HomeMy WebLinkAboutPermit Electrical 2008-6-27
S, PA'~G "_ ~ 'ON ~_
~' ~ INITIALS \J.}
~ DATE \0 .1).. i. ~
~ SOURCE \1, C~ ---
,~- , ..""'..., ~ <"' .).. ;:-..... . ~ -' - -:.'~-.
;'. ""CITY OgSPRIN "D"0REGON > ~': :
~, ~"'. ~ ~ '" .. " ,~ - ~ '"" ! _.: ' - .. (- . _.~ '
225 FIF11I STREET . SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PFJ!.P4IT 1;fALICATION
ClIy Job Number \.. ,~ - \
l;,. -
1 [LOc4:i [ON 'oF IN:sprfA'ItoN';>'
t\~\ ~. ~'C2""' <l{'"'
LEG\~~\\ ~~.
JO~~RIPTIO~~ e
Per~ts a~ranSferable and exl uwork IS
not slarted wlthlD 180 days of ISsuance or If work IS
Suspended for 180 days
2 rCO.zVTRAtiO~'INSTALEA.TION ONL~~
Electncal Contractor S ~JF- I rA'.n.t.
Address
f {; 86-'; 1-/5' I
ClIy Pur!
;;;: ;il- J. I."f..,S
Phone
....,
SupervIsor License Number ~...,~ 1- 1- S
Exprrallon Date I d - 1 - I <!
1i.f1b/g
(/-3: - (n
Constr Contr Number
Exprrallon Date
Signature of SupervlSmg ectnC18D
#J. 1/- ~.
. Owners Name \\ i~ \i ~ \ ~ Kj n
Addr:t\ ~~f9 .. U.\~~
ClIy ," ~~~p one l44.~S
OWNER INSTALLA nON
The lDSt4ir.Iiii!ll1'~<H~In~r:,If\',':,Jt{.'WP~ILM1'h
IS not Jil!b(l~d"tIJ.e:lh~B~@-atWd~e ~(egoiilffilily
Notification Center Tfiose rules are set forth
OwnefSlSlMi~-OOt -oat 0 through OAR 952-001-
009:r'-you may obtain copies of the rules by
.:..:::;;-,; t~: szr.t:r t~~:~: ~~':' ~,:,'':'rh''me
number for the Oregon Utility Notification
Center IS 1-800-332-2344)
InspectIOn Request 726-3769
fUi 14l-to6S
Date
3. ~coJlii>LETEil<;E.SClmDvLEBELQW
I I
A ~~~_~~:~;d~~~~1 :=,,$J~gl~'~,:)vf~fti!F";;~';rflp~~~1r~li~~r ~~It y '~~
Service Included
\~l~
li)pD
\
"6
1000 sq It or less
Each addllIonal 500 sq It or
portion thereof
$11700
$2100
Each Manufact'd Home or
Modular Dwellmg ServIce or
Feeder
$55 00
B rSe;Y]!~~fOr ~ff~~~_~l~~ta~~~b~~n, ~~!ti:~~~~f~:'~~l~~~il~~ ':~J
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 70 00
$ 83 00
$13800
$18000
$41300
$ 55 00
c LI~mJQi~.ry'$;~:::~_~):e'~~"~~,~:i~t{~~~~QtDr:~~~~
InslaUatJon, AlteratJon or RelocatIOn
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
$ 55 00
$ 76 00
$110 00
Over 600 Amps or 1000 Volts see "B" above
D Fl[fan-"hCI;;~';;;is:'
New AlteratJon or ExtenSIOn Per Panel
One CIrCUlt
Each AdditIOnal CIrCUlt or WIth
ServIce or Feeder PermIt
p
..
J
$ 48 00
$ 400
E IIVI~ell;~eOlt;J<~~,r;y~~I,f~;~~1~~t~~'cl~~~~i~j~~j~~~,~,a~~o,n, j
Pump or rrngallon $ 55 00
SlgnlOutlme Llghtmg $ 55 00
Lumted Energy/Resldenllal $ 28 00
Lumted Energy/CommercIal $ 50 00
MIDIIDUID d~~~t::;:=:tJ~n,~:e,:; $:~~~~::urcharg:~ \
4 ~UB :t"'-{W"V.lIlruuVj"Wt.EXPIRET'F.qJH~ ~
12%~M ER THIS PERMIT IS' .
10% \~ [fcQR IS ABANDONED FOR
5% e~ 0 6lB- (JeW PERIOD .or )
TOTAL fJJJA .\dJ
Shared Dove([ )/BUlldmg FormslElectncal Permit Apphcanon 1-08 doc
225 Fifth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
8.. P"!NQ.,E!-'? ~
. ..... -
.-
I
I
City of Sprmgfield OffiCial Receipt
DcveloPlI!ent Scrvlces Department
P,ubhc Works Department
Job/Journal Number
COM2008-00 184
COM2008-00 184
COM2008-00 184
COM2008-00 184
COM2008-00 184
Payments
I ype of Payment
CredllCard
lRLcelOtl
RECEIPT #.
2200800000000000982
Date. 06/27/2008
I 22 44PM
DescriptIOn
Residence W JrIng 1000 Sq Fl
Residence WJrlng Ea Addll 500
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Amount Due
11700
6300
900
2160
1800
$228 60
Paid By
STEVE HAUCK
Item Total
Check Number AuthorizatIOn
Received By Batch Number Number How Received
Amount PaId
IIh
021509 In Person
Payment Total
$228 60
$228 60
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