HomeMy WebLinkAboutPermit Electrical 2008-3-21
SPRINGFIELD - _~ z~~\- 'J\ 'CJ
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22S FIFTH STREET · SPRINGFIELD, OR 97477 · PH'(541)726-J7SJ · FAX. (541}726-J689 ~ SOURCE '\'""0\ \> ....:::.J\r2 )
ELECTRICAL PERMIT APPUCATION \ ,-
CIty Job Number ~/~(6 -CYJV'; Date ":l/2-I/e~
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3. .:t:()MPLETEFifE:Sei1.Er.lrJtE1i...liJ;OW~T'''~:~_..-: <.oJ" :-; ~
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2350 YOLANDA AVE. SPFLD. OR 97477
LEGAL DESCRIPTION:
YOLANDA ELEhr.u1.ARY BOILER BLDG.
JOB DESCRIPTION'
Np~ plpr~T;r~l ~pp~er for boiler rooa.
Permits are non-transferable and expire if work is
not started withm 180 days of issuance or irwork is
Suspended for 180 days.
.OONmAcrOR'I}iSTAIJ;,.fidifJjN13/,
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Electncal Contractor Sc.nf.;pl.1 "Rlectric Co.
Address PO Box 2765
CIty Eugene
Phone 541-686-8612
Supervisor License Number
42188
Expiration Date 10_01 -701 n
Constr. Contr Number
/138702
Expiration Date
12-21-2009
Signature of. ze ~'S' g EJe Tlcian
4-- I
/- /'
?~.. tf' ,
Owners Name ~ So * 19
Address \ D'l '==> r-J L{ 'L tJt.
City w'~'-'''\101) Phone '7 ~~- Co3? 5"
OWNER INSTALLATION
The installation is bemg made on property I own which
IS not Intended 'Or sale, lease or rent
O~j~re ..___
( '\~
, ~: 726-3769
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHOR!ZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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A. .J~t;~;l3.fl\id~iitip~~'W~~!! ~l?~Mtlf~1:fiij![fp~t{~'Y~lii!ig,uni~. .. ;'_
Service Included
1000 sq ft or less
Each additional 500 sq. ft or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$1 1700
$ 21.00
$55 00
..-" ,.+::'i~;_~~r/'''''';;f~~-~''';~-''-'~''''':~~~:_''''''':; .. _. ~ ..__"~-, ~ .
B. .S~rvic~s,.or.,Fee'ders'::, iIi~.illiatjon;-Alteiatfons or Relocation:
-- ~ __J "1;/- _ - . ..... 1 ' '\~. ..' ~ ,. -_ _ _ _
200 Amps or less 1 $ 70,00 $ 70.00
201 Amps to 400 Amps $ 83.00
401 Amps to 600 Amps $13800
601 AmPA~t!JN: Oregon law req&lm~ou to
Over lO~fkiJws~~ adopted by the OiegcnIl) Utility
ReconnNbll~atlon Center. Those ruleUti'4}~et forth
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c. ;,.'t _, - _~u _;'.,
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calling the center. (Note: the telephone
InstallatiMJ~fl\i6r m~etriwt Utility Notification
200 Amps or less Center Is 1-800-332~~
201 Amps to 400 Amps $ 76 00
401 Amps to 600 Amps $110 00
Over ~02 ,Amp~ o~ 1000 Volts se~ ':B':.ab..~y::. _ _
D. ;~.r~-n~J) Circ~its . " ~:'~;~-\;-::'; >",--.:: ;, " ' ~,' f _
New AlteratIOn or Extension Per Panel
One CircUit $ 48 00
Each Additional Circuit or with
Service or Feeder Permit 8 $ 400 $32.00
,-
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Pump or Irrigation $ 55.00
Slgn/Outlrne Lighting $ 55 00
LImited EnergylResidentlal $ 28 00
LImited Energy/CommercIal $ 50 00
Mini~~m EI~ctric Permit Inspection Fee is $50.00 + Surcharges
4. :~.8tqt~PJ},jz~Q..$i~~::,~::;;}:~.> >-:-:-_::: $102.00
.. .. .. ~, '....r '. '
12% State Surcharge ~ 12.24
10% AdmlDlstratlve Fee f If) .-2-0~-
5% Technology Fee $ 5.10
TOTAL
_ ~ 1 ? <)--..51<
Shared Dnve(T )/BUlldmg FonnslElectncal Pennlt ApplicatIOn 1..Q8 doc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-00093
COM2008-00093
COM2008-00093
COM2008-00093
COM2008-00093
Payments:
Type of Payment
Check
cRecemtl
RECEIPT #:
1200800000000000267
Date: 03/21/2008
DescriptIOn
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstratlve Fee
Paid By
SPRINGFIELD SCHOOLS
Item Total:
Check Number Authorization
ReceIved By Batch Number Number How Received
dim
63279
In Person
Payment Total:
Page 1 of 1
1l:35:37AM
Amount Due
7000
3200
5 10
1224
1020
$129.54
Amount PaId
$129 54
$129.54
3/21/2008