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Home My WebLink AboutPermit Electrical 2008-7-1 (2) - 225 FIFTH STREET. SPRING HELD, OR 97.477 . PH (541)726-3753 . JoA X (541)7263689 ELECTRICAL PERMIT APPLICATION CIty Job Number COM2 007 - 01463 C t-T'" , Jh' 'i:-~ '-S"""'t'-""-''''-%'-->'~_","1f' ;d"'~.>t~ tfw1il-"t" ;:;'~~ -r':;'~.;:'-"t.~ , '~"'~ ~~ empQ,r~ry ~e11~&U~0" e~"J~'rS:;;r, -?-;.:;;;;:''r'-Z'''_''V'__,"~~~~1'~_~,! ~ o('~e, 'aN (eq\)\I~ao'n Ut~\iW .,. "1 ,(.),,, .... ,I ' In.s!al]atlOff, \\:lte~'I,t\,'\..I1t<lo"".locatlOn )c ^c~ ru\8S a 2001- I ,200,Amps or\'<e)'}\R 95 - , ,~\'.r20'10kiJ,\?s~~gQl\ ~\es bY . ,2 l, , ),1\.' cap I wili>l:)\1One , {r,d rnay C4~~ (lWl1? ~flO ~'U\\catlon ~ , .' '" ,J \he cel}\~'[~\AJI,\W'IJ'l,9,~.o Volts see "B" above b'( lor \he'f!'4^'''''82~5Yk., " ".~ ~lg attI2---#ure of SupervISIng EICi2ctrlCO:lJan,.._.3--_IlUt1_' l.:: ceot~r '~!2~!ff r_c!lJts~"p~t~ ,':.,. ::l-.:< '~.' New AlteratIOn or ExtenSIOn Per Panel One CirCUit $ 48 00 Each AdditIOnal Clrcult or with Service or Feeder Permit E ~~jts~I~1i~~~I(~~C~f~~Ae~oJ W~i@~d)<;~1~h~;J~si~fI~t~1~ City Spn.ngfle1d Phone335-2817 1\CiumporlITIgatlOn 11'-t\filit'1'JO~~ $5500 hO ~~1.I\.Kb~ I'E1'-WlI'T IlS \'\lV' $ 55 00 OWNER INST ALLA nON ililS I' I3cml&ijm\~~'!)\'}~E\) fOR $ 28 00 The installation IS being made on property I own which {>.UiliO \:9lQlilr~!~merclal $ 50 00 IS not Intended for sale, lease or rent C~'llfi~J.~,!U~~lt InspectIOn ~":~2 ~5~ ~O+ ~urcharges Owners Signature (>.N'i b~}!IJT,fJ,lAL, P!;'j}.l}1,!X!1~;; '~"3?~&l:"'~~:'::' i 78 00 12% State Surcharge 9 36 10% AdmInIStralive Fee 7 VU 5% Technology Fee 3 crt) ?'10f# fXl~ "?6. Shared Dme(T )/BUlldlOg FormslEleclflcal Pemllt ApplicatIon I 08 doc Wl}ftAj;'j/iNQ!JN.~r,,4iii;AJ:Jf/~/~~ Cardlnal Way & MLK LEGAL DESCRIPTION Monument Slqn Servlce JOB DESCRIPTION 3333 Rlverbend Permits are non-transferable and expire If work IS not started wlthm ISO days of Issuance or rfwork IS Suspended for 180 days l'#'e6NFRACt~msTATfT.;{ffo7(6NLy:;j m~~'\""'" ~ "")JliL.!:rt~l!ihl~~::&;~LZ~-""J-'~q:-:;:..::~JlJ 2 Electrical Contractor E C Company Address 32758 Old Hwy 34 SE City Albany Phone Oreqon SupervISor License Number 3257 S ExplratlOnDate 10/1/2010 Constr Contr Number 22-15C Explralion Date 7/1/2011 Owners Name PeaceHealth Address InspectIOn Request 726-3769 ZON fY\ v..U 'NlnAlS Ntv' DA TL "tJ.,- 1 . n~ SOURCE ()'\ f).,;{Ju Date 6/19/08 3 r.r@I.