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HomeMy WebLinkAboutPermit Electrical 2000-5-12 r i . '. ~ .. "i approval. IL-- Zoning LD '5~ 1'2- --crp ctSvJ ~ . .'... Date - T'. ~ "1...., Authorized Signature> 225 FIITH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 97477 726-3769 1. LOCATION OF INSTALLATION II{RI:., +\a....cI~ ~(';dn.. ~~d .u -Q LEGAL DESCRIPTION I+O,~5d.'J-. ()OI.{C() JOB DESCRIPTION SennJt,;. 0, rJ"""v" p/ "- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY B. Electrical Contractor ('/;rS t;/ertJ-tlr1 'D 0 ' L--- Address J () DO l' / r;~ d- . City <;;'f,)/)fidd- Phone TYI -dd-3~ Supervi.sor License Number Ilo<?l.:,S It) -0 \ - 0 \ 5gyq q-I -()O Expiration Date Constr Contr. Number Expiration Date Sign~)r of Supervising Electrician / Z~~~-;-- ' ;:e:s Name 0"",,- ~ -n1.p Address 142S +-l~...^B.n., 12AL Phone 14l-C41..1 L/ City OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE: RECEIPT #: RECEIVED BY: 5 DATE:MAY 12 2000 AMT RECD:2 $ 55.00 CHANGE: CASHIER:003 ELECTRICAL PERMIT APPLICATION City Job Number n()-oo6'q~-OI 3. COMPLETE FEE SCHEDULE BELOIl A. New Residential-Single or Multi-Family per dwelling unit. Service Included, Items Cos t Sum 1000 sQ. ft. or less Each additional 500 SQ. ft or portion thereof Each Manuf'd Home. or Modular 'Dwelling Service or Feeder $ 85.00 $ 15.00 .$ 40.00 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 amps/volts Reconnect Only $ 50. 00 S ()> $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80,00 Over 600 amps or 1000 vol ts see "B" above D. Branch Circuits .' New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 ,Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL 50,~ :5 ..so 1.~1i Sf:" - !.4 . . . r. 0.. "'(, . I ('t' \ /"",.'"^ ..~ .;.~J. ';d.~:~1;. r J. ,':;.i t C".n~.:~l ,.... v,___ " ~.~ ..' " . ::i'~~;~:J ";11~: r;~lHc.:3 I ,~ f '. _/' ~ ) ,:) ;/ . I DUPLlCA TE RECEIPT DUPLlCA.TE RECETP I ---- - - --------- --------- ----------- --.--- ---------------------------------------- " . CITY OF SPRINGFIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 (541 )726-3753 -----------------------------------..---- ----------------------------- ._------ .. --- WELCOME TO DEVELOPMENT SERUTCES AND PUBLIC wonKS ------------------ ---- - - -- -- ----.---.-- --- --------.--- ---------- ---- -- -- ----- - - ---- REG-RECEIPT:Ol-0001705 C:HAY 12 2000 CASHIER W:003 11:53 alii A:MAY 122000 ---------------------------------------- - --------- --- - -------._- - ----- ---- ----- -- 1004 ELECTRICAL PERMIl $50.00 JOB~:00-00693-01 1099 SrATE SURCHARGE(7%) $3.50 JOB~:00-00693-01 1098 A0i11N FEE(3%) $1.50 JOB~:00-00693-01 TOT ilL DUE $55,00 RECEIVED FROM: C AND SELECTRIC CHECK: $55.00 TOTAL TENDERED $55.00 CI1ANGE DUE $0.00 ---------------------------------------- ---------------------------------------- .Pay Name :D AND SELECTRIC .~ia; 1 Mdr :214 SOUTH 19TH STREET ,Cty/St/Z :SPRINGFIELD OR 974T1 .Site Addr :1485 HAYDEN BRIDGE RDA ---------------------------------------- ------ -- -------- -------------- - - - -- --. --- -- ----.------- --------- --- ------ - -- - --.--- ---------------------------------------- lHANK VOU!!!!!! ---------------------------------------- ---------------------------------------- DUPl.ICm RECEIPT DUPUCATE RECEIPT ~ \ .c .. TRANS#:01-0001705 DATE:MAY 12 2000 AMT RECD:2 $ 55,00 CHANGE: CASHIER: 003 '. .'. " . ., ~