HomeMy WebLinkAboutPermit Electrical 2008-5-19
Date
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SPRINGI"ISI...D
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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