HomeMy WebLinkAboutPermit Electrical 2003-12-5
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE' 726-3759
97477
726-3769
1. LOCATION OF INSTALLATIO~
~ 7 L\..i::, ('oh non tfP ~ \
LEGAL DESCRIPTION
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o JOB DESCRIPTlQN P
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PermIts are non-transferable and expIre
If vork IS not started vithln 180 days
of Issuance or If vork IS suspended for
180 days
2. CONTRACTOR INSTALLATION ONLY B.
Electncal Contractor Ku,ld.ey'\ Cledvl(
Address IL1SMQcllSOrl
Cl ty !SUe,e n.f'
Phone 4150 O'Jdd
SuperVIsor LIcense Number '2QQO - ~
ExpHal10n Date /tJ-/-O 9'
Constr Contr Number ~dC. l/;)1tiJ
ExpHatlon Date/D'I-(ff
Si~re of SupervIsIng
(~J1I~/
Owners Name BOb i.4..Q,t,; J. "
Address 37aS Chemk.eE'S{..
City 'S Pf1 rL\ 0 e I d Phone
u
ElectrIcIan
OVNER INSTALLATION
The l~OO:Cft:'on IS bel'?lL.madj:.,!I[\. Wf)RK
pro pe ~M\S ~WMl'fhS~ALh..fl\ttlBEllli tll1!<l ~tl"
for saAtJ'fHbmi'W'eJND~~t1HIS PERMIT IS NOT
~ OR IS ABANDONED fOR
Owners .
AN 180 DAY PERIOD
---------------------------------------
DATE:
RECEIPT #.
RECEIVED BY:
,;,,/11/1'/11111
<,llflN(-d If:'fP ()!tO/-I,-,-
(S" I) 7?6 3;-'T1
r1y/t:;tfJ 7.'(> 11-;,110
El.ECTRICAL PERMIT APPLICATION
Cl ty Job Number CIM12tJo 7 - 0/ Z If
3. COMPLETE FEE SCHEDULE BELOV
A. Nev ResidentIal-SIngle or
MultI-FamIly per dvelllng unIt.
SerVIce Included'
Items Cost
Sum
1000 sq ft or less
Each addItional 500
sq ft or portIon
thereof
Each Manuf'd Home or
Modular Dve1l1ng
SerVIce or Feeder
$ 85 00
$ 15 00
$ 40 00
SerVIces or Feeders
InstallatIon, AlteratIons
or RelocatIon'
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50 00
$ 60 00
$100 00
$130 00
$300 00
$ 40 00
C. Temporary SerVIces or Feeders
InstallatIon, AlteratIon or RelocatIon
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
$ 40 00
$ 55 00
$ 80 00
volts see lfBI1 above
D. Branch CIrcuIts
E.
Nev, AlteratIon or Extension Per Panel
erlUlresvouto //3 Ar\
Onrr@.lfP,\L.1!t Oregon laW r :J:._~ 0\$ \:.-: ::.. ..,. IN
~Icn Adjd's b.Q.lla,led by tho ~ -3 e set torI
fei't~Jl t'" o.rervi\thT\Sel,vllc\~S ar 00
l\drfICF1!~(1dflb(P\~8!!nl! thrOUglJOAR?5~~ 3 00
,1 OAR 95~- blain caples OT the ru es
~~@eeY~an~8~so(ser~lcekfeedewrno~lncluded)
-E't\:i;Jlrl~S Ifai 'l'll'flo~ V'Utlllty Notification
P'Wd'm~Bri'!i,):\tgartJi8flOn ~~^ """14$ 40 00
Slgn/Outdlne Llgh1~~g -- $ 40 00
LimIted Energy/Res $ 20 00
LImIted Energy/Comm $ 36 00
4 (0.00
7 ,,"-
/I: tbO
C;=-? S L
- i/
5. SUBTOTAL OF ABOVE
7% State Surcharge
I~Adm1n1~tratlve Fee
TOTAL
,;
225 Fifth Street
Spnngfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01215
COM2003-01215
COM2003-01215
COM2003-01215
Payments
Type of Payment
CredttCard
.i:t4i
ReceIpt #, 1200200000000002555
DescnptlOn
Add, Alter, Extend Ctrc
Add, Alter, Extend Ctrc Ea Add
+ 7% State Surcharge
+ 10% AdIllllllstratlve Fec
Received By
dIm
Check Number
Batch Number Authorization Number
PaId By
BUILDERS ELECTRIC INC
000240 013088
CIty of Sprmgfield OffiCIal ReceIpt
Development Services Department
PublIc Works Department
Date 12/05/2003
4 09 34PM
Amount Paid
Item Total
4300
300
322
460
$53 82
How Received
In Person
Payment Total
Amount Paid
$53 82
$53 82