HomeMy WebLinkAboutPermit Electrical 2002-10-31
JOB :QESCRlfTION f). 1000 sq.ft or less
\lti' I-r.rr-~ $. (l. V c r'AN6L Each additional 500
I fie. 'allowing piOJect as submitted ha~~Jf;1efto8p'll\lffi.
. zoning a.nd does not require specific.)land I)St! IOn
PermIts are non-transferablea')j}}!<5\IIDlre thereor
if work is not started within 180 daysZoning LtXZ- Each Manui'd Home or
of issuance or if work is susp.ended for \ 0 _ ?( _ 0 '2. Modular Dwelling
180 days. Date ~." ~Vl\'~VC ol""Feeder
Authorized Signature ~
2. CONTRACTOR INST ALLA nON ONLY B. SCI'viccs or Feeders
Installation, Alterations 01:
Electricat Contractor Rclocation:
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 ,
.. INSPECTION REQUEST: 726~37'69
, '.-. ',. <,
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
.f1s to 0 8.e l/ev /, /
(
LEGAL DESCRIPTION
1703. Z72.. L.
01.(00
Address
City
Phone
SupervisorLicen~e NUlnber ir(
. .' ~Ib
ExpuatlOn Date f,WI'
v
Constr Conlr. Number
...-
Expiration Date
Signaturc of Supcrvising Electrician
Owners N i!mc j f{},J ~ e L.. ~ \ e"" 5../J ~
Addrcss f?,rl.(fal /+: .nb)~. + y.(,~ IL
"" . / v 'V
City !2 U) .{ "J,. _ Phonc c; /:2 -lok2.l
OWNER INSTALLATION
The installation is being made on
property I o\vn which is not intended
for sale, lease or rent.
OWIlCrS Signature:
Jy::yL J~'
ELE rCAL PERM1T APPLICATION
City Joh Nu~bcr ELI.::!:Z06Z ~ 00/3. 0
3.CO:MPLETE FEE SCHEDULE BELOW
A. New Rcsidenti;l]-Sing]c or
Multi-Family pcr dwelling unit.
Service Included:
Items Cost Sum
$106.00
$ ]9.00
$ 50.00
200 amps or less:' I $ 63.00 ~3
201 amps to 400 amps $ 75.00
401 amps to 600 amps $125.00
601 amps to 1000 amps $163.00
Over 1000 amps/volts lk'\t. \j\IOR\\ $375.00
'\?\ltf;connect Olt~)t~lf\~"\f \1 \~ $ 50.00
\>ZIij ~ Ii \\1\~1 S\i~t: S \'t~W\\ ~
t\r\lfcg~~N~~m~ "t.O fO
p\\J11~i1\rnOt~'f\llQi . e ocation
CO\\fiN\t;~~ &. ~ ~t,i\\OO.
j>..~'l ~~ wnps or less
201 amps to 400 amps
Over 401 t0600amps
Over600 amps or 1000 volts see
"B" above
$50.00
$69,00
$100.00
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit $43.00
. unes \lOU.'i?
Each A-d~~ua1 !@1\H~@fe~SAi.\\lt'J 1r
\" ,\::.~'r\~~8b?t~iO\ltne.. aJese't~OTt$ 3.00
r-'\ \\0\1\1 (U\es a . "Tnose fu~es AFt 952.001 :",
1 t?'t\~&aI{IOTh~~'[}!~~~'O't\;ll:~~~~1hW~UAa€d'9~
~o OAR ~1is~~~\\~tO~\e.s 0 \e?'none
f~ 90 ,/\ju.l$i0b' Rh'~1ti~cte', t'n6 ~ ~\~\~~~\OIll$50 .00
,.0 ~\\\~Wt~~h~~llt~i&1JJ,~~g;,' "\.:,IW~, ~ ~). $50.00
c ~l~titR~J.?g}~es"c.~?~~.GA $25,00
{)U'({hlIl~1j.t.ed~~i1~lgy7C01:nll1 $45.00
Minimum Electric Permit Inspection Fce is 545.00 + Surchargcs
4. SUBTOTAL OF ABOVE
7% Statc Surchargc
8% Administrativc Fee
b>
TOTAL
'7 Z'-' S-
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:
ELE2002-00130
10/31/2002
10/31/2002
4/30/2003
SITE ADDRESS: 2360 BEVERLY ST
ASSESSOR'S PARCEL NO.: 1703272204600
Springfield
TYPE OF WORK: Alteration
TYPE OF USE: Residential
PROJECT DESCRIPTION: Change service
OWNER! APPLI CANT:
STEPHEN JENSEN
85469 APPLETREE DR
EUGENE OR 97405
541-912-6827
ELECTRICAL CONTRACTOR:
STEPHEN JENSEN 541-912-6827
85469 APPLETREE DR
EUGENE OR 97405
CCB # Expiration Date:
Descrintion Amount Paid Date Paid Receint Number Cashier
\IOu ~v
+ 7% State Surcharge 4.41 10/31/2002 , N (lj.lj)Q'!!(}Oo.QOQ.(i)(i)'QOO 170 dib
+ 8% Administrative Fee 5.04 lO/~JBP-9~O{\ \3\1 nl:fQ(!)z~~og1~~OJi)'~170 dib
Perm Serv/Fdr 200 amps or less 63.00, -'\t:.\~ \ \1\(JY3\1~~~O 'o~ t ~~~~a(i)OOO )~Q.Q.011'70 dib
,.. \ . -r?u lV' _...",c:.B _ "Q 9.:> .....,
. , ItUIV- ,p.{.'''- ,OX\v...,n\e':l..-.
To Request an inspection call the 24 hour recording at 7~6).~~~'~Mhins~~h~{)sl~~\1eS1P<;Hj~(~W5LINOO: am.\~ill be made the same working day,
inspections requested after 7 :00 a.m. will be made the f~.u19\V'~~~8in~lday a'o\a\n CO~~~~'(\e \e\e~~c~\\Ot\
\nO ,...I"'I\{'(\a~ ~^. n~O ...."~,,NO\\
QQ';:iu.:' \neC~'''- Onuw'.'?,AA.).
Reauired Insoections: Ca\\\ng 'ot \ne ?{e~GO_~?>'2.-Z
1 El . S . AI' d' '1l'>.IA'l'C\'oe{~^1 \~ '\- .
ectnc ervlce: pprova reqUlre pnor to uti 'luTcompa-.1}~'~nerglzmg service.
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the worlscribed herein. I
further certify that only contractors and employees who are in compliance with ORS 701.055 w~~\N this project I
further agree to ensure that all required inspections are requested at the proper time....~~'3c'ff a \Y~~~Q. adable from the
street, and that the approved set of plans, if applicable, will rem~,\~e S~~t\U\tihl'~\~~ o~tJ\i\ction.
~ ~ ~t.~~\ ~~Dt.~"\ f\~DO~t.D
"\\\~ LlOlA\1t.D :- \\ \c.. f\tO
Owner or Contractors Signature f\~"\ {\~~~ttt.D ~t.~\OD.
COW' ~\) Df\'{
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