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
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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
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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
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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 .
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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,
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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
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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
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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