HomeMy WebLinkAboutPermit Electrical 2007-2-9
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Wt~ INITIALS NY'-"
K:.~ DATE a-I~-07'
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Date I),-Q-07
CITY OF SPRINcOLD. OREGON
215 F1FfH STREET . SPRINGFtEW, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPliCATION
City Job Number (l~" - 00 75tf
I. LOCATION OF INSTALLATION:
-11SJ-/ 4/st../ G-I~c.'(L1C- v.'.e.....J
LEGAL DESCRIPTION:
I g O~ OS-" ri.). of~ ()
JOB DESCRIPTION:
$r=12-
PermitS are non-transferable and expire if work is
not started within 180 days ofissnance or if work is
Snspended for 180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~ yl!,e.. E I-(..C. -\r. c. r....c.
Address 341115 ~... ~ ~
City t:: IAfj-tM'.
Phone $' 2.0 - CD '1 (g (p
Supervisor License Number
32%55
Expiration Date
lO- 1- 2...0C'T-
Constr. Contr. Number Z.c - 5 '2.01 C
Expimtion Date '1- \ - 2-00g'
Signature of Supervising Electrician
3.
COMPLETE FEE SCHEDULE BELOW
A. New Residential- Single or Multi-Family per dwelling unit.
Service Included
1000 sq. It. or less
Each additional 500 sq. It. or
portion thereof
Each Manumcl'd Home or
Modular Dwelling Service or
Feeder
,OL $106.00 ;)...'~.-
cf/... $19.00 3~.-
$50.00
~
B. Services or Feeders -Installation, Alterations or Relocation:
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolls
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
C. Temporary Services or Feeders
Installation, Alteration or Reloeatiou
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
$ 50.00
$ 69.00
$100.00
'JI' qJ P J NOTICE- New~te,:"tionorExtensionPerPanel
W~ VI ./1~f)AVL--. . One CIrCUIt
V I HI::; t'tHMIT SHIllabIOOl:I16lirMi ifW&IMG~th
OwnersNam':lln.tdUv. 1 OI,>,~~~ZED UN~R'~1'S~'l'YtNOT $ 3.00
, t, I CEO OfllS ABANDONED FOR. .
Addres(5,.QO g ~ ,,\~IV < 29 QAY Pt~I06'.scellaneous\Servlce/feeder not mcluded)-Each Installation
City ~~ Phone ..R.,L/iJ.... ) 15?' Pump or irrigation $ 50.00
SignfOutline Lighting $ 50.00
OWNE ST ALLA TION Limited EnergyfResidential $ 25.00
The installation is being made on ~. v~~.;; I own which Limited Energy/Commercial $ 45.00
is not intended for sale, lease or rent. M FJectri~.P;t 'ftO ~ F . ~A5 00 + S h
Anr.N"IIUI\l:Ufeif~m',l.flv~G'l;n:lfye"..:<,"p~.;un ee IS.... . nre a..ges
followrulesadop~d~VE ~.-
Notification Center. ~~fiIt\!~hM,t forti ..to . -
inOAR952-OO1-OO10~QIMi\~FJP1 OIS.-
0090. You may obtai~iV~Iirl3IJ~les ~' 1<9.. ~
calling the center. (Note: the telephone c"
oumberforthe OreglittUWty Notification 1307.
Center is 1_800-332~lJl!ive(T:)lBuilding FormslElectric:al Permit Application ll-06,doc
Owners Signature. ~
~{jf;~ yjR~\'1P" b
~fIon~~::;' 726-3769
$ 43.00
. . i
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006,00784
COM2006,00784
I COM2006,00784
COM2006,00784
COM2006,00784
Payments:
Type of Payment
Check
cReceintl
"'iiiiFlIlU>' ,
. ."',".""'''''''''-'''}
""'~'~-. c, 1
.' ,
. ;" 1
'. "-,",--'~ --
C&of Springfield Official Receipt
.Iopment Services Department
Public Works Department
, RECEIPT #:
1200700000000000142
Date: 02/12/2007
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddtJ 500
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MATHEW OLSEN
CONSTRUCTION
Item Total:
(;heck Number Authorization
Received-By Batch Number Number How Received
Ikw .
7049
In Person
Payment Total:
Page I of 1
9:33:09AM
Amount Due
212,00
38,00
12,50
20,00
25,00
$307.50
Amount Paid
$307,50
$307.50
2/1212007