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HomeMy WebLinkAboutPermit Electrical 2003-5-21 OS/21/03 w~u UU:4J tAA 3q~,~O~uo~ ...~. I I I "I.( ,',II 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PB:(541)n6-3753 . FAX: (541)726-3689 .. ."., .:....'., ELECTRICAIrf.!:..I9P,.kAPPUCATION . . :~~i~~loWi~gtOiect as SUbmitle~ ti~~'i~~'tol;~~~ City Job Number ~~ Dan: ~ I'Z; J a ",ppro~a~n oes not require specific land use,ng ~;); .~". ..". ,. ". ....d ... 'd:.< .', .. .. ,..,<,~",~",,,,,"..,,,.,,,,,,...;iWJlipf-",'u""~"J.';"!1=~~,;~.l}k.r"',,"'~;;"1l1 1. {iti~~i9.~9.:&~~i~i~~f.Ji5;j~~; 3. >~,~'Rhe;r:;$#!.!~~'t.~~\'J~';.fif~~,fi't~ :)., <::: V C,Kl ~I..) t'I'::" Sf, . ..,_,.'. _~lbDri2A~_""'_~",,-.""'"'~w,-,~.'+.~~ I - 0 ") :!~O"\2l~'"~:~;;=~:'~: Eaoh additional 500 sq. ft. or f'tlt11- Q,,pr;(}V\<;ot'l' '::::..~~"Tl? M portion thereof S 19.00 ~.~::-.-;;;;::",,:~[~;~q'@re#~~~~~i~~f'l!lf~ ~~.. ~ . w'/t;....~..~..';t~ .~lt."?~z:;..;,::;::-t.&.'..n:""~_.Eli.::-..s:<t-~......-~~.~,i.It"I.~:ii:~...:r.u;.,;;\!'~.~ ~~ ~ ' .,...._ '~.. " , ".... ... w' . . ' Expiration Datc .. A>Jb .2. 0.:>::' ,"! ~ ~ ~_8.!staUa110D, A1teratioo or Relocation " , 9.~'I;, k,Q:.~ ~ ~~OO Amps or Itss S 50.00 Constr. Contr. Number i 1..1 'iY1o,...;<",~ '~r- ~ ~~~ 201 Amps to 400 AmPS . ' ..~.:69.00 ~~<.Q:.'\' _~\; 401 Amps 10 600 Amps . ,,,'\ ,'\'S1QO.OO Expiration Date "UG.~'2 ~~ ,<:::Iv ~~' , ,," ('I" ~".!.. ~~~~C'\. -J.. c:>.~~" ~. ~;~~~~?'~!~~..Y~~~>~[ij,::~n~:li6~~:?~,Z-~,;;;,y,'~'''''"!iIi.' ~ s;gnar;rsuPervimQ.l! !j,pA<y'\J f;i""' D ~ran ~lr.(.\11 ". ..~~f'';'~-t\'t-h[~ ~. ~'." #~~:4.-:!Jl ~- ~rmt ~'.l!\ ~ ~f;;)'t-".~,~~ ~ ':::':;:~:;::~'::1::~t~~~6~;,~;~g~;~~!"''' ,: . _/I "S ~ Ii- ' One Circuit ,.>.,:F ~,el.)-<.,~o"'-'ovrs~<o 0 S;4~.OOf' .~. EachAdditionalCi1Wi(obwitl1)~' o~' .-s-c \~o':0' .-,- ,Service or FOederLP&.nit~ Ri' . ~ v ,e' ."S,3..00 OwoersName 1"(2.<;,(: c.JeP. '. "v .<.,>' ^\f ",,::J ,^,'iY ~- 'S' ()!I E. if.JJIf~~i~~(~~<?~'il\oo;""-i:"~~<<~,,:"Jm~~~qJ[g"'~!i"; Address jlILl,") !J\COLL~7 ,..,/I"lL ..k_..~...,~.,_..,_J~.,~-.~..",' -'.' ,.~ .,.-",.T;;f,~'t~"" ~-- 1Y" r~......~,"""",''''''''-~''''''''' ..........~ .....__.....~. ". '"'.~."...-. ""'.... ....~._"M........n:..__ .-- . .,," 0-- ". cr v. ~. City L......J\J;'^{>;lll5, .Pbone b\2. 