HomeMy WebLinkAboutPermit Electrical 2002-11-26 (2)
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225 FIFTH STREET _
SPRINGFIELD, OREGO~77
INSPECTION REQUEST: 726,3769
. OFFICE: 726-3759' . I
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EL.CAL PERNnTAPPLlCATION
CityJoh Numhc~'ELEZOOl-COl '-{ !;
, ..' 3.. COMPLETE FEE SCHEDULE BELOW
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I. LOCATION OF ~STALr,ATION '.: L !,'.
3.030" ~~ 'S.'F-..c:.'A:'New'Residcntiill:Singleor'
Multi-Family per dwelling unit.
Sen'icc Included:
LEGAL DESCRIl'TION
1""70 "37.:2.0 a
,
02...10 f
Items Cost Surrr ' .
..',.
$106.00 ,
~
$ 19.00
",
$ 50.00
-.",,\
1....
~:..~SCRWTION
, 0...\ w'Q.,o", (Z~ rf'Ic-,C-Lll.l
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manui'd Home or
Modular Dwelling
Service or Feeder
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. CONTRACTOR INSTALLATION ONLY B. Services 01' Feedcrs '
:. '," " '. e \NOP-v. Installation, Altcra,tio~~,or ; ....
Electrical' CCAArtele>c rJ.lBT,\\I\'r~,\\W'~ 'ISINOJ Relocation: " ,'.'
"1.1\: "ftllJIl"i S"'~\.: \'\IS \'t~~" ,.,. '"
AddressJ~,,' . R'~ \j ''-. tPI1~~ ~;'hl.,[.~.'.-.t)tJ...,.,,',.~......P.", ,t~. ..\\ 200 amps or less, '.
City F1JG4~~WI~~~~~~~~'~ti0."') . . ;~: ~~:~: :~~6~::;~~'
.' b.i'\'{'\~O \J . .{ .,:t1:, ..,. ,601 amps to 1000 amps
Supervisor Liten~e. Number 2.it9.s .... ~,.,;:>" ..<'.[.:;:.":,':,. eWer 1009 .amp,sl-volts:,-:: "', .'
E~~i,~ti~~D~\~'~.~/~1AP;'~~';;,i]}~:.~;"\::~tf~e~l:e:.:~n~:ri:~~;:;r~~ders ,"" . ,~'
" Con~tr contI', Number '. ?f'i_itif . ~.{,,:'i<",,::!~;:Jhstailatio~iAlteraiIon or Rclocation,
., '" .,--- u ~',' '~' :j~~ :"",..:;~:- '. ;^~\ \0' .- J"~ - ):~:'.^4.. '-.)~,' '-' ',-.- - ,': '..
";',' '.Expirauon Date 10/01 /O~ . ,:,' ,'.\' ~t~~'?l-(Y"\\\\'i.~200'.amps o~less" :. :,\'" ':3 _ ,$50.00 '_'
. ,. " ia.\~'~QQU \0.291 amp~ to 400 an:P~', , ' ': ----.-:.:: $69.00 _'
,;;ignatu~c of Supervising EI~$Wci:u\l6 ~'ll:(\e s a.le-sa\O~rAOl.to 600 amp~ .' .,: ..' _ $100.00..---..:'
, ' : ' '.!. .. \ '(;.\,' \ \V OO~\e OSe IU\eO~~ 9'02 e~VS: 600'amps or J.R90 volts see. , ..:, ' ' ,
~:', '''(11''\ ,',,' }\eS-O: 'el,,\n. 'Our:},n "'Ii'leIU\"B':;above "~.::-.~' '.,".',. .
.' ' '''''" ,I ()\'(I 0' ' "'OIW " '. ..
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. . h..;...... "'" ~,,,. .. \l\v'Jt" ,'(\e\e ......I),~~O. ..... .. , ..'
'. :--. NA:lYA ~1f1IT:.~J dOl(\: , ~O\e'.'. ~. \c.~ranch Cl~CUlts .
