OWNER/APPLICANT: . .'
HUNTER PATltiCI~' S~"',.. --,'
1324 MObOc'sf :' ~.r' . .
SPRINGFIELtio~'9.?477 .~" --' '
Descriotion
Amount Paid
EI~rrRTCAL CONTRACTOR:
huT, \I t:-
~~~gALL EXPIRE IF THE \fil1Jm~6-5444
~~~~)~ER THIS PERMIT IS NOT
~~~Mi!~~D OOMfa,fifM\~at8M9125fjOb4
Ai'fl' 1 CC 'C;',:t ;--~~;~O.
Date Paid Receiot Number
+ 10% Administrative Fee
+ 7% State Surcharge
Penn Serv/Fdr 200 amps or less
6.30
4.41
63.00
04/02/2003
04/02/2003
04/02/2003
1200200000000000927
1200200000000000927
1200200000000000927
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,
Reauired Insoections:
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete.
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I further
certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree
to ensure that all required inspections are requested at the proper time, that each address is readable from the street, and that
the approved set of plans, if applicable, will remain on the site at all times during construction.
j)wI ~ft-, ~ 4'-- 2- -CJ.:I
O~ner or Contractors Signature Date
Page 1 of 1
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 . .
. b .tted has the tolloWlng
ELECTRICAL PERMIT APPLICATION .hie tolloVI/!n9 proJect ~s su .mJ s~ecific land use
c- 0,' / / /. '11)9 ~nd does no. reqUire
City Job Number. \t::~oo3 -OCJC)'I~ Date 0 C-j U;}-, ~$~va7 V"-) (L.
L
/17- L/ /J1lJdo C (I. S.;fJ 97i.f 77
LEGAL DESCRIPTION \ ~CS3~ \4~cx)
k..r!.:f' I v.. u.. ) '-' ~ f?'I.N.- / - ~c.., y
JOB DESCRIPTION
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor IZobs Ele,-Ih~
Address 2 I >.5- OJ/IO J J-.
City (;Vt? eJ,-.<L Phone 6 f! {,- :ri'-/ Y
If I '/lJ S"
Expiration Date / (J C'_ D I - (;) i
Constr. Contr. Number ~- / '/6 1'-/1
f-l.)"- 6Lf
Supervisor License Number
Expiration Date
Signature of Supervising Electrician
/drt
~~
Owners Name \~(tWL~~J\Ul\l~
Address lDil.. A '\\\C'dOC A
CHy ~~;hon'
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owner~ Signature:
Inspection Request: 726-3769
3.
A.
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.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
~,,) :~'~ -r f ,{ -: r .
· .. 60'1' J{mp~ ,~Q-lOOO,Alnps
I' ~-<! :::.: ;) ". ~: :' '\1; :'_'~: "1,'--,. '; ,',
..... '(WerlOOO AlllpsN olts
," Recdnnecr Ghly
I
I
$ 63.00
$ 75.00
$125.00
$~63.00
$375.00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less ~ $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
Over 600 Amps or 1000 Volts see "B" above.
D.
~
New Alteration or Extension Per Panel
One Circuit
Eal~h Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E.
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residentia1 $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
7% State Surcharge
10% Administrative Fee
/.'/ ~0
0~-\:'
( 3L'
...:> ..
4' . L.U
.$ 7.5 - 7 /
,
TOTAL
Shared Drive(T:)IBuilding Forms/Electrical Permit Application I-D3.doc