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HomeMy WebLinkAboutPermit Electrical 2003-3-31 225 J.Ulrt STREET. SPRINGFIELD" OR 97477 . PH:(541)726-3753 ELE~.I..tUCAL PERMIT APPLICATION city Job Number {'/J'U-? ~3 - ()~ 2../SDate y "}H":.T:l~~ irp~. ,..jl4\"'tJ!j".,,,,, '" ",;'I;l~\iJil.!~'a\I't~,(tH~':":~:;~' l~lI~lt!l;W;'IOI.ii\l.Ifll;.\,:;~,,:I,~\~;~iF*ii.ifr,rrl~'~;: 1 ".,,~, , '_~'~."., I' \. ilf:~'~' ...,...'.'-""1'..'.. I.,'. I , '..' " :. T'" 11 ~ -' .. .. ,I. .I.; . j,ltl:li"~,r;\tn'I' -j","1 .,. . .' \ . '\ '.: ~ . " ;"., ......".jl,'.... .;, \....:. I...,'....,.. .;-I~.J~,"'/l':l~"';.,~\:,...,..., \.:' .'.': ~_ '. ~,I ":,::,~'~:-I:I:;: ~~:~,:,:,.\; "1," \,~\I~\:~::.:~-' ~1~,'1~t.;'~':':'~"n\.1#""~1 ...::,...",." ..1.:...........................,.. ...'_" I'." ".___.__ .....'w.,.. r,~_'._M..H..."V.J ......,-..-..-...... .3-.60 -P~/.SV.=K4S-~w.MLA LEGAL DESC~ON ./dG-.K ~..ft---,y.... 2.f-~ JOB DESCRIPTION t/drr A~~.# It! / ~ J//C Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, Electrical,Contr:actor.\l"1 II C,. in', j,,\:\, .'(-,dlll{~;;: Vi',l ';':, M' .L..I".,,-,,,I -- v I in.)'; '. A1~Wi~C;~{:~I~~~~~:~~t.e;~~~~:;h'~12~J:~~~~i~~~:: in OAH 9!i~-OUi -OO~ (} i::;OI'r;fl ifA'0. 95~-Ob'~ Ci~O~~. \.'-::'.:. ~:'.~' ,:,,:,:,,,;r~r~J;~ f"I'~ ~l1". "'I d(.\"j t calling the center. (N~: ':10 telephone mhYlber for th8 bOre;J'un ! Jt;lity Noti{-ication SupervISor License Num.. et,;,., '" '" ,..,.,,.. I"\n ~ A \ ~..f'rtc:" 1. .1-'", ," '..'. ,'_ -.-, ,. . " , / " Expiration Date // Constr. Canll'. NUinber / t!Ql!r~ ~~ ~ '^L' c"olfl~ n:: THE WORK THIS P \Mll VI to -,,, .- T A' t(l@~rEilctM~~ERMIT IS NO COMMENCED OR IS ABANDONED FOR , !\N" 1 Rn nA.Y PERIOD, Owners Name Po..:r t3reJ' -A+-tJi t/ Address '5 ro en 0 L:>a ;5 u Sf 1(fr 4~ ...J Phone 5r11- 'l'lV -~;;'5J' City ~J. OWNER INSTALLATION The installation is being made on property T own which is not intended for sale, lease or rent. Owners Signamre: A~ ~li Inspection Request: 726-3769 . .. . . .' . '." .. , .. " ' . . ct as sUb:miil~tl:~aS'I~:;~: :,: ::::: . F~5111~nol rdli:'~:',~"",,,,,,, """ 1I~"l'.w!ng approval ":'i,~'~~,~l'eClfIC;'~(ld use: ,......,........'........' , 3. Zoning 'r.l''''I-'-----~- . '" 'QIG1.l""."'4 .. ....,........rlt,.""n'l':r;"".....,........._-~.......,......lP'tlolf\'tmUi'/I. ',".-'" ~.!.I~:.l.;.,ii....:.;~l)'.;i 'ljl\~\':1l.:.n~'- '." ..jj,......!~~~r~i;;iF.i'll.:\.:-M:x\ \ '.IlI:<'.:~':''''''': '\fP~,'::~...."w(':tl!l:lfli.:.lll~m'.:'I'ti(:" ...~,:,:\..\.;..:~:1,.l ~ .(;!i,~lr,.',~j. A. ..,~"' ..'. .. .. ......, ~f .$J~;..."'."'...' . ~~,.,..,~..-.. ....ji;"..IIIl.'.... . ,....."",..'.:;:..:/:;':',.....,,,' ~~.'. I .~~:- e.;u..!, U'~~I!i.' ' , !l l!jOU' . -J \l'U....l~'~:').)I~;.' ::~I',\ tl.t..~:,.~f,;~,1I , , '~'U;\:..,:.;:..,~.'l':.::;}ii.\:..:. ....,.'.....~:~1-:-I';.,,,.\I...,~.