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HomeMy WebLinkAboutPermit Electrical 2003-6-13 (2) :t, , (..... ;. "... ",'~ '.'~.. , ," I" ';.".' .. ,'"',-,,,:,,:- ':.CITYOFSLdNGFIEED OREGON '.".." /':'... fJ' . . ;'. . t.". _ ,.-' ~ .,. ~., ,',,""" , 225 FJFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F" Y1' {,'4H.'I.?&.ltill91s submitted has the following Hte on<JW1''In''''1 '''lc land use ELECTRICAL PERMIT APPliCATION zoning, and does nol requlfe ~~~9' I City Job Number t3-ezoc3-OD/I-f:> Date ~//3,101 approvalzOnin" c:.-. (l , ( . '7 ~ - I _ /7~t>? 3. r:;;'c'fiMPIilltEfJimSC;'nuiJiill'1$J:.Lo.l1t" ,t' '<:1;/,;,;,"7,\ ;,~; 1 it.'." ,,' .'L ,,'-" . "'"'>t~~J~~~~~ri~'-~d -S~;~~~tui~! .,'l.....,,:":,~.I"!',l.'..;'.r.;~',J'~~"'u ':..,1 200 Amps or less / $ 63.00 tJ? J ,DO 20 I Amps to 400 Amps ' $ 75.00 401 Amps to 600 Amps $125,00 _~~Amps to 1000 Amps $163.00 Phone S41-688-6121 ~ ~\()~ 1000 AmpsNolls , $375.00 ~ '\'<' :\ \sR~eonneet Ouly $ 50.00 Supervisor Lieeuse Number -.J.7 SgS . ~ .~~~:~~~~~\iiUpjif;tiY;&e"ri\.J.se*~€~~ii:s.:!)i;.:;;iI!,:::i,~~Y-:;;:.~ ~~';;i:,,:,;" ~:&,~ ~:. '0'<''(' ~~' 'X-~\j Expiration Date . 1966WQ4~~\- \\~~ ,c.,_~'?) Inslallation, A1leration or Relocation "~\'O '< ~~1..~~\) \)~~~\)\>' 200 Amps or less Constr, Contr. Number '\ '(Jl;'i.'9:4():-~" .~-4. ~, 201 Amps t0400 Amps ,(,(~~'\'O~ \>' 401 Amps to 600 Amps Expiration Date 1010r'Loo. t. Signature of Supervising Electrici . ' 4 IU /J NOueWcAlte~ation or Ex~~~~o" Per Panel < , T.<ln-v ( ')/ e IfCUlt . \\,eS' \\,\i\'l $ 43,00 ( Each Addition~I'Circuit br with\< / I /' Setvic~ br'l\eede'i'P6'nnitSe\ 'QO\ f. $ 3,00 OwnelSName ("};t.a S-rR-AS(!,A-v,tfJ-l \0\~'U'~'~"O'O'J'. ",\eS':"noF::J~' l" ~.. ,..\ 6(fl.Gr...".tfI...'r'.,.!;....~...d~'....:\!"..,.:~"..~~~~r::!.I..\..~.:i';~........""'..~\.,y.;;.....'1.,,"I.J....~. :~~;.'~ Address 3l~ l4. ~ q, ~ ,\ \ \.- r\ \\eS E:(~~~~~J!~9~~~~\~!{W~$![~~H~lj!~}!~:~C;1~~~qt~~~~~j~n~t~l~~.~!~~~ e R. C{ll(6 \01'-'" \,O~ Cu,~.CO"\~ ,. r.,o'9'(;-;' - \e\e\>:'- \,o~ City f. ~Af.. Phone .~;.\IC'" n,,~.\)\Pum~9niiTigati9ri~e ~IO\'\\C'Oo $ 50.00 .' - J ) \' ",",,,;; "1" IN')' ,.,."I\~ - - 'n 0'" -/0" \\'Sigu/0utline Lightillg' n' A.'. $ 50,00 .\" "v..... r-~\'" 00\\ ~ ('\_'~.JW"'I OWNER INST ALLA nON , 0090. \' (Ie;) \r-r.iffiited\Energy/R2sidential $ 25.00 ca\\\ \I~I.\1 ~~ , . ~ .'6v -. , The installation is being made on property I own which ",\)el Lumted Energy/Commerc131 $ 45.00 . . ~.. ~- IS not lOtended for sale, lease or reUl. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges c.l 7) ~zS .'],S{;) B 7, 75' , I. ttt. 'iotAtj6N/dji/iNstM3:t:AnON6;"";~~:~1;;;..I E' ,',.,.".. <.", ..."'-_",....,'-4",."", ". '., ,r_,'"'''' "~'A".,.:..""l_.,J".r~ -f.3.!/I> 1)",0 1 <;:: 1M tr LEGAL DESCRIPTION /703"2.700 Zst> 0690..3 JOB DESCRIPTION' I StAt, 1/t7JGL ~ 4 C r/2..ui. JJfJ r;~ {/f/lt.:( Pa-JI./Tl /J(, Permits are non-transferable and expir; if work is fi1}/At I, not started within 180 days of issuance or if work is Suspended for 180 days. lifCONTRAeTORiiNsla,.;r5iTiON70m]Y;,,-,j' 2. t8'~,...;J~ ,,;:~-,-~..,..r..' ,~;"'l'~';~_;,h,' ?1"~'y,"\(r"","'~"J'<""",'".~@;"",i(.1 ,"~1;t.'i'~Ir:".:_A"!t"""1i:S / Electrical Contractor .rh;-i ~t-= 1<'1 ",..t-,.i,.. Address 1 ?qR R"t-h" 1 f),.i"" City Fllg~nc OwnelS Signature: y . Inspection Request: 726-3769 ~~\f1 A. RNj~'i~!~i~a~e~!flffi\$in'gi_~~~,:~~Wli!~fh:.n.ilt.\~er~~'~~ilii~g~.~wt L11 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 1~r'-"1"""~~fz.#" !..Jt"';'rq~..~.'"