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HomeMy WebLinkAboutPermit Electrical 2006-1-5 t Q,';;~I~J~'~J,111'~""': ,.. " ":"" ,I ,"'.' ~ ;>,~' '..':'~1 'n, ,-';1 J..'" "",'~,0\),I'"'",/", \~~ O"':>^"'PRINF'!~~ON'/" ,.', ).';'" ,':,'" ':";^r'r,.J..~' t:;;,:\':";~"" 'j . .I:t',~ , \LI ,'I ",'.',". 1:;~~J ',,;."';'" ,~. ~}'~l.' ...r.~:,'.' J. .~ ',-~H^r~J'I,~,...n.~.,"'C , ./._....;- .:1 'Y~" ,',., ------_---~..-;;J .tted as\,~CIOS'- \ as SLlb~~ s?e~1 . ,,___ 0\ reQU\ l?"J SPAINCFl ... 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)7f62~~- - ELECTRICAWftRM1T A.PPUCATION. . / oate --- CityJobNumberC~ -1)60:2.3 Date'; /(}6/;;)tJ?;~ ,oollzedSigna'U,e . /' 1 j-\>J 1. CrIJ:ToCATION/bP.ffNsfA!f!&ifioiY "'111; ~~~ 3. !teo:n;IPi1ETE'fEEE'SGH'Eiiti.tiE!BEEew.:'"~"~"~Y."l CJ'LIzJ'.....;/f-'''.-;j...' .' ." . ,..- ~"',......."..,....,.,..._.~""',.."..~..,_......__.,,,_...,r.~~._d_""'~~",,'ii1~. ~..~.:s:.....'lc-'.>"~.~.-f'4.V!~"'"~.w:~;..,.,......,~I'-"'~~~~.~~';{1:",-....\';r:;F~~:'(.:\.~~ W:''': LEGAL DESCRIPTION A. 1~~r~~~~iil~!!gi!I;;;!!iqgl~,!!F_l\l!!~tjzf'!mily;p.e~,.'!ir.~!!i~g;j1,nit .~4 /..7 03 3S ~;;( () 3~tJV JOB DESCRIP'I'ION 6 J)//lc.V ~JulM4i~, . Permits are non.tranSfe:b::-:d4Pire if work is Each Manufact'd HDme or not started withiD 180 days of issuance Dr if wDrk is Modular Dwelling Service or Suspended fDr 180 days. . Feeder i1"';;;\"";~'1''''''~F~~~;:W~~'''''''1'''~''''''''{lt;'J4''''i''{j'll..",....~ :;..;:",,~...,..,.........,i:; ij'!'T~~'j;'~"';r*i~'''.v1(\'~<';<I1~$":!'11~;;;l>-?,;.......,~~~~J1.;;f.tn--~"~~~''~;t..,.~"~;;tr.l ~-ii<!NiTRACT.OR1NST'i1IJEATIO 'ONL~ B. i;Ser:vices,or'Feeders--""'Ins{allatiow.-lI1tenitiooSto"iRe!ociltian:'l.li!. :lectn:a~:::::"C~f:;;~[~'~ 0uCJ 2::~~';;?{;~'&~~P:c;~;~~~~~~i:'Z'3"~.'.CJD P /I B 20IC~'!.'Bs tpo1pO AmpsIJ81 0 throuqh OAR $!!2'(~OJ1 Address U 0 X -12.{) / (P 401 Amps t~160~,'6fsblaln caples of Ihe$.125.00... .....~.IJ 1;:1 lfle CE::nter (N' -.....""..... 601 Amp.s:tDIOOOA~s' ole, the lelel$163'00 City bUgrlM,.- q7jf>>$ne ~ {fl /2.S9 0 Over IOOO~A~~';N.~I'fs uregon UlIIllY NOlifS315cW .~ v _<1,,,, 1$ 1.8003' . Reconnect Only , J".~;j44J. $ 50,00 <J. ,r:; 535 /0/( 16t . I I Constr, Contr. Number J ,\ ~ l?Jh..o-.cf,.r><!- I It) 11'1/01 . I I Supervisor License Number Expiration Date Expiration Date Signature of Supervising Electncian -iiJ^ PrtAAA h. ~e()A/\ Owners NamSb JA fl.J ~dZ.J5if)C1y . . -- ".-- Addresspm Qt ~ pU ;S I Ci&vJ..-, ~~~-7IJJO OWN;R~STALLATION The installation is being made on property I Dwn which is not intended for sale, lease or rent. Owners Signature: IDspectlon Request: 726-3769 Service Included 1000 sq, ft, or less Each additional 500 sq, ft. or portion thereof $106,00 $ 19.00 $50.00 !""'"'''''.'.'-';'>''''''<''"''''<';i'''''"~-''"'''''''''''*,_-ii\'''''_li\IJ\''''~-'>!ild C. 'bT~I!!P?I"?!rY.l~e.!'Yl~~.o.i:'~:E.'e~ije~.~;;*-~a~,.;.\~~7Jt'!If;~W~~~~lj~~1'11 Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69,00 401 ~WfI'e~O Amps , $100,00 OVilt:m~ove. . D. ~i' '~-'ll~ffl9~tw~~~~~l Ne.e~MW:~{~iW'l\Umf~e'l!JEb EO~R NOT OnAf\l~Jag (JAV figlMO $"'43.00 Each Additional Circuit or WIth Service or Feeder Pennit $ 3,00 E. ~~~~li1fff~~t('si~wr;tJtrtigt1fi~hilr~aE;~i$rW~Iiti~~. .;;c, -'"-W~"",,--~..._.'-' "....,..-='.,~..!Dz.."'.,..,~""'...k;"'..."'-""'....=~J.. .,i._.,,"""" . Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45,00 MiDimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. rS;;;~~rAEOE~O.VE1,~~~.-"",~tf-l-;i1b/3 60 ~:;'..'l'a~.:o->;t'''~~~'''~':;:'',-~o;:fu-:}~:!'it...,':!':\f~~'''~'~i~~~.UB\.o . . ~% State surcharge' . ~~ 6 . () V 10% Administrative Fee (p. sO t/;J14. 3</ TOTAL Shared Drive(T:YBuilding FormslElectrical Permit Application l...o3.doc / 225 Fifth Street , Springfield, Oregon 97477 5'11-726-3759 Phone Job/Journal Number COM2006-00023 d?M2006-00023 Q)M2006-00023 Payments: Type of Payment CreditCard 'I o :, 'C :t 'I ., -. o " :c .'f "j " '\ 'I: '1 ~ 1/5/2006 . RECEIPT #: Description Perm ServlFdr 200 amps or less + 8% State Surcharge + 10% Administrative Fee . Paid By THOMAS LEE BALCOM JR. GP~ ~ JilY of Springfield Official Receipt _elopment Services Department Public Works Department 2200600000000000011 Date: 01/05/2006 Item Total: Check Number Authorization Received By Batch Number Number How Received njm 061108 Phone Payment Total: Page 1 of 1 lO:52:39AM Amount Due 63,00 5,04 6,30 $74.34 Amount Paid $74,34 $74.34