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HomeMy WebLinkAboutPermit Electrical 2008-9-9 225 FIFIH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 I, ELECTRICAI;1'.ERMIT APPLICATION CityJobNumberUmZirvk-('7/ ~ &, S Dare ZON \ N\ \ INlTIAL~ DATE 'll\,.\O.~ SOURCE \'L"....n.-o '. U't. . - ';F'CITY QF SP~GFIELQ, OREGON , , . { '( 1. IE(jWjij()Nl{jFllNS~ON1'lBII, tf~kii!h'JW""~"*",*Th;ur''''''~'''''"''"''.'''''''''''''''''"-'''~'1J~~P1iP'':l<;",",''';""~dj;'0)_ ; _ ~ - , /2--3 , h 'ktrrJ &Lho'n / 0-;t , T LEGAL DESCRIPTION: IZlutv-bf/nc:! /1n1ey. I> 1- :2/Ld PL. -I'/fflItJ LoG-Gt (L/fr:!. I ' JOB DESCRIPTION: . 1000 sq, ft, or less Lf7LV ()OLT~& IL/tn/7l!f]) @II~EachadditionaJ500sq,ft,or l.c1?-6t.F //IJ's;i?!-U portion thereof 3. .1f~Q~~~~~~.1B~\fJI&'_t. A. W,"-,,";]mrR--:i\1.;:~illi:!~rIJffim;.JS-1~ffi'$0~it;'0j~'M;s~-lti--:;r~PB[I~I*~~a",qK~u- ~~~I' ..._..-..eWi :esIU~llLtiI;:;;}~g!l!t~~j':+.i4~,~~!mVYie!fTh;,~!!!g1,1!~I-+il1 ~~_ Service Included $121.00 $ 22,00 Permits are non-transferable and expire if work is not started within 180 days of issuanee or if work is , Suspended for 180 days. Each Manufact'd'Home;or Modular Dwellirig Service or Feeder' , $57,00 .~""'"dri';'" Vi"i?? LAIA IQ Address $'7b N. /!J!JD wr:Sf. City L<5TmtJ I IA.-T- Phone t/3J- 752- (p 'fOS Pump or iITigation $ 57,00 I $ '/3 Z- / ' SigD/Out1ine Lighting $ 57,00 OWNER INSTALLATION Limited EnergylResidential $ 29,00 The installation is being made on property I own which Limited Energy/Commercial' I $ 52,00 ..c; ::::> o---.J is not intended forsale,lease or rent, Minimum Electric Pefmit Inspection Fee is $52.00 + Surcharges ,L;';) _ 0--.,:;) L. & <:J 0_ ~ '-( :'5,';:) <) &0. y--( i2R#P&:~W"lli,';iM~W'r.';,MiJi!lfH~W'#f,;%','1:P', "'''''"',' '1:~)i1fJ$1JjilWi?f'''''o(lp,0'','''',-,'f."W'H'1\'$~'./rc& . OONJ1J1l2tf31X)R1/NS'F;,w1!:f&'F1JiJN.9NJiiH 2. '>'~0"!i.'.:)t:VSZ0%m7W%$~"1~ilil!1l1i'0$"ot%$;r,,,,.d$i)1h1,,,pq0e~.ful"''S'6lX''';idG#'i11il#h'-'i!ii'!, Electrical Contractor' C. tI E 200 Amps or le~~, $ 73,00 201 Amps to 400 Amps $ 86,00 Address 3333 Ct1m~~ /2J). 401 Amps to 600 Amps __~";,c,,,vc$143,OO . . . .~..-;.. \_ nrr~l,"'t' t,;:\.\, i "' , ,.:.;ljt I ' , ,601 Ap).pS\f6!1000'J\nii>~:;:'_ \,' ':e e.e::)':<n $186\~0 , City ~flIZtAJ{,-R(;'Zf) Phone cnl- Z3>S-1t/1v.> overlJoo?i^!#k~~\~~;:; !i~,'", 'U"'"' 2re_s;~~~99 . , Recob'nect'qiilY2 ';01,001:) l\\!Ougn Ul-\~ O'$i5'Z'16~ ' . . . . in~A~,D':~:-~~r" h~..'\n COpIes u.\ tH~rU~t1 .-:z",g 3.- J ,<Y.2. c. ~rn:llrf'f.j1:=~~~~l. Supervisor License Number .;;.,.7-1 _ t--t:5.f,.:./. ~,,,,,,,".~~~.i4ti'-'i'1:"~4,~Y;f.4;.~~ ,. "'. - -'. . \flO_~.. ~"___". '" ki0&.'W';;fu1 0; / / ' ';~~ber i.or the, ur 0_332-2344). If> /0 2()og Installation, A.ItllrIIiiOnI!j,~i.\loeation , 200 Amps or less $ 57,00 / t.j fZZ 2-- 201 Amps to 400 Amps ~ 79,00 / / IR /09 ' 401 'Amps to600,Amps , , $114,00 ~y!:r!iQ<f-Amps or 1000'Volts see "B" above, 'D It.~, "','~""'i"'''''''k,Y' ~;;lii~;;;;""-."'m' '"w..'lI'!~', ",'".",~l~,_"" ",'-",1:."., . g;fu~;.i!!JJi~~n~\~u "';;"'~'.', ;.', ' "',:~,' 'f., ," ,m:.~&.3wr~l~ N'J~:.\lfi,v..~idJ~~INit'1,JJi~~P'JIPMIJi IS NOT ThlMblfcllit:ED 0R IS ABANDONED FOR $ 50,00 iEa2h WtidiflottaIRi1fCllIDn- with Service or Feeder Permit' ' B. Expiration Date Constr, Contr, Number Expiration Date $ 5,00 Owners Name E. ~M~?ef~~~7~6tmr~ma~~Ei~~itll1 j!1tw''''__i1~.)txM*,*I%WM'''~''',",''''1iiITi''"'F'''mE8W\i!ffi2i5lli'''fA_'0'l?dM'''''''''~'"",)s,c;;;='~",_,",'"""'~"i=="",,' . c'" Owners Signature: 4. 12% Stale Surcharge .10% Administrative Fee 5% Technology Fee , ,Inspection Request: 726-3769 TOTAL Shared Drive(f:)/BuildingForms/Electrica1 Permit Application 7'{)8,doc 225 Fifth Street -- ':' Springfield, Oregon 97477 541-726~3759 Phone Job/Journal Number COM2008-0 1365 COM2008-0 1365 COM2008-0 1365 COM2008-0 1365 Payments: Type of Payment CredilCard cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Department, Public Works Department 3200800000000000639 Date: 09/09/2008 Description Low Voltage - Commercial Indus + 5% Technology Pee + 12% State Surcharge + 10% Administrative Pee Paid By CACHE VALLEY ELECT " Item Total: Check Number 4-uthorization Re~eived By Batch Number Number How Received njm 009169 In Person , 1, Payment Total: I, Page 1 of I 10:35:37AM Amount Due 52,00 2,60 6.24 5.20 $66,04 Amount Paid $66,04 $66.04 9/9/2008