. OwnersNam _;:;..n1f.f..s.\ 'lir.1t5;/~v'iJ{/J!.);!-;, ~~. New..AIterationor.ExtensionPerPanel,
, .....C;'2\J..' .t:;"... .y/,\fZfr7VO,1'ClP-' ., .'.."
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Address '2.,()'2,r) 'l\SQ.Aol!~j~4 'S, ODe Circuit - _ $43,00 ::t:LUO
. r\\}"\W- t""'?,\,f':~~
City~Q..\~'Iq,,\d Phon;' .
C, .
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. .
$'63.00 . "';
~$75;00~':
'$125.00 ~';
., $I6~,00 .
$375.00,-':::::'
$..50.00' ,
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OWNER'INSTALEATION
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The installation is being made on.
property I own which is not intended
for sale, lease or rent.
Each Additional. Circuit or with Service .
or FeederPennit' .....5-. $ 3.00 ~O
E. Miscellaneous (Servicc/feeder not included)
.Eacltinstallation
Pump'or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limiled Energy/Comm
$50.00
$50,00
$25,00
$45.00
Owners Signature:
l\linimum Electric Permit'lnsJlection Fce is S45.00 + Surcharges
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
8% Administrative Fee
t;E'.~~
U,(oU
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TOTAL
lJ ( 0 .1[L
scb ()Dl~oL\l
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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:
ELE2002-00145
11/2612002
11/2612002
5/26/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
3030 GA TEW A Y ST
1703220002109
Springfield
TYPE OF WORK:
TYPE OF USE:
Alteration
Commercial
PROJECT DESCRIPTION:
Add 6 circuits In Sears store
OWNER/APPLICANT:
GATEWAY MALL PARTNERS
liON WACKER DR BSC 3-04
CHICAGO IL 60606
ELECTRICAL CONTRACTOR:
CHRISTENSON ELECTRIC INC 541-688-6121
1631 NW THURMAN 2ND FLR 543-419-3600
PORTLAND OR 97209
CCB # 458 Expiration Date: 05/01/2003
Desc rintion Amount Paid Date Paid Receint Number Cashier
+ 7% State Surcharge 4.06 11/26/2002 2200200000000000233 djb
+ 8% Administrative Fee 4.64 11/26/2002 2200200000000000233 dib
Add, Alter, Extend Circ 43.00 11/26/2002 2200200000000000233 dib
Add, Alter, Extend Circ Ea Add 15.00 11/26/2002 2200200000000000233 dib
To Request an inspection call the 24 hour recording at 726.3769. All inspections requested before 7:00 am. will be made the same working day,
inspections requested after 7 :00 a.m. will be made the following working day.
Reouired Insnections:
1 Rough Electric: Prior to Cover
2 Final Electric: When all electrical work is complete. E WOR\<.
By Signature, I state and agree, that 1 ha~\Q~~~m"!W\1~6i:~J~~ ~:N>\lli~l.ltIbn and do hereby certify that all
information hereon is true and correct, miJl.li~~5~t'ftj(X\!I.iat lli'Y'anl ~al\J~~\Performed shall be done in accordance
with the Ordinances of the City of Spring_b\UPthilkePt\t.!l~a~1d 8regon pertaining to the work described hereilL I
further certify that only contractors and e'8~'Y.e'o!S~rJ:iJ ar"tit\\~mpliance with ORS 701.055 will be used on this project. I
further agree to ensure that all required i~~iqijila~~e~uested at the proper time, that each address is readable from the
street, and that the approved set of plans, itapplicable, will remain on the site at all times during construction.
Owner or Contractors Signature
Dat'"uui ,aw reqUIreS you to
. . " . :;'d byth€ Oreoon Utility
ill\lll'^' rl1lt1l .JdO!JI~ I! vre se' fo'1b
\\ ,t'CClllOll Center. Those rUhe~tR 952-001-
, j",: , 'l!j;N)01'OO1 0 throU9, '
: ,;\:1\'1. YOl' moy obtain copies ~f tile ru~~~ b)
calUn" tn,- C_lnter. (Note: lh~ tele.~h .
nurnlJ~r IN the Oregon Utility Notlllcatlon
. "'1'" "i-R00-332-2344).
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