~\:....:.,I\\""tl:.lll'._.?:\ : i,' ",',~1~:.\il~"~'.1I 11\,~.~..,...:."",d!:ll'.'.,,",: .1':'.I,ll"lj ,... M _.......... .:1.:;,__,.,10:1""''1. _..~_, "'... ....,.,-,_-,...1",1 'I ....-.-...................,..,.,..............,',11" Serviee Jncluded 1000 sq. ft. or less Each additional 500 sq. ft. Or portion th... .wf Each Manufact"d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ".:(.;..,~:.:WIJ..\;.Il'.l'.......~T..._..._--I.""""'"I"~1\.:I""U..' '.'l~m~"." ........ '''-~.,flI_~'otflT\...11111.11....'''''' 'fiJ'".,,"--'......MI\,&\.\.\II. ',.;4.~It1UW:~~l"'. .,,',iim~,'mr: 1,~m'~I~~',"...ir"~:~!!i;;;;i;.;;mnstalil~w:I.,"'O..~,';:.~7.,;.,,~;l'~.'~;,'~;.:i~,;.~.. ;;'~"',.\II):I...:i~';;il;liilSlI )ij,,'i;'ij),~~W~!:-':~J"" \~,'~~,',.~ti.jl.I..'.~!..t\':/i,~;\h\\, B ,,., ..'...'I.l... "'......1" ,.w.. ...,.'''....''',.. - ,'.,-,.."" , 1:"",;1' "',...... . ".", I..'...."~.,...'#;.,..." . ?r:' :If,~~'a.~esio~ ' '" ~'. ,.,1....."'....:."~1 . I:'d.'f U . ia-e. ' . llil.~'H...:';' J\~I~~.' 1~1\.n..'''''.r'ltl1.llln'A~ . I ,.\I...."~:"...':"o';'n. '.""\'\I.\I\\U:~i\::'..,'J~. ,::,,".'."""'I."":""J~.':'I~,c..I"\O:::~'::':\;'~' ~~:":""''''~.'.I(I'~ ...I..'~'o1U1."\\:l:'J.\:l,ll '~""r_"" ,..1.;,.~l"VlWlIl,.....:.I,41"VJ UIl..c;.,:'>:;.l.:..::.I~,.t,... "'~"""""l'''''''It,llOlII,;...,~uQ'.:u.:~:.::.:.l'.'\"::'':,,,',,:, ':I{, ""\"'\~""'''' 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNotts RecoIlI1ect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 . , .. --~P"'-=-[;'("'1UiZ--r.r':':"':!I'-mil'ff'" ''''T'IT~,...~t.mI'!tii1--~I''''-''ml'llfl~ 1.11.1"''''''0-''.' C. 11~ijJ!'~I\!"'"~~~i~':~: \~ "1/Qlto"\~F . ~,,~~I:'.II~HIIlFJ!~g:r~fj:!j'~'" 1iil.i1~~::II!i!;ih~ ...,,,~il!\i:~~, ~~!i\tll\' 1,,:;\~l\t~mw!~:~\~,:'f,:~~:ll.'r:i~'i''''~\tJ'I;'\'~!l:I;~bI~~:)l, "Q . , 1 ,.' f ~ e.!t:~n 'jl ". . ~{~gmm~!~:!!,,!p;:"ljm~~i!~!~;I~'tl;;;;.d,;~l;!:~i;)~f!r!I~;t~:;:!m~;~t,'i:Wl,(r. 0./& 1"..,...I.r."'~1I IUIIlI ~',l',,,---, ' ".,.,1:': ~,~M,,,, ,~\ f.........,.....,.,....\m.':..:.,':,.~.).Y~w.,....,,: :.~:. U't\ll"".l."""I,J"I.a'~".I',.':)jL' .m....,... _............. ....,._____., ..1J'l ,.....___ __M.. ,.u..__l,:;IO..'1,,"'..,~" ..._1,'..;;. -..0'"............. _" __,.,__, 1.,....' .n.u Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. ~"""'!'.""".""""'_~!1l":'l~~T' tIT.l'IT.=.-.;.l,TI\:r.tI.I1fJi\\A..-.....rp'Jjili.--~I1I~!r.-Imf.r..\~"'~....I'rrlltl!..' ."..t(",w_-'-"-"'''''J'}Ull\l'.'''' D fv:iii~-:~~l:i:t.r.::"\l.I~~~.j l;t mrJ:\~~:.l !;~~I;"lr~b'li;~;,~.l~.u~miT~ii.1Smf~llv.r1l'mi'l~r;~ll'.:"r~:~J!ilf:~\r~::.il:l~t~1~t::!:2":'lt1Jht.;ti . 'tlilD ~~..IX~ ll:'lll!t:!';';,:u "':t:j!:!-!;~fl~~t("";'I"\fl"j:' f,":jil~+,~~~i~,~\,:.\:~\:':n tl~c~m~:~:~.';'II~;~;.rI~.,lm\1~t""'~~lilr;rI" :_1~~:1 ti...,.\II\::'''MI' .~ "":~l.!...., ,~,Z'~'''I'II~:N\~Ii:iniii~i')\~)''!of)( "'::I.'.'..:.......~:I!~'O)r~\I.I>'IH.I:J.:"..I..iu,,,;:i!;I\Iii..\it:"ll~11\"l:-,:..::t~'1;tlll"'1 _._-., ~11A1TI.1M~_ ..::.\WoI:.lIt:t.I_.........r"r::'I,I:JtNollt\IoIWJ~/,\..I..,:.I...liol.nW~~'I.WIII.~,..,.....,..,..,....I'N.Nt'IW'IIIIIIlU..,...o.l.... New Alteration or Extension Per Panel One Circuit v- Each Additional Circuit or with service or Feeder PeImit $ 43.00 43 p~ $ 3.00 ""~~:'ii;:ii:l;::~"""'~'" _ ... ~I"...t"_.~.\':',...,...._..__~, . "'''''.''~::::','::':':''::'lmI'' ""'''_'''I1'll"'' ,.......,..,.,.......... .,' " .."...''':.;':\~,'":'I':'....,..... "ill !\. ......i',,:~::.,:,,-~..'1,'\1,41. 'l!.'"'. I.',..,"!,~I,',l'~~113'r.I~t\IMlflj,l~i::J~:~:.I;.&,' ~~{m~"~'~::~..~..:.T'flll,',.' '. '.'lI~!t',! ~',~)~ li_'l.\ilj~l.a\ 1..~\:rr:~,,~I~"J::r~I!. ~~\tm;-n(lo1'..,.",',' E ..,' .."".., ...., , .... S''.d!Ii'1 ',.., '. i.O:o:"'("'~:i!'n" I' ,W ,,.. .,....,. '. . ';!j... "il:'_.'" . :~~,' . 'gee " . .. 'US: Al~X:' UIli~;UQ4'::l 0 :0 e :l.llol ' ~. 'EtIlG - a,l' . :f:':: :it:Qo.l\r~.':.'.t:~.I:oJ.II"P;-~,',..,J:~\~.,:\:~T~;.It\l~t~,~..~'(.,,.rI,...".."~'t!~~~~~I~ji.,...\~..Io\M,:,U\..:.~~fl'J~f,'.!~~n'I''',...,,''.,~I.l''''''~.,J, . __,____..._......,.....,...,..............__..,/:......:oJ.j... "N l'Q1'" aIo:aII.o....._.....o:......._,_,." .: I,.,.,.",,\J, l'U,lI.\l:.l.l..;;.~!zHf~, Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Comntercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges l,~Cm~1~(~~~~~~ii~I"~~ )tT~~Jlmm.;!~~;:#.;m;lifiiO,:It-rJ~~;:ill~~~lt~~l!':*::::ml~~~H!~~ 4 ""S:!I ..... .;:,. '(.I'.'.,IlI\t,l\ill.\lI.:.~:.\....."'~\ l\-(r.'I(lf........:'.~"" ~'I' I., ,'.'~ .. " I'T"."."."oI"L't\ll,~I\~~ ...1 -, ) I"I'.'''''.~J . /,\:). .. )' I ( 'I' 1 'Ill. <;. .... ~. ...~.. '''',:..jii1:::=i::~~~:'J:..,~:::~!:!\:~.~;\t 't'~~h.;~:i~i7.~j'" ~.;~,',;r.L,t'j;,,;;....i, \. f~.'.~Ii._,"l:i:J'~\i.;~;~a\ll'.,:..r.:\'~l~~.Io)~\~"':;i\),~il.l.'.,"~~,;~~~lm~;~!?~~y~j~!\t~!,'.;(.u~!~\Im',i.l;~r..:ll'li,,,.,';,'.lr .., .._M~_",'."""'-'- I\,I~ ON n""''''II'~''''...w,.,ilil, -..........,--..-..--...,"...-'"".".. ~ 45fNJ , Ir g', 4J-O f ~2_ (pj- 7% State Surcharge 1 0010 Atlmini~trative Fee TOTAL Shan:d Dri"e(T:)IBuilding FormsIElcctr\ca1 Permit ApplicatiOlll.03,doc FROM 5417263689 OF Property Services 3/18/2003 9:30 AM Page 1 '" f;..b:t:J~&:"'!A~'j, 3/27/2003 12:10:22PM " :; 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt ; Receipt #: 1200200000000000901 Date: 03/27/2003 . Line Items: Job/Journal Number Description Amount Paid C0M2003-00215 C0M2003-00215 C0M2003-00215 C0M2003-00215 Add, Alter, Extend Circ 43.00 2.00 3.15 4.50 Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Line Item Total: $52.65 Payments: Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid dIm 1346 In Person 52.65 .~ Payment Total: $52.65 I Check PAT I BRECHTBILL Page I of I cReceiptrpt