HomeMy WebLinkAboutPermit Electrical 2008-4-9
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. .'_ \,^, __________~' INITIALS
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225 FIFTH 03. IU!.ET _ SPRINGFIELD, OR 97477 - PH:(541)716-3753 - FAX: (541)726-3689
EEEf..:'11UC4L P~lfIT tif!LlCATlON
City Job Number \j Cf, - \ *\ '1.-.
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LEGAL DESCRIPTION I~ \~~:,{)~~A. :'''CTI Re~hJcntial- Sjn~le or \.lulH .fami\, per th,diinl; !.miL
F\lU. S~aV *-(~ TILW\f. ~(lVrvvO~iceIncluded
JOB DESCRIPTION 1000 sq_ ft or less
n WI.~ ~:J I (,\f 0 fJ SO \J ~ 'S I J.a () F Each additional 500 sq ft_ or
~ 5,. I If; portIOn thereof
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling ServIce or
Suspended for 180 days. Feeder
New Alteration or Extension Per Panel
One Circuit \ $ 48 00
Each Additional Circuit or With ~ _ i
serviceOrFeederp~t 0 ~$t~~~~
E. :VIiw:dl:m.{'t}U<; ('Se-nice/feedc . not included) -Each In~tanation
~~R,,-N!one~~ Pumpo~HJJJ1;CE: _'_ $5500
: -- ~ Sign! rm ~ MIT SHALL ~^t""ltit 1~$f~WORK
OWNER IN TALLATION . '"'C,..".-"~ ~ Linnt~t la%~N~DER I HI~ ~tH~1iI ~ NOT
The mstallatIon is bemg made on property I own whIch LlIDlte~5~~fJt I S A 8 Ii N UU N ~<f6{f1
IS not lDtended for salrtese or rent Minimum Electric r ~. ~~fihspec 1 ~~ee is $50.00 + Surcharges
A NTION: Oregon raw requires \IN.....; T TJ7 1l1.n
Owners Signature follow rules adopted b th 0 ~ ~BTOT.tL'pF A.BOl..:. - W
u .. . y e regon UtlI""o/- ,-
tHotlflcatlon Center Th()<;:j:> rules are set ~~mr State Surcharge · ~
Ib OAR 952-001-0010 through OAR 952-~;t, "Administrative Fee ·
ao..You may obtain caples of the rules byTechnolOgy Fee ..
Inspection Reque~~~ center. (~Nhe telephonerOTAL ' ·
T O~~_{1 ,ty Notlflcatlonl Shared Dnve(f )'BUlldmg FonnsJElectncal Penmt Apphcatton l-U'/\ doo
~ t 'k;:?J~ 322344) r ~I\. wid- F-<i& ~ ~~ fff:-f{J ~ T'"
c.\.~ 0 F sfFLfJ {be vt c..A:tWL (
S TI rJe-MftN .
1. LOCA TIO:V- OF LVSTALVt TIONo:
2.
C01\TRtlCTOR llVST ALL-\TIOX O}...T.Y
Electncal Contractor ~K to L. \ ..PI~ / U
Address ~ \ ~ ~\ 0mfj 'S +
C.ty SrS.Dd Phone 1% A!?Sk
Z\ <61'5 S
Supervisor LIcense Number
Explfahon Date
fD-I-/D
Con~r Contr Number
W -d-Il L.,
l-l-fQ
Expiration Date
Signature of Supemsmg Electncian
City
Date
3. COl\fPkH:. FEE SCHEDfJLE BEI.On~
$117.00
$ 2100
$55 00
B. Scn icc!> or Feeders - fn".aUatio;}, 4.Ikratimls <JI' Rdocation:
200 Amps or less
201 Amps to 400 Amps
40 1 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIV olts
Reconnect Only
$ 70 00
$ 83 00
$13800
$18000
$413 00
$ 55 00
C. T emplJr~ry Set"; kc.. or Fe-cuen
Installation, Alteration or Relocation
200 Amps or less -~
201 Amps to 400 Amps I
401 Amps to 600 Amps
'J~O -
cCa-
$ 55 00
$ 76 00
$ll 0 00
---
Over 600 Amps or 1000 Volts see "B" above
D. Brnnch Cireuits
..
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-00l42
COM2008-00 142
COM2008-00142
COM2008-00 142
COM2008-00 142
Payments:
Type of Payment
INT CHGS
cRecemtl
RECEIPT #:
Description
Temp Power 200 amps or less
Temp Power 201 - 400 amps
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdmInistrative Fee
PaId By
100-35200-647009-P20534
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000000452
Date: 04/14/2008
Item Total:
Check Number AuthorizatIOn
ReceIVed By Batch Number Number How ReceIved
!NT CHGE
In Person
Payment Total:
Page 1 of I
1:37:11PM
Amount Due
330 00
7600
2030
4872
4060
$515.62
Amount PaId
$5 1562
$515.62
4/14/2008