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HomeMy WebLinkAboutPermit Electrical 2008-5-19 Date ZON \ ~V INITIALS l\.~'VV\ fa&, DATE (17 ....(iJ -- l"') '{(' .,, SOUR~ ~rV -,~~ ~ S/, ~ / D~ , " SPRINGI"ISI...D , r 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ELECTRICAL PERNllT A PPl,JCATION CIty Job Number t~'{y];) ooy- (;) Il-f 8"g 1 LOCAll0N 'OF INSTALLA1ION: 3~33 ~\~(~n-J Dv- LEGAL DESCRIPTION \1d~ ~~ rotDqOb- JOB DESCRIPTION L-OvJ lIath'je. T,-C- CC,.;I~ /eJ ,to..... ,)~GlJl'.'f\, PermIts are non-transferable and explr/'f work IS not started wlthm 180 days of l'lsuance or If work IS Suspended for 180 days 2 CON11?liCl'OR INS1'ALLA'110N ONLY Electncal Contractor Address ~07 <k('.,11~1 5,1-, :tit:, Cdy 4A~ Phone 5'11- 72t-CJZO'i YLLJl LEA SupervIsor LIcense Number ExpnatlOn Date I 0 - 'ZOO.::x Constr Contr Number /.5'1 ] lJo ExplratlOn Date _7// tJ / :J-()rJ CJ S'gn'ru" 07;;1"~2A,1L _ O",\e" ~ Cl r R ",,,* S2--~~ A&ifes\b Eb;(. \q'-11 C'~dQY\~7~e OWNER INSTALLATION . The mstallatlOn IS bemg made on property I own WhICh IS not mtended for sale, lease or rent Owners SIgnature InspectIOn Request 726-3769 3 C01UPLE1'E FbE SCHEDULE BELOl1l A Nt'" Re~l(lcl1tIal- "mglc or Multt-Fmml) per d"cllmg umt Service Included 1000 sq ft or less Each addItional 500 sq ft or portIOn thereof Each Manufact'd Home or Modular Dwellmg ServIce or Feeder $117 00 $ 21 00 $55 00 B Sen KC" Of Feeder.. - Inst,lltliton, AUclahon'l OJ RelotatlOn AT" -r'\'TW. I r ,( ,~ '-I' , -_~ ~II'\U to 200 Amp~t9F,i~sl " : d\ J ), -} \;:S;:io'o'6htVtl- 201 Ampsltd;400Amp~~~" > )l_t-;:n~~;~1}_~r I~ I) "C' i~-\ \1-..Jt1lv ~lll ,..H"~~11 v, ,n ~ 01 401 Amptflto 600'Amps~ 't 'r v ",Il:"" of tt~~~lQ<g bv 009\) You may au ,1, I li~l_ - - 601 Amps t8rh~Pt~~,yeenter (Note the tE$El~bQoe Over 1000~Qb$ the Oregon Utility N~u~~~n Reconnect Only Center lS 1.80U-~;;S,-,\)4'$)55 00 C Temporary SCH'ICCS Ol feedcls InstallatIOn, AlteratIOn or RelocatIOn 200 Amps or less $ 55 00 201 Amps to 400 Amps $ 76 00 401 ~f~ne<@9 Amps $110 00 Over"P.€t~MIT06drl~~k~~,~gttJ~01~E Ws ONROTK D BrA4.l:l1H:ORlJi.o UNDER THIS PERMIT I ('[)MlIII~f\Ir.~O.QR IS ABANDONED FOR New}\Jtel'iiti'oii''i}r- ;)Ii1rnfBtPer Panel One t\~~l~ 80 DA . $ 48 00 Each AddItIOnal Cncmt or WIth SerVIce or Feeder Pemut $ 400 E Miscellaneous (~en lCe/fecder not mcluded) -Each InSlaHatlOn Pump or ungatlOn $ 55 00 Slgn/Outhne Llghtmg $ 55 00 Lmllted Energy/ResIdential $ 28 00 _ <'0 Lmllted Energy/Commercial / $ 50 00 ,0,-- Mllllmum ElectrIC Permit InspectIon Fee IS $50 00 + Surcharges 4 SUBT01AL OFABOVE le ~ 17V 12% State Surcharge 10% Adnumstrahve Fee 5% Technology Fee TOTAL ~ 3~~ Shared Dnve(T )/BuIldmg Forms/Electncal PermIt ApplIcatlOn 1-08 doc 225 J?Ifth Street Sprmgfield, Oregon 97477 541-726-3759 Phone City of Sprmgfield Official ReceIpt Development ServIces Department PublIc Works Department Job/Journal Number COM2004-0 1488 COM2004-0 1488 COM2004-0 1488 COM2004-0] 488 Payments Type of Payment CredltCard cRecemt 1 RECEIPT #: 3200800000000000377 Date: 06/04/2008 DescriptIOn + 5% Technology Fee + ]2% State Surcharge + ] 0% AdmInIstratIVe Fee Low V o]tage - CommerCial Indus Paid By NA TIONAL NETWORK Item Total Check Number AuthorizatIOn Received By Batch Number Number How Received nJrn 027026 In Person Payment Total Page 1 of] 2 39 02PM Amount Due 250 600 500 5000 $63 50 Amount Paid $63 50 $63 50 6/4/2008