~lzETE;FEE g,iJ!jli'ijj,EIJl~lSo:.TY ",i~: :!"I':,{', ' '1 A ~~~~~Res,~I~Jla'f ~~ifjgi;"~~r~i~i{~~E~rfi!ly:~-[~~il,~g .u~'L~~1 Service Included 1000 sq ft or less Each additional 500 sq ft or portIOn thereof Each Manufac!' d Horne or Modular Dwellmg Service or Feeder $11700 $ 2100 $55 00 t="'''-''l''':if.-.1l~~''"-;'''.r-~;..,-;t''~''''-0?~--",," ~", ~-,-'=.."'...._",'" "=-""~;;"", ...i:s.\,' B t)Ser;vlc!.sAor<!Feeders..~JlIstallatIoiiJAltenitlOns,or RelocatIOh-~ ~". o >-",.....,\h_~~t/t;~::..-0.:^,""" tl.""'':.\il:.~'1lbJ-;t~~1i;i\)",~;:;y.~:;''0~".""",,,...,_~.f., 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only 1 $ 7000 70 00 $ 83 00 $138 00 $18000 $41300 $ 55 00 $ 55 00 $ 76 00 $11000 " '1 -", "".\. 2 $ 4 00 8 00 TOTAL ZON i'Y'u.0 INIIIALS Nf\II_ ,; DATE 1~I...0'1 SOURCr: m Cl~) 225 FIFfIl S11U.ET . SrRI~GFIFLD, OR 97477 . PH (541)726-375] . F..\X (5..11)7263689 ELECTRICAL PERMIT APPLICATION CIty Job Number COM2 0 0 7 - 014 6 3 Wip.c;1t!QN:",qFI1'fSJA'Tt~ijok":,i Rlverbend & MLK LEGAL DESCRIPTION Monument Slqn Servlce JOB DESCRIPTION 3333 Rlverbend Permits are non-transferable and expire If work IS not started wlthm 180 days of Issuance or If work IS Suspended for 180 days kiO'if~;~4.."'_ 1,~_--4 """_'(.""'~i-'"f ...."';'>._~J;:'.;c~""""....~::;;;"~'_ "",-~, 2 [!,r:;:12~!!~l!!J1IJ':l!jN~1/i1.Jlg!jIJJlj!iY.l Electrical Contractor E C Company Address 32758 Old Hwv 34 SE CIty Albany Phone Oreqon SuperYIsor LIcense Number 3257 S ExpiratIon Date 10/1/2010 Constr Contr Number 22-15C ExpiratIon Date 7/1/2011 SIgnature of Supervlsmg Electnclan t j09 ~ Owners Name PeaceHeal th Address CIty Sprlngfleld Phone 335-2817 OWNER INSTALLATION The installatIon IS bemg made on property I own which IS not mtended for sale, lease or rent Owners Signature InspectIOn Request 726-3769 Date 6/19/08 t __,~,~ ,_ ~__~ ~"'-'T~7"'f'!:"\\I'!l'm."..>.,.,...,_" "t""""'__ _ 3 f:c;Q.~If'AET.E FJIE SP!!IiD.l!Pfi'BELOWi'- A ~~~1~~~;~~~~~1.~ ,s.~i~~;~?1Vi~iTl~F~1.n~'~~J~~t(IJn'g~uWrt-:7' Service Included 1000 sq ft or less Each addItIOnal 500 sq ft or portion thereof Each Manufact'd Home or Modular Dwellmg Service or F ceder $11700 $ 2100 $5500 B t:Ser~~:.~t; ~!!~~~~t~~jt~iG!lO!t:~~i~i!i.ii~~ or ~.i',~.c~~_~.;~~~~ 1 70 00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps \^ "0\.0 - Over 1000 Amps~lreo.\I\leS , \ltlll~ $41300 Reconnect,Gnly 18. '''e OlegOll . ."rt\\ $ 55 00 r l' " b" '" se\-' . , ..q:l'-\1 '::",,,.c' ,~\:d ';sel\llg?