HomeMy WebLinkAboutPermit Electrical 2008-7-11
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225 FIFIH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ('..AV12/J79~ -ntJ 7;;g 5 Date
I 1~:iQPiTIQ~ OF; iN$.T.AgATIO-N:'\~.fi~i~'1
-If/ S, 7/Z,c;T; .
. ' .
LEGAL DESCRIPTION
/ 7(] 2- ,) -s; 31- t) 7/07
JOB DESCRIPTION
/yA-7f.JP, ~ f CMM~
Permits are non-transferable and expire If work IS
not started wlthm 180 days of Issuance or If work IS
Suspended for 180 days
t,OONi~crOR INsTAiUiiON.oNi}T;~
2 ifuzoo;.::r, ,cy"""",~,-:- r 1 ~_,~::-~w,"~" ,~~JA"",~A~",~",,.,,~, L, L,,,,_~:l
E1ectncal Contractor f:l9h' s Clair I L m(
Address f' () [J.", x 2 'is' 2- I
City E"l'7i!"tf-
Pbone fi'//} ~ 9(, n.';!f'
SupeTVlsor License Number '-/7'-/ i./ S
ExprratJon Date / (J - CJ / - 201 D
Constr Contr Number
,!}r;(, 78
Expiration Date
q-/y-2.0I/
Signature of SupeTVlsmg ElectncIan
~~ -<---
Owners Name )M/J/f) 4?tI5tTAJ
Address $-10 ~r r t.J.,L.
City bt.4WJ:./ Phone .f,1J<g, '~L)9?7
/
/
OWNER lNST~LATION
The mstallatlon IS bemg made on property I own which
's not ffitended for sale, lease or rent
Ownerstm'rf'tE:
TI II::; ;'[P,/vllT SHALL CAr "1t IF I HE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
i'Ud\Reqqe~A'9 4'lbHRl'I.J,
(060rst4 7
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! ... , . .. --. . .... . .,. - ~. --'''li!I'';;J'''",,'' ""-F. 1
3 I, COMPU;TEF.JIl~S.CHJiI{lJIfi lJ.gg>W:-:'~;-;":%l..iii'~;';: ~:::. '" j
A i~jX~;'R~id~:rtiaIl ~i~I~'I!~~:r!!\,~J,1~ID!r~:~~!:~~eiiIJg"~~n-It:. -I
ServIce Included
1 000 sq ft or less
Each addItJonal 500 sq ft or
portion thereof
Each Manufact'd Home or
Modular Dwellmg Service or
Feeder
,
$11700
$2100
A
$55 00 1135>.. CO
ii' -~'-'" l/~f<<"W" ''',"'r'''<'' """~~"""'''''!r'''' '__~"T '" ~"";"<:rtjiT1;'''~U- ~
B ~'S';ri-Jces' or Feeders ''':' Insbillatlon~-AI(en'-bons ~or~RejocaboJl:
~-:~~.7PC,d_"_,_>~,,w=- ~d,_ n ~'m""1C_0 ,,,,1d',,,~,2>"" _~, _u_~ =-0Xd,~'"+-''''' """"'
~
200 Amps or less J ~ '7.Q.Q,! /rJ
-
201 Amps to 400 Amps $ 83 00
401 Amps to 600 Amps $13800
601 Amps to 1000 Amps $18000
Over 1000 AmpsNolts $41300
Reconnect Only $ 55 00
C
lnstallabon, Alterabon or RelocatIOn
200 Amps or less $ 55 00
201 Amps to 400 Amps $ 76 00
401 Amps to 600 Amps $110 00
Over 600 Amps or 1000 Volts see "B" above
D J
New AlteratIon or ExtensIOn Per Panel
One Crrcmt $ 48 00
Each Additional Crrcmt or With 1 4>
Service or Feeder Pernnt $ 400
E tm_~~~ila~~~~f:(~ffi~~;r~~;:~;~';-~~~0did)Si~iij~~t~ll;il~~i J
Pump or ITTlgatlon $ 55 00
Slgn/Outlme LIgbtmg $ 55 00
LllDlted EnergyIResldentla1 $ 28 00
Lumted Energy/Commercial $ 50 00
MlDlmunA'lilRNFl!Widll~lIn~~ljo8g tt>"urcharges
4 ~1"J>.~j>H~Y;P~ii~~W,f~~ilIJJ1I1JY -i' - '2 j(4 GO
~~~~~~l'UleSxar~rth .;./ .
8~~e-0010throughOAR952-001_ (3.(
100"p~~~rn caples of the rules b't----i,{ . 4 ~
5% f.!l!lm&JooAftllter, (Note the telephone !",..,n
numoer fOr the Oregon Utility Notification I 10..
TOTAL Center is 1-800-332-2344), 4.4.., l.Z.
Shared Dnve(T )/Buddmg FonnslElectncal Peront APPhC~IO~7-07 doc
225 Fifth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
~~
City of Sprmgfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2008-00785
COM2008-00785
COM2008-00785
COM2008-00785
COM2008-00785
COM2008-00785
Payments
Type of Payment
Cred ItCard
cRecemtl
RECEIPT #:
2200800000000001072
Date' 07/11/2008
Description
Manufactured Home Feeder
Manufactured Home Service
Add, Alter, Extend Clrc Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdmInistrative Fee
Paid By
ROBS ELECTRIC
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
Ilh
004957 Phone
Payment Total
Page I of 1
1202 20PM
Amount Due
5500
5500
400
570
1368
1140
$14478
Amount Paid
$14478
$14478
711112008