HomeMy WebLinkAboutPermit Electrical 2006-10-17
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
. City Job Number CO~ voo, - 01 Z 1 rl
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LEGAL DESCRIPTION
) ~oz. 03'Z-J 04100
JOr D~SlRIPTZION
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Permits are non-transferable and expire If work Is
not started withIn 180 days of Issuance or If work is
Suspended for 180 days. .
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2 ,CONFRAcroR:INSTAEI::ATJONONI;Y,.
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Electri~alContractor Ab:S E/t"c,Lr/c .:2/7c
Address ';?Vi &) A' d d" d /
City ~e/'Je
Phone &;,f&; ~<)7I('/sf
Supervisor License Number
S".7t/'/S
Expimtion Date
//}-/z17
Constr. Contr. Number /5007J?
Expimtion Date .f' -/ .y - t:' 7
Signature of Supervising Electrician
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Owners Name ~ (l,it6/ ( L
Address ?o 130)( -z;X'CO
City TA~Pt3l )~e 71(1:. . OJ~J
OWNER INST ALLA T. ON
The installation is b . g made on propeny I own which
is not intended for ale, lease or rent.
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Inspection Request: 726-3769
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3. EqJ,i11J'iE.rn FEE SCHEDULE:BEL()W;Jf;r~)~~ '-';41
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
ponion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
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B. t~~~~.n;j~.~~~rJ:e~c~!r%~!;:~~l~~~~tf~=:t~!l-~,:lg.~p'~
AnENTIUI~: "'~. Oregon Utility
200 lll\lf'J~rll,Sl~ adopted by the . ,J.,~6J.:..Q.O;ort~
201 A9Aps,IOt4, Oil ~psler. Those lU''''::. ~~ ;1,5;00001
Notllll.la vri - h .t'l ;:,...-
401 AUlP.S.!9.I>01hA:mps.0010 t roull"~: ,($125.005 h\
"n Uf'n S.,i~ ... - It; 11,..t.~
601'otJWJ 10!!9.!lor,\II)"pS'btain cop\t'.~ ~'.;~#?:Qole
Over J()Oo'\AmpSA\\1lltll3nter, (Nu,.,,::,~::,~ ~1,$a".S,OQion
t;a '"'~ . -" ....~tl._-
Reconnect Onllf for the Oregu., """"'!'; . $)50.00
nulTru~1 ris 1_800-~~~-t'-v'''''"t .
l!<" :""""- Cent~_-.!>u""'+_'~'-'dt., ....~ . ....~iIi'..'..--.-...,.j'.,.-. .... ,.,<'
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C. ~~!"poran.' Scmcesor..Feeaers':~g~.:; ~'r:,:i!l,<;o;,~<::.4;~;:~~:~,f,"'{:~'.~<~.t,u. :"',il
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Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps t'l-ffl~'~~ $100.00
o~er~69g;~!'I1~rll'~~IJve:\~:'.!~~EIF TH: W:UKI\~,
~=~~~~~A=;t~~'"
Each Additional Circuit or with 7
Service or Feeder Pemit I $ 3.00
E. fil~~~~s_t~~*!~~~l~~~~~;t~~~l~~~~~.~~~
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
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8% State s'urcharge . " .-"-.-....,,".- --" '"1 b5
10% Administrative Fee l./ f:p
S % feetf- f'e'" J 5~ ,0
TO'I A~ha"d Drw,(T VBudd;ng Fo~~~al:1l Applicauon l-O:dOC
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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C_f Springfield Official Receipt
~opment Services Department
Public Works Department
JoblJournal Number
COM2006-01218
COM2006-0 1218
COM2006-01218
COM2006-0 1218
COM2006-0 1218
Payments:
Type of Payment
Cred itCard
cReceinll
RECEIPT #:
1200600000000001536
Date: 10/17/2006
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Paid By
DAVID LAWLER
Item Total:
t:heck Number Authorization
Received By Batch Number Number How Received
njm 009629 In Person
Payment Total:
Page I of I
1:23:16PM
Amount Due
2.30
3.68
4.60
43.00
3.00
$56.58
Amount Paid
$56.58
$56.58
10/17/2006