~a.le 5?:9P" _ _", 'h , '''C\~2!PQclr$Wc~\o~left1\es \)",:;,,-,~:"-- ,_:'~"",,'$.';"":,1.~ 1< ,[\1,," ~F2-_GG~'OO ,1I COpIeS O~t.lllep\lOnlil 1(\ \)'~\'\%\s'\I!,(ijrfi\r18\,~ ~ ,,"t'l8P'Ol\ GG9G t.~illi~Oll \It\\\\~4). ca~M>l A.qf. 31 ..~6@p~2- l\\Il1"""~. e '\\j 40 I l'l: ps to 600 Amps $ 70 00 $ 83 00 $13800 $18000 $ 55 00 $ 76 00 $110 00 Over 600 Amps or 1000 Volts see "B" above t~Tl""~"r-.t ,,~3";"'~~"~~'-~~~J"dkf 'J,'-"'-t '~:W~~'" >:t.1j '!-;f~ D ~r:a.nc!1,-€g~u~ts~~~ "-'-0~~' ":.-'?-~ - ~~ ~-;7'",~^,,\ }~~#:~~::>'",t. .~l:~~, 1.1.;1 ~ New AlteratIOn or ExtenSIOn Per Panel One Clfelllt Each Additional CirCUit or wIth Service or Feeder Permit $ 48 00 $ 400 8 00 2 E J;;M;~clITate"(;'us1(S~"~,i'ijft~d;f~~ot;~clitdtQ.Js~itlirf;tJ"~)I"O~ j J ~........ ~-""'" ~~,"=,,--. """~ _....L ...~ "'--1"'=--~"'~-~ fc~~,,~ - c. ~P\?C \f Ie. ~01 PUtl~~llon\'f S\'\t>.\.\.~" S 'i't.~~\' ~tP1J Slg ~gl~!~5.lt-\tlt" i\'\\ .,~M~.DfwM Llml ~~~_'O"(YR"S t>.~hl't - $ 28 00 Llmlt~~v~f{\Otl. $ 50 00 Mmlmum E~~'fI~%Qrh\h"nspecllon Fee IS $50 00 + Surcharges 4 ~tfjI:QT:V--:QfA!ilrJ~;E,1t}~J:iJ:.)'tJ~i~~\~178 00 12% State Surcharge 9 36 10% Admmlstratlve Fee 7. 80 5% Technology Fee 3, qO 99-01/ TOT^.L 87 JG SharLd Dme{T )/Bulldmg Forms/Electncal Permll AppllcatlOn 108 doc LON 'm.lleJ INITIALS N V-- DATE.. -I - CP1 SOURCE rn 0:"> n i..I 22:; FIFTH STREET. SPRINGFIELD, OH 97477 . PH (541)726.3753 . f.AX (541)7263689 ELECTRICAL PERMIT APPLICATION City Job Number COM2007 - 014 63 Date 6/19/08 &tb~tl@fri61j;{~$:z:A.iJ,AflOk: ~:~c.:,j 3 t;f~Jiip~Ern FEE sPHi:pi!tE.'1r#:.f6li'~~',\~.r~ LaneC & MLK LEGAL DESCRIPTION A f~~.~~'{iR~s!?e~~t1;.Ii:-.'.~;Iig~I~~~r;)!~Fi~F1ffi)J~~.iff;d~~r;ifg u~i1...:::i Monument Slqn Servlce Service Included JOB DESCRIPTION 1000 sq ft or less Each addItIonal 500 sq ft or portion thereof Each Manufact'd Home or Modular Dwelling ServIce or Feeder $11700 3333 Rlverbend $ 2100 Permits are non-transferable and expire .fwork IS not started wlthm 180 days of Issuance or Ifwork IS Suspended for 180 days ~"C@NFIDtcrORfiN..ST.A.LlATION:ONLV1 ~~c ",om~f "~I",i~i;.?,""^--''''~0''~~~',"", ,+j",..'C,"~'~ $5500 2 B G.'S~F~~~:t~~jF~-€de~~WI!li~lI-ai~~fZ~l~a'tiSns"~{R?i6cdt;oft~,~~1 b""", "-,'-'+=Xc",,*,,~--:I~:1l:':...it:' t.>z _:i.,",~ ",>%",,.1'MkJ_,,\~ _-",/,. - --;r~-~'~~~^",?if",~ Electrical Contractor E C Company 1 57000 70 00 $ 83 00 $13800 $180 00 $413 00 $ 55 00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only on laW regUireS you to Supervisor License Number 325 7sTTEN:~~~ ~~:~?ed tG t~t.Qift~~~~~ <fr'Feidr~~~_-' IUIlU" ,-.- Those ru es ar l'lo\lllca\lOn Center nh QAR 9q?-OOi- Explralion Date 10/1/2010 ^.',O Q<;?_001-0010thrQIl!lt'lllb1'{R'e'IbIIl\!"'ll'Pn or Relocalion 0090. You may obtain C~&~Itl!lllJTlhlsne Constr Contr Number 22-15C "HlImQ the center (~n2(}lMt'l'p$()limmt)Qllps number tor In'' orie~OO4$.l2\llllA~600 Amps Center IS - Over 600 Amps or 1000 Volts see "B" above D f~w~n:~_6,':~\;;cJit~~::t:~~ Address 32758 Old Hwy 34 SE CIty Albany Phone Oreqon ~ ~~~.~ ; . '" "\ ~ I .:!:..~~<<-~ $ 55 00 $ 76 00 $11000 ExpiratIOn Date 7/1/2011 z)J2J Signature of Supervlsmg Electncl;1n ,~~~~ .~I '!; 0\\ ners Name PeaceHealth New AlteratIOn or ExtensIOn Per Panel One CircUit Each AdditIOnal CirCUit or With Service or Feeder Permit 2 $ 48 00 $ 400 8 00 Address E ~~;ce~i~e~~~(~~~:cl!/f~.~~e~~~~~~i~~e9X?o:'~ctl.ijst:~h~~~~'1 City Sprlngf leld Phone 335 - 2 81 7 Pump or lITIgatIon $ 55 00 Sign/Outline Lighting $ 55 00 OWNER INST ALLA nON Limited EnergyfResldefl{}:lbr.\( $ 28 00 The installatIon IS being made on property I "N't}'ll\~: ~rt'tl@'Wh.\fo-mft,{S''\llOi $ 50 00 IS not mtended for sale, lease or rent U\S PERN\\TlI~li\ Ip.E1n1\b' ,,~RM\In~ctlOn Fee IS $50 00 + Surcharges 1 [I \2E~ 1!l)",1?~- .-~B~mrun-\I;~" . Owners Signature /l.U1HOR CEOI~~ . . ~Pl{E,,;;. ~-:: 78 00 CONlNlE\'l ~ p€~S!ihe Surcharge 9 36 /I.\'l'i i 80 aPl 10% AdmlnIstralive Fee "7 eO 5% Technology Fee ? <it) CjqCb InspectIOn Request 726.3769 TOTAL Qc ~ Ii Shared Dnve(T )/BUlldmg Forms!Electncal Permit ApplicatIOn I 08 doc 225 Fifth Street Sprmgfield, Oregon 97477 541-126-3759 Phone ~~ ~ City of Sprmgfield Official Receipt Development Services Department Pubhe Works Department Job/Journal Number COM2007 -01463 COM2007-01463 COM2007-01463 COM2007-01463 COM2007-0 1463 Payments Type of Paymeot Check cReceml] RECEIPT #, 1200800000000000702 Date, 06/26/2008 Description Penn Serv/Fdr 200 amps or less Add, Alter, Extend CIfC Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdminIStratIve Fee PaId By EC COMPANY ALBANY Item Total Check Number Authorization ReceIVed By Batch Number Number I-Iow Received DJB 3820 In Person Payment Total Page I of I 2 24 23PM Amount Due 21000 2400 1170 2808 2340 $297 18 Amount Paid $297 18 $297 18 6/26/2008