-' ';.r- .';~kl-'''li;'~'-. ,r, "~J"'I.'T;- j,"'-~'''.:a.~''t.....,.-.... :'j'-., '-":~'l'11 B. ~{,~~i~f~f~~:~:!~!I~~.r~J..t~~!"!~~\i,?~i;_~;I:~~htt~~~~~t\]!.~.I.o~~tJ!~~ih;i,SJ $ 50.00 $ 69,00 $100.00 .} /Z ~ ltt..,~ ..tf<II:.~"""';"..)rt~~r.~1:'_"" H:':~JV.:.';u~_:,':'I'T_ 'it&;....;';".~~~..-~~;j~'..it~~' 4. f!SUB1iO!FAEOEiA'BOVEf...."'iVit.",~t,i,,;''''~t!.lii ~i..i'i~~",.fi',,~~.:,.:....A.~I'MiJ...I',l:>~~.'j~;!..;t~~1.ijf."'?j;AUI-t.~1t'l:~. 'ft< 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1-03.doc . . City of Springfield Electrical Permit Attachment . , "-. Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00145 6/16/2003 6/16/2003 12/16/2003 SITE ADDRESS: ASSESSOR'S PARCEL NO.: 1940 DON ST STE 250 1703270000903 Springfield TYPE OF WORK: TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add sub panel and 4 circuits OWNER! APPLICANT: STRAUSBAUGH GREGORY L & ~ 3642 RIVER POINTE DR EUGENE OR 97408 ELECTRICAL CONTRACTOR: CHRISTENSON ELECTRIC INC 541-688-6121 1631 NW THURMAN 2ND FLR 543-419-3600 PORTLAND OR 97209 CCB # 458 Expiration Date: 05/01/2007 DescriDtion Amount Paid Date Paid Receiot Number + 10% Administrative Fee 7.50 06/16/2003 1200200000000001534 + 7% State Surcharge 5,25 06/16/2003 1200200000000001534 Add. Alter. Extend Circ Ea Add 12,00 06/16/2003 1200200000000001534 Perm ServlFdr 200 amps or less 63,00 0611612003 1200200000000001534 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, Reouired Insoections: 1 Rough Electric: Prior to Cover 2 Electric Service: Approval required prior to utility company energizing service, 3 Final Electric: When all electrical work is complete. ,0 By Signature, I state and agree, that I have carefully examined the completed application anddo bcr~by,certify that all informatiou bereou is true and correct, and I ~rther certify that any and all work performed\rhail,b~'do;lldn accordance with tbe Ordinances of tbe City of Springfield a~~~ laws of the State of Oregon pert",i,n,i.ng i~'ilie.~~(t'de\~~l!ed hcrein. J further certify that only coutractors and emplof}~ ".@i are in compliance with ORS ?.9!\055~iII'be used onJlils project. I further agree to ensure that all required inspectio!'8,,~ J!i9i&sted at the proper time, thiii'~acb,a'd'dress i~~~-;;adabie:fro~the street, and that the approved sct of plans, if apPIi~lsIm~'1I~ll8in on the site at{'n.tiMe;,du'l-ij,'1i\c'6lm~-uctil.'rl:. -0\ \'(\'" ~'(\o<'\":'o(\ ;$-~c.. Q,~:~~ f>-~\~ ~~~e; ce~~~()()\~ ~'~o~\~~'(\e \~~~\\~\G'3-\~ . . , ~I", ~~.J ..."';V \0. \c7>\y. ~'-:- (\'v v,,:"''O.\ .".,,\0. .;~'~ ,.... ~.., Owner or Contractors SlgQ~tUf~" &~ ~o\\\ \I-?> g"D~.t~>'l (\\e~'" 0<'\ \)\.\ 2:??"" ~~ ~<<; ~ ,(\0 'lol,) eGe o~eg 0'?>~ 'N<i,'';:- -\::'~R-f?~~. \()g()'~\w9>\'f;\ ~\'(\e. \'~C'l ~" fff ~~ ~ ~ fff G'O: :ue~ \0 ~\e~ \5 ~~ ~ ~ ~<i2' ~<<):A Q, ~'V~ ce ",-<:- ~-<:-.~ ~~ ~ ~- 'b~ ,,~ :A" ~ Page I of I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number ELE2003-00 145 ELE2003-00 145 ELE2003-00145 ELE2003-00 145 Payments: . Type of Payment CreditCard . / 6/16/2003 . City of Springfield Development Services Department Puhlic Works Department Official Receipt Receipt #: 1200200000000001534 Description Perm ServlFdr 200 amps or less Add, Alter, Extend Circ Ea Add + 10% Administrative Fee + 7% Stale Surcharge Paid By CHRISTENSON ELECTRIC 10:48:16AM Received By djb Date: 06/16/2003 Amount Paid Item Total: 63.00 12.00 7.50 5.25 $87.75 Check Number Confirm No 000095 086363 How Received In Person Payment Total: Amount Paid 87.75 $87.75 Page I of I cReceipt.rpl