HomeMy WebLinkAboutPermit Electrical 2008-8-21 (2)
OCT-25-2007 14 08
10/25/2007 13 07
BUILDERS ELECTRIC
7263676
S41 485 4055 P 01/01
CITY OF SPRINGFIELD PAGE 01
CITY OF SpRlINGFIELD, OREGON '
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ZON C.:r;
rN1TIALS N i'-""::
DAIT 1<",2,-l-u<
SOURCE 'f'Y\. ('"6. ~rv
225 FlITH STREET. SPRINGFIELD, OR 9,.77 . PH ('<4')716-J75' . FAX (5'1)7l6-~~
ELECTRICAL PERMIT APPUCATlON
CIty Job Number (0""'" zoo8- OO:Sl 0
I, '.200 Amps or les, S 70 00
201 Amp. to 400 Amp. $ 83 00
Address l-=-(J I)('r(~,( y~ 401 Amp. to 600 Amp. S13800
NOTre,:, 601 Amp"o 1000 Amp. S18000
CIty t=:", TAl:<:: PJ:P'nW g\!rAe !:.~;:, CC L" _ Ov""IOOO Ampsrv&trENTION' Oregnn ~}},QQ .' -
AUTHORIZED U d: L^' " : ,," ,-, _ 'f(l8!\econnectOnly fOllow rufas adop'''.-j tJi/5Rl~6l '-O]W ,,'
GON/MI=M('/:n ND!R !H~"'ER,~d] IS NOT __" __ ,- =~t~o.,~Uj,,;.;',~;'~"':~.~Y
supervlSo'Aff'YibNod ~~ QR,li;7$AI~lJOiEIl.FOR C Tempotary silOs[ Vi ' -QIHC 1fJmUgll O,~,':14fi'~u~~h
DAY I't:HIUD. . ou may obtain caples of the rules b -
E.ptrabonDate 10-/-/0 ID'tallatlon,Alte..ji\\jUrw~r. (Nole thet I h Y
IlUmber for Ih 0 e ep one
200 Amp' or le<s e regol'1llS$J)fl/ Nnhflf"~11
Const!" Conu Number 4 Z C1 1.,1: 201 Amps to 400 Amps Cenle. IS l-BOO-1ltl2ll113441 en
401 Amps to 600 Amps $11000
Over 600 Amps or 1000 Volts see "B" above
~~ ~ ~ "'__~_. ,...~ ~i'r' --r' ,.,.... '-I r~ll- ......,
D Branch Cfrr~its .. ~ ~ :. \ '. f,
/?tIS ~
Owner; Name HAW E~ L....rl +-_e-.... -I-
Address 28" Z Crt:? .5Le",+ Eo M'""'.ell~D~'b (~~'.;f;;d;;~ot l~eiDded)-~E;~IL-I;.t~a~~D'"
, J < " ~ - .
City cu.. 6-~"'l? Phon. .3 3. S - 50S' '11.( Pump or Irngahon $ SS 00
SIgn/Outhne LIghtIng $ 5S 00
LImIted EnergylResldentlal $ 28 00
LlDuted Energy/Commer.tat $ 50 00
Minimum Electrl. PenmllDspeetlon Fee IS $50 00 + Surehar~..
4 ~-'s ~ioTAiOFABOVz; ,," : ~-:' - 21 ()
1~ P , ,- ., ,
State Surcllarge ZS :t.o
\0% Adnlllustrallve Fee L I
5% Toehnology Fee 10 ~o
$2 bb 2!!-
I ~1QPtT1QNOF:iN$T~O~;, .
400 r,^~I'i^A-+IM.4-1 W Y
LEGAL DESCRIPTION
/7C>':$/Sl(O
JOB DESCRIPTION
0050C
~
~e-
E
Permits are non-traosferable And expire If 'Work IS
not started withIn 180 day. or...nanee or .rwork IS
SDspended ror 180 day.
i'(."""~........~.--,""" -~ r ....... ...,,~r~" ..........". ~..-- -~...-~ --
2 ,PPlVpU-CTOR JNtr1f4t710NH?LY
Electneal Contractor A, , I (' 10 y ':: E- I ':' ( n ,(
EXpllOcon Date
~ t. -1(\ - "
SIgnature of SupervlSmg Electnclan
OWNER INSTALLA nON
The mstallaMn " hemg made on propertY I own whIch
IS Dot mtended for sale, tease or rent
Owners S,gnature
InspectIon ReqDest 726-3769
UZ7b
cC& y~
~1~411 II
e'll 'l>:>
.x)-?,I) oK
Date
3 cO~iErE FEESOODriLi BE.f4:fiT,: : ~~ Y"j '" ~~J'
r ~'I' _ .. ~- -,. -~~ ~ ' --....,.",...,-- -.......-- "".-"'"'1
A New R..ldontJal- Single or MDlti-Famlly per dwe"..g unit" ,~
, ' ., ~. _ ..~~, "c
S.mee Included
looo'q It orle<, $11700
Eaeh addItional SOO sq l\ or
portion tlIereor S 21 00
Each Manufact'd Home or
Modular Dwclhng Sernce or
Feeder
SS5 00
B
_ ~ ~- -0., ~--v .....-~ - ~ ~' "i ":~TI!"'''''"'''''' ~r '"'i'-~~'"
S.N1ees or F..den - Installahoo, A)ttrotiOM Dr Relocatiou: "
" , ,... " l '..' _, -, ~t
"
New Alterahon or ExtenSion Per Panel
One CircUit I
Eaeh AddItIOnal CII"Ult or with
Semce or F ceder Penrut
so
IbO
~O 0'0)
3Z $~ (5)
TOTAL
Sbved Onvc{T )/Bwtdmg FormslElectnCl.I Pemut Apphcmon 7J'J7 doc
TOTAL P 01
225 Fifth Street
SprIngfield, Oregon 97477
541-726-3759 Phone
CIty of Sprmgfield Official Receipt
Development Services Department
PublIc Works Department
Job/Journal Number
COM2008-00310
COM2008-00310
COM2008-00310
COM2008-00310
COM2008-00310
Payments
Type of Payment
Check
CReCell1tl
RECEIPT #,
2200800000000001271
Date' 08/21/2008
Description
Add, Aller, Extend CIfC
Add, Aller, Extend CIfC Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdmlDlstlal1ve Fee
Paid By
BUILDER'S ELECTRIC
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
nJrn 97902 In Person
Payment Total
Pa2e 1 of 1
9 57 22AM
Amount Due
5000
16000
1050
2520
2100
$266 70
Amount Paid
$266 70
$266 70
8/2112008