HomeMy WebLinkAboutPermit Electrical 2002-12-27
i
:i~ FIFTH STREET .
SPRINGFIELD, OREGON 97477
INSPECfION REQUEST: 726.3769
OFFICE: 726-3759
I. LOCATION OF INSTALLATION
930 Prescott Ln
LEGAL DESCRIPTION
_.1]03.-:> l{ / Z
2, CONTRACfOR INSTALLATION ONLY
Electrical Contractor JB ELECTRIC. INC.
Address 4685 Isabelle Street
City Euaene. OR 97402 Phone 541.687.5770
Supervisor License Number 3872S
Expiration Date 10/1/04
Constr Contr. Number 37587C
CCB
104929
Expiration Date
10/1102
3/14/04
'~''P(f-::'' -
/ I ~
OwnerfName
Address +>h-/{ I IL"e, ~
City Sorinofield~e
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Owners Signature:
JB Job #
~
ELECfRlCAL PERMI.LlCATION
City Job Number El..t=2..Coz..-OOl7"L
200 amps or less $63,00 $
201 amps to 400 amps . ",\\0 $75,00 $
401 amps 10600 amps (eo.U\(tll"~\\i\\\\'\I ,)'\$125.00 $
601 amps to 18a~~eO(~'" n""\~' $163,00 $
Ov~"-9~Qb~'lilJIlJ~ (U\eS\1l.'':';c.~~~375.00 $
p..,\\~oN/.\~~(.~05e ~"O~":-r'\O\) $50.00 $
~\O~~u ce~ '~O"'(OU ~O\",... '~ot'$
C'!5'1fi16~~~~~~\~\"e\e\~~\(l&~O(\
\(\ O/ll.~ "IOU ('I\&.~(\\e(. ~~~\\\\'!~~).
OoV!=O. \,,0 O~~":': fl'J.'2:''l-;r<'
~ ~~\"''1~O\r''''
!\ll9Tamps
Over 40 I 0 600 amps
Over 600 amps or 1000 volts see
B above
Items
3. COMPLETE F~ SCHEDULE BELOW
~o"'"
A. New ~i~-Single or
.",.,0 ~,~,c, 't1uiti.F ' per dwelling unit.
~,)o<":e ~'" Se' e Inc ed:
o '7 ZC 0 .J' nc" ~ ,'00.,)' -n~
Q\ 'f\o \ ,\to
,oi'"'' ooe~ \(;;
JOB DESCRIPTION ,'0"'0 "I> 0
""-In e. /I"
->e-.....Vlce- c.H-M6-+'" ~"",,,<1>-,.,, c,,,Q,:f' I C dditional500
'~<i(r -~vQ;.... . q. ft or portion
Permits are non-transferable and expire ''11".\,)' thereof
if work is not started within 180 days Q'O''O ,,'00<;" Each Manufd Home or
of issuance or if work is suspended for ,'1'0" Modular Dwelling
~,)
180 days. Service or Feeder
B, Services or Feeders
Installation, Alterations or
Relocation:
--
Cost Sum
$106,00 $
$19,00 $
$50.00 $
63.00
$50,00 $
$69,00 $
$100.00 $
$
D. Branch Circuits
New. Alteration or Extension Per Panel \\'t. ""Q~~
X. \r \ \'::. ~Q
One Circuit \. 't."''?\~ f'c.?~\\ r~'OO $
Eac~ M~ilI1ilia1 R<"B\fi~&\liVi~~~'t.U
or ~lS ~rttll;) '0~1;) ~\l.\>.~\) $3,00 $
\\\~ Q~\1.t: Q~ \S
E, MisceIlanet>-\3~~~e~~"~Uded)
-EachI!JlSMp\lI8U 1;)1>'
Pump or irrigati~i
Sign/Outline Lighting_
Limited EnergylRes
Limited Energy/Comm
5. SUBTOTAL OF ABOVE MINIMUM
7% State Surcharge
8% Administrative Fee
TOTAL
"'s.oo $
$
$
$50,00 $
$50,00 $
$25.00 $
$45,00 $
$
63,00
4.41
5.04
0~
.
,
.
.
City of Springfield
Electrical Perm it Attachment
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541.726-3759 Phone
541.726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: ELE2002-00172
ISSUED:
APPLIED:
EXPIRES:
12/27/2002
12/27/2002
6/27/2003
SITE ADDRESS: 930 PRESCOTT LN
ASSESSOR'S PARCEL NO.: 1703341209200
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Residential
PROJECT DESCRIPTION: Service change
OWNER! APPLI CANT:
ELECTRICAL CONTRACTOR:
JB ELECTRIC
4685 ISABELLE STREET
EUGENE OR 97402 ..~o
CCB # 104929 Expiration D~"lO\l\J'.!l14/2004
..<E!l 'i'\\~'~
Date Paid ^\e.~'~O~'~~ecil li~bmher
~O\' <<'00 $\'1;, -.,j"
+ 7% State Surcharge 4.41 12/.' ...\e6'O'!..e,\)\i&~f,~~ 000472
+ 8% Administrative Fee 5.04 d~ p-&0.0Y~, ~g"- ~~,(\'1.~~1JJ 0000472
Penn Serv/Fdr 200 amps or less 63.00 ~.:Q . _^ 6~l\n'\O~~\e:!1~ . ~00472
, ~.. ~,y .11'l.~ ~\,. i\.e,v ~C.
To Request an inspection call the 24 hour recording at 726-3769. All ins~"~~iS.~\~':f~'T:~?-..'bl19. \')i/.t-'llll the same working day,
inspections requested after 7:00 a.m. will be made the following working O~ "'OU ~ aa~\e ~o~ ^~'2:
~ -"'0.... ,<<,13 0' ~:>"
,\\ "!.. !'>~ . one . 9.\J"
CP'" ~,vl ~''O.
Reouired Insnections: ~U~:00 oa~"8!
1 Electric Service: Approval required prior to utility company energizing service.
HOLMES PHILLIP A
930 PRESCOTT LN
SPRINGFIELD OR 97477
541-687.5770
Desc riotion
Amount Paid
By Signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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 Slate 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 al the proper time, that each addr~ is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times d.~~egtt~~uction,
~\~t. \r ~\ \S ~
~ ,'1 \ t.~ r q~~WI .-C')'P..
Owner or Contractors Signature ~'U....\t r.~W,,"Vjlit'C';~r.I'- W;~~()~\:\J ,-
,\\\S 'II ()I'-\1r.() \) ()~ \S \>.~
\>.\i'i~ ~t.~c,r.\l ?r.~\()\l'
c,()WI \ 'O\) \l\>.i
\>.~"
I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
ELE2002.00 172
ELE2002-00 172
ELE2002-00 172
Payments:
Type of Payment
Check
Paid By
JB ELECTRIC
Description
Receipt #: 1200200000000000472
Date: 12/27/2002
Perm ServlFdr 200 amps or less
+ 8% Administrative Fee
+ 7% State Surcharge
Received By
Cbe<k Number Conli nn No
djb
Page I of!
12/27/2002
1:58:12PM "
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Amount Paid
63.00
5.04
4.41
Line Item Total:
$72.45
How Received
Amount Paid
In Person
72.45
$72.45
Payment Total:
e
e.-
cReceiptrpt