7&\-sS72 . Pumpor.iffi"saliim-l.Ovo-S-e ~-S-e;.f;v $50.00 .' SignlOutlii1<;? ~igh'tinii~o ~,o ~'<j S 50.00 \l' ." :0~ CJI?, - Limited EnergyIR~ideDtial S 25.00 Limited En"'1!YIC~,crcial , $ 45.00 4Foi pt> MinimUm Electric Permit Inspection Fee is $45.00 + Surebarges Pennits are Don-traasferable alld expire if work is not stllrted within 180 clRYS ofiSStleDCC or If work is Suspended for 180 days- 2. &i!~tii;~~!!wj-~ Eleettical ContraCtor C ASt:..I'.Oi.. Llf'~ 9('(;7'( Address ;J'7,:) I 7 2;JO ~, ~L City <?A,-1';""" Pb<1ne 95'> 313-27v4 L:>o~3J5'lZ0'0 SupeMsor Licen$c Number 1c:;:&.a,)L~ . OWNER INSTALLATION The iDslll!latioa is being made on:property I own which is not intended for sale, lease or ri:nt. . Own"" Signature: Inspeetloa Request: 726-3769 '1 Each Maoufact'd Home or Modular Owelling Service or Feeder $50.00 "!:",-._:t!"".I'~'r.,,;..,~,.p.:"~'";~:(i"'~~C;::iril:fjlt'iG;"'j:,:-,;,,.~.=r:'I":::':~-:::,~. ,.... _._...."t!,'lil'l:'iO:~IJ" ~~...:;.:1..~'.'l"'....f:ic\!.,.:;-llJ> t!;:;:;:r.;;;.-P . ..,...."-....-.,[..-.....f'. .iil'r...."........~..!n;....'....~'lit B. ;,<>t"vicCs'i(i"."" ' ;;:'.,milfal1atlO . ~terJitJil....c'~~""" 'lro,il~~' ':V-:'::=":'~:':_:'G';;:":~.f~~:~I~...:c:iffUd;..:-c:....r.iill*L\~.......;.:;,{;#..4io~~';:':~~juI;'I;'.A.r;~ 200 Amps or Ie.., 20 I Amp. to 400 AnlpS .401 AnlpS to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $ 63.UO S 75.00 $125.00 $163.00 $375.00 $ 50.00 ~_"~~~",...'" ___.._.___~.=_ ~~ _' . __',~-:'~"""J1--~ ="-".'l' "(If .....-~.,........,..f~_.......... M':"''''-M''''~.L,:,,;,y~-~'''::'~.:::.~'-'''}'~..cW'J 4. ~~~'. _': .-,~P~~~~~~~~~~~~ ~);;.:r-~'.jf.io!~-:~~;e.:#~1~toigfJ~'d""-=v:n.~g~-?~n' II ~ ,tAl ~.IC- .~,'S\;) :;2, foe;;- ,7% S13te Surcharge 10% Administrative Fee TOTAL S1W'cd Drive(T:)lBuilding TomLSlElectrkal Pc:nnit Applicalioo. l.oJ.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number C0M2002-O 1369 COM2002-O I 369 C0M2002-0 1369 Payments: Type of Payment CreditCard . . ; .~ '~"'H"'" ' IZ."",''"'''''''-".."..."._- " :, i "'"A!; I , --;1 , .",.,._,....., __ .c ..__-,.' "'.J Receipt #: 2200200000000000918 Description Low Voltage - Commercial Indus + 7% State Surcharge + 10% Administrative Fee Received By jmp (.;beck Number Batch Number Authorization Number Paid By CASCADE LIFE SAFETY 00077 104335 City of Springfield Official Receipt Development Services Department Public Works Department Date: 05/23/2003 4:29:44PM Amount Paid Item Total: 45.00 3.15 4.50 $52.65 How Received In Person Payment Total: Amount Paid $52.65 $52.65