HomeMy WebLinkAboutPermit Electrical 2005-12-22
0ne,Circuit S 43.00
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p~~a9_PERIOO. S 50.00
Sign/Outline Lighting J S 50.00
OWNER INST ALLA nON Limited Energy/Residential S 25.00
The installation is being made on property I own which Limited Energy/Commercial S 45.00
is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is s.t5.00 + Surcharges
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Owners Signature: . 4. "SUBTOTAL:OFABOVEE~&,\;\\;,".'!'-;:~"..::k CO
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Inspection Request: 726-3769 ,\rv t:J TOTAL .
Shared Drive(T:)IBuilding Forms/Electrical Pennit Applic:llion l-03.doc
Cil>' Job Number
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I. ::LOCATION OEINSTALIATIONi. ,. ;~,-~-:;,~
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LEGAL DESCRIPTION J7033!>'l"Z... ObYoo
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JOB DESCRIPTION I U .
J1u1J./A ;11. Pole-J,OlVl
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. Permits are non-transferable and expire if work is
. not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor .../iilf/J1JatJ S/qJ1J1MC
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li)ll Jf (fer S{)/\ Sf.
Address
City E VlQ;pj/LQ.
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Phone 'Jjf 2-- I/(P Cj
Supervisor License Number
(,,'-/4 s: / G
Expiration Date
/0 l Df,
Constr. Contr. Number
fJl" 31.{ Z z..
Expiration Date
10/1>10
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Owners Name t3reOj It? Ie W101/1.
Address 9 t? 3 n1;:;.; II -5+-
City 50n'f/Q Rd of Phone /1{7 - 337'(
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3.
1000 sq. ft. or less
Each additiona15oo sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
S 106.00
S 19.00
S50.00
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, 'I :J\'.' ruic' aOU~lt:U u~ lll<.:i V'.....~v.. . -./ .
I ;c'200:Amps(Qr;Je'ssr. Those rules are.se~ I?rt~63.00
In (2OPAiiips't0\40(f~p~rough OAn ""~'~~t75.00
00'0'1 '.<:.:.' ::T1t"'6oo'b~'!!.n r:oples 01 t,,~ 'U'W SI'500
.. IUUPS 0 I'UUpS h t ,. .._--" _.
"-"i,,n thp Cont'1r (Note: t e '-,-....._..~ .
601 Amp.s to JOOOJAIDp'sl Utility ~lnt;r;f'~tinnSI6,.00
1:' ImbOI tor tile l re4u1
Over 1000 Amps/V.lo1ts,O 332,2344\ S375.00
Gente, l~ -uv -
Reconnect Only , S 50.00
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Installation, Alteration or Relocation
200 Amps or less S 50.00
201 Amps to 400 Amps S 69.00
40 I Amps to 600 Amps S 1 00.00
O,:,er 600 Am.ps or 1000 V 5!lts s~e,:B" above." _ . '.. _ _'
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New Alteration or Extension Per Panel
SD
225 Fifth Street
I ' .
Sprmgfield, OregoiI 97477
541-726-3759 Phone
.
Job/Journal Number
COM2005-0 1733
COM2005-01733
COM2005,O 1733
COM2005-0 1733
COM2005-0 1733
Payments:
TWe of Payment
Check
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12/1912005
RECEIPT #:
Description
Sign Plan Review
Sign 0-35 Square Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Sign - Outline Lighting Each
Paid By
RAMSAY SIGNS INC
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.ty of Springfield Official Receipt
Wevelopment Services Department
Public Works Department
1200500000000001824
Date: 12/19/2005
Item Total:
LuecK Number AulhortZBIioD
Received By Balch Number Number How Received
djb 1055 In Person
Payment Total:
1 of I
1I:12:04AM
Am... nl Due
40.00
80.00
3.50
13.00
50.00
$186.50
Amount Paid
$186.50
$186.50