HomeMy WebLinkAboutPermit Electrical 2008-10-3
225 FIFI1I STREET. SPRINGFIELD. OR 97477. PH:(541)726-3753 ~FAX:(541)726.3689
ELECTRICAL JlERMIT APPliCATION
City Job Number LD rn l.ffiJ!5 - (Y)()(P 9-
1. [lilEO'GAiFjONlij"~:msT~mtoN~I_
;, ~:1"'0=;;"_.l!j;L,..,~..,_.,._--,,,,,,_v...",...
'--~ 95 Ii 5772.&1 .
Owners NameJJ/d Y) JJfJ:nr ~ (~ U.&2-
Address <3 q 5 q 8 ttOiffCE: E.
City~U uG'Odh~~~u~~ ~~~4~~R~ IFrTH~iO~J1. ' $ 57.00
() COMMENCED OR IS ABANDm~!WT1! IJ,tmg $ 57.00
OWNER INSTALLATION ANY 180 DAY PERIOD.PtJSt~d~n';lrgylReSideritial $29.00
The installation is bemg made on property I own which Limited Energy/Commercial $ 52.00
is not intende r rent. Minimum Electric Permit Inspection Fee is $52.00 + Snrcbarges
~ . ~.~
, 12% State Surcharge
10% Administrative Fee
5% Technology Fee
LEGAL DESCRIPTION:
I '7CfJ.. 6 J / ,-/D3 5 QD
,
JOB DESCRIPTION:
~'4hradