HomeMy WebLinkAboutPermit Electrical 2006-12-5
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12S FIFrH STREET. SPRINGFIELD. OR 97477 . PH:(S41)726-37S3 . FAX: (541)726-3689 "--~ _ "'-J
ELECTRICAL PERMIT APPliCATION /Z I.... /, I
City Job Nwnber C O~ ZOC>b- 6/ S 52.. Date /5 I It"
Each Manufact'd Home or
Modular Dwelling Service or ,_ $50,00
Feeder \ r8C1\1ITb j"" .-
,c.TTtN'1'4GN:-OLe~nn a\:~ ' -: ,: 'r---- - .1
j B. Senicesitlr-Feeders ,.....ID!l..hlll~ltion. Alterlltion." or Relocation:
Oi\'J\U_\,.lIIw,....-~.' . . . -'..u~_____~
N ''f.r~tion Center, I ,',J,- , ..,; . - l' ., -'J1.
0" 200 Amps orlessi 0 \1-,' -' ,-" - $63,00
, in ~lio'I~P~~0'400AmPS"" :~ ~.. :'.' ""'-~ l'$\I75,OO
3l'3 5. ~..J1, J)j; -If/IS- OC'-~O{~"~~600~Am'sO\(;' ': ,:' ,u,.'.J$125,oo
calilnq \,~'" "G, h... p. n
60LAm sto,lOOO.-Ain-s U'.,~.'.~I \ .uUlIvCHlU $163.00
n\;IIIUvl p..., ...~ -P 2r
Over 1eJl9.'~psIVciltSO-332 """)' $375,00
Reconnect Only $ 50,00
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1. i LOCATIONOFINSTALLATION
353 --in p ,'1'1 57. '
LEGAL DESCRIPTION
/7D") 3S-31
1(000
JOB DESCRIPTION
J-kdk wr ~[I fC ~ Iv 519),
Permits are non.trnnirerable and expire if work ill
not started within ISO days of issuance or jrwork is
Suspended for ISO days,
2. [CONTRACTOR INSTALLA TION ONL Y J
ElectricalContrnctor !i1e;!ytJ l1J~rl1
Address
City 5fJn~.HdJ Phone 7%-3312-
Supervisor License Nwnbcr 558 5 I q
Expimtion Date 10 - 1- () F
Constr, Contr, Nwnber / (j,t) J"W
Expiration Date
f1-zo -0 ~
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OwnersName .:&+J.v 1/-6.HE'IL
5S3 ' MAIIV ~f
City c:... ~ F ~ Phone 6.5'4 - DC cr Z
Address
OWNER INSTALLATION
The installation is being made on t......y......i I 0\\11 which
is not intended for sale, lease or rent.
\ .
"ection Request: 726-3769
3, I COMPLETE FEE SCHEDULE BE!-OW
I
...._J
A. ~e~_~":,idential- Single ,;; M~I~i.F~mily pe;;'~"elling un~.-:
Service Included
1000 sq, ft, or less
Each additional 500 sq, ft, or
portion thereof
$106,00
$19,00
c. L!emporary &n"ict.'s or Feeders.
!
InJt8UatioD, AlterutioD or RelocatioD
200 Amps or less $ 50,00
201 Amps to 400 Amps $ 69,00
401 Amps to 600 Amps $100,00
Over Iti:OOSlDt 1000 Volts see "B" above,
D,; Br;qffiS1~MIT SHALLEXPIRrWTHEWORK--J
New MMhil.QRJli~J.lffP'J~.:r~I.[.PER~lnS 'NOr--
Onec~'v1MENCED OR IS ABANDON~f.~
Each ..wfl.i\foQ~I(c\il;ui,/ c1flWiJlOD,
Service or Feeder Permit
$ 3,00
r-' ._..,..___n -------.,------'-)
E. i Miscelhmeous (Sen"ice/fel.'der not included) -Each lm:tullll,ion
Pump or irrigation $ 50,00
Sign/Outline Lighting I $ 50,00 .37)
Limited EnergylResidential $ 25,00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
~,[ SU;;TOTALOFABOVE --"1 :::;0
8% State Surcharge
10"/0 Administrntive Fee
$ % 7er.H rfl"".
TOTAL
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Shared Drivc(T:)lBuilding FonnsIElectrical Pcnnit Application 1-06.doc
\
, 225 Firth Slreet
Spri~llfield, Oregon 97477
541-726-3759 Phone
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1Ji"- . -
car Springfield Official Receipt
D~lopment Services Department
Public Works Department
Job/Journal Number
COM2006-0 1552
COM2006-0 1552
COM2006-0 1552
COM2006-01552
COM2006-0 1552
Payments:
Type of Payment
Check
cReceinlJ
RECEIPT #:
Description
Sign - Outline Lighting Each
Sign 0-35 Square Feet
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
METRO WESTERN SIGN
1200700000000001126
Date: 08/30/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
10081
In Person
Payment Total:
Page I of I
10:55:52AM
Amount Due
50,00
80,00
6,50
4,00
13,00
$153.50
Amount Paid
$153.50
$153.50
8/3012007