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HomeMy WebLinkAboutPermit Electrical 2008-6-5 ,;;::-, . ~ 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 ~r/~ Permits are Don-transferable and expire If work IS not started wIthm 180 days of Issuance or Ifwork IS Suspended for 180 days r~ - ------ 2 I C()NT~C!OR ~STALLATIO~ O~~J Electrical Contractor "'"' ~ 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. "'------/ 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 r::- -------- -- 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 "-- -- --- ~-- -- -- -- 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~_ _ ' il ~ Jiji;:- ali" - . , - ~ - ... '-'- ~ ~--- ~ 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