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HomeMy WebLinkAboutPermit Electrical 2001-2-6 , \- i:':..,,' \ " '. o €). i! DEVELOPMENT SERVICES DEPARTMENT f2{!.- o--~ \ \ 225 FIITH STREET "SPRINGFIELD, OREGON I INSPECTION REQUEST: OFFICE: 726-3759 1. lJJ.<;ATI...ON QF INS:rALLATIO~.., l1)~() L..AUQ.A- >iT. LEGAL DESCRIPTION J7/)7>27~. ~~"3~.b .jOB/ ~ESquPT}:.ON . /v E\.V ~P\('\11 c.p J Expiration Date iO /, /0/ . I Constr Contr. Number \":)..=t~R7-C: Expiration Date ID/t / () i I f Signature O~g Electrician Owners Nam/ Pr Ii\. t eVCeJ I Address /<6(00 }...pUCGt ~ Ci ty Spit "^~ C;4Phone2tO Sf/.1:j20.3 OWNER INSTALLATION The installation is being. made on property I own which is 'not intended lJOO:~31~S\f.Jale, lease or rent. 1 :39N~~gr~ S~~atu.re: 00' O~~r $" G: u8.:Jll-1W\1 1002 90 ~~W:31~a Z19lJOOOEluu~~~OQ~---------------------------~ DATE: RECEIPT II: RECEIVED BY: 30 COMPLETE FEE SCHEDULE BELOV I r'~dfl\"'''''tl\''' , . I ~. /,1. ~ . t.... ...t:. ... ....'(....1', Ao New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq,ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or 'Feeder Items Cos t Sum Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. iF lip &'5 20 CONTRACTOR INSTALLATION ONLY B. Services or Feeders 'T' - r)' ~ Installation, Alterations Electrical Contractor~\')I--l I--:CT..k'J.t.IX7t.or Relocation: AddresstA/ (JhS' J I J. Il..fll .:/::1::; f ~ 200 amps or less L _ '. ,201 amps to 400 amps Ci tyt::..UC enp , Phon@:}.") 7- W 401 amps to 600 amps \ /J 5 601 amps to 1000 amps Supervi~?r' License Number, J'67/} c . Over 1000 amps/volts Reconnect Only $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100,00 $130.00 $300.00 $ 40.00 YID c>> laD.m Co 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 volts D. Branch Circuits . $ 40.00 $ 55.00 $ 80.00 see "BtI above New, Alteration or Extension Per Panel One Circui t Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2000 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation , Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 50 SUBTOTAL OF ABOVE 7%, State Surcharge '-.... 3% Administrative Feel TOTAL 40.00 40.00 20.00 36.00 $ $ $ $ 5e:o .cr> SotiV '-.. '::J (n . (j{ ) , ....... ~ -.-111 . , . . ~ TRANS#:01-0004612 DATE:MAR 06 2001 AMT RECD:2 $ 550.00 CHANGE: CASHIER:004 Job: Address: 1860 Laura St Owner: Print Xcell 01-00116-01 Received: 2/12/2001 Unit: BLDG: FLR: FEE DETAILS Fees Electrical Subtotal Service or Feeder Installation Permanent: 200 Amps or Less Permanent: 200 Amps or Less Permanent: 401 to 600 Amps Branch Circuits Branch Circuits With Feeder or Service SubTotal Value/Quantity Amount Due Amount Paid 8.00 400.00 1.00 1.00 100.00 4.00 500.00 50.00 8.00 58.00 :Administrative Fee Electric Administrative Fee Administrative Fee - Electrical Administrative Fee - Electrical SubTotal 1.74 15.00 15.00 1.74 Surcharae Electric Surcharge State Surcharge - Electrical State Surcharge - Electrical SubTotal Total for Electrical 35.00 4,06 35.00 4.06 550.00 63.80 550.00 63.80 Grand Total: Page 1 of 1