HomeMy WebLinkAboutPermit Electrical 2008-6-5
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CITY OF S~ "INGFIELD, OREGON
225 FIFTH STREET. SPRING FIE: LD,OR 97477. PH (541)726-3753 . FAX (541)726-3689 ~
ELECTRICAL PERMIT APPLICATION 8\\0
CIty Job Number ~~-~ Date ~/5"/~
Jo.~i~~ffiV~<iliI~N ~J 3 L~~MPI:E~ ~EE S_~l!E.i?~EBiiL_O_"!~~~ ----=-~
LEGAL DESCRIPTION A r ~~,;: Re,-,-d~~t;l- ~lUg~",~1."1~!-F;;;.'!yp~r dwe~ng uUlt-J
/ 70.~ 22-42 tJUd-t? SefVIce1ncluded
JOB DESCRIPTION
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Permits are Don-transferable and expire If work IS
not started wIthm 180 days of Issuance or Ifwork IS
Suspended for 180 days
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2 I C()NT~C!OR ~STALLATIO~ O~~J
Electrical Contractor
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SupervIsor License Number /
ExpiratIOn Date /
Constr Contr Num7
ExpiratIOn Date
I
SIgnature of Supervlsmg Electnclan
Address
CIty
Owners Name 6.",,-) L<>,J k..:.........
Address? O. \S ~X '75 '5 'Z
CI~t2e+ 1+D~<- Phone 72..6-0 ?'?rj
OWNER INSTALLATION
The mstallallOn IS bemg made on ~erty I own which
IS not Jntended for sale, lease omnt "\
Owners ~ture
("/ F.
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InspeclIon Request 726-3769
1000 sq It orless
Each addltlonal 500 sq It or
portion thereof
$106 00
$1900
Each Manufact'd Home or
Modular DwellIng Service or
Feeder
tc::-- - -------- - - ---- --- --,
B ~ef\lces or Feeders - InstallalIon, Alterallons or Relocallon i
~-- ~-------...---- --- - ------ --~-~
$50 00
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsIV oils
Reconnect Only
$ 63 00
$ 75 00
$12500
$16300
$37500
$ 50 00
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C I Temporary ServIces or Feeders
'-----.-- - ---~----- --- - -
InstallatIOn, AlteratIon or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
$~
$ 69 00
$10000
IHJ
;;, 0.
Over 6.2.0 Amp~ 1.QlJ!l Volls see "B" abov-" _ _ _ _ __
D fBranch Circuits
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New Alteration or ExtenSion Per Panel
One CirCUIt
Each AdditIOnal Clrcult or With
Service or Feeder Permit
$ 43 00
$ 300
E [M,scella~io~ (Serv,ce/feed;r not mclude~~E~~;' ~;-t;;;ah~';-]
Pump or lITigatIOn
Sign/OutlIne Llghtmg
Limited Energy/Resldent131
Limited Energy/Commerc131
$ 50 00
$ 50 00
$ 25 00
$ 45 00
Mlmmum ElectrIC Permit InspectIOn Fee IS $45 00 + Surcharges
4 [~UHioT~~--?_l<'ABO~ -_~__ -! 4J(t"~
IV;. State Surcharge & , ~ 0
10% Admmlstratlve Fee .~J"O
TOTAL _ 2...7 r
Shared Dnve(T )/BUlldmg FormslElectncal Permit APPII~~.d! r
.
225 FIfth Street
Sprmgfield, Oregon 97477
54]-726-3759 Phone
Job/Journal Number
COM2008-00005
COM2008-00005
COM2008-00005
COM2008-00005
Payments
Type of Payment
Check
cRecemll
RECEIPT #,
DeSCriptIOn
Temp Power 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdmmlStratlve Fee
Paid By
RIVER VALLEY BUILDERS
SP.,~A1~"'J;1~_ _ '
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Jiji;:- ali"
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,
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Ot- 'If Sprmgfield OffiCIal ReceIpt
D~ _Iopment Serv,ces Department
PublIc Works Department
1200800000000000599
Date' 06/05/2008
Item Total
Check Number AuthOrization
Received By Batch Number Number How Received
dim
14120
In Person
Payment Total
Page 1 of 1
II0638AM
Amount Due
5500
275
660
550
$69 85
Amount Paid
$69 85
$69 85
615/2008