HomeMy WebLinkAboutPermit Electrical 2008-6-11
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225 HITH S"l REET . W'RINGFIELD OR 97477 . PH (541)72&.3753 . F~ (541)726.3689
ELECTRICAL PERMIT APPLICATION
C,tv Job Number ('f;rY) :2.[XJf1 - (9a!- 3 ~
1 LOCATION OF INSTALLA TION'
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LFGAL DLSCRlPTlON
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JOB DESCRIPTION
UfYL{) !1JWC{ 4tJ[) J...r.'\...D/J
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Permits are non-tr.msferahle and expire If work IS
not started wlthm 180 days of Issuance or If work IS
Suspended for 180 days
2
CONTRACTOR INSTALLA TlON ONLY
Electncal Contractor ~r:OFTKf.n RT.F.CTRTC CO.
Address PO BOX 27 6 5
City EUGENE. 97402 Phone 686-8612
SupervIsor LIcense Number
4218-5
ExprratlOn Date 10-1-10
Constr Contr Number 38702
?fil;r:
Owners Name <;;D r ':;:;.,-A-e..U .S::J,l1O/ /)13.-1-
Address 5':2. S u J ~ E
C,~ LV I L ('}:?.A'hone
OWNER IN~ALLATION
The mstallatIon I" bemg made on property I own whIch
I" not mtendcd for sale lease or rent
Owners S'gnature
Inspechon Reque.! 726-3769
Cus ton1.u/" 1';1J~rJ- ~
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3 COMPLETE FEE SCHEDULE BELOW
A Nc,,, RC.!lIdcntml- Single or Multl-Fdmlh per dncllmg Unit
SeITICe Included
1000 sq ft or less
Each add,tIonaI 500 'q ft or
portIOn thercof
Edch Manufact'd Home or
Modular DweIlmg ServICe or
Feeder
$11700
$ 2100
$55 00
B Scnlccs 01 Feedcflt - In~talldhon. Alh..ratlon\ or Relotatlon
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/VoIt,
Reconnect Only
$70 00
$ 83 00
$13800
$18000
$413 00
$ 55 00
C Temporal) Sen Ites or Feeders
Installation, AlteratIOn or RelocatIOn
200 Amps or less
201 Amp' to 400 Amps /
401 Amps to 600 Amp,
$ 55 00
$ 76 00 71/1 OD
$110 00
Over 600 Amps or 1000 Volts s"e "B" above
D Brdnch CIrCUJts
New Alteration or ExtenslOD Per Panel
One CIfellit
Each AddltIondl CIfCllit or WIth
Service or Feeder Penmt
$ 48 00
$ 400
MJ'icclldneom (Scrvlcc/fced<...r not mcluded) -E.lch I""t.1J1ahon
Pump or 1ITlgal1on $ 55 00
SlgnlOutlmt Llghtmg $ 55 00
L,mlted EnergylReSldenl1al $ 28 00
Lmllted Energy/CommercIal $ 50 00
MImmum Eleltnc Pernut Inspection Fee IS $50 00 + Surcharges
7c",d)
q./~
/_00
sU{O
Cj(P. 7J:J-
4
SUBTOTAL OF ABOVE
12% Slatt: Surcharge
10% Admm,stratIve Fee
5% Technology Fee
TOTAL
Shared Dnve(T YButldtng Fonns/Electncal Permit Apphcat.I~m 1-08 doc
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dfXJ~ l.e..ny:> Se--vUiA...(,. 'fa tjCO~
225 FIfth-Street
Spi..ngfield, Oregon 97477
541-726-3759 Phone
Mr.P~~Fl!",!'.. -
:" J
_, ~___,~_ 4 ~
CIty of Sprmgfield OfficIal ReceIpt
Development ServIces Department
PublIc Works Department
Job/Journal Number
COM2008-00438
COM2008-00438
COM2008-00438
COM2008-00438
Payments
Type of Payment
Cred,tCard
cRecemtl
RECEIPT #,
1200800000000000640
Date: 06/11/2008
Description
M'nlmum/AdJustment ElectrIcal
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdministratIve Fee
PaId By
ERIC SCOFIELD
Item Total
Check Number AuthorizatIOn
Received By Batch Number Number How Received
ddk
711152 In Person
Payment Total
Page I of 1
3 26 43PM
Amount Due
2100
105
252
2 10
$2667
Amount Paid
$26 67
$2667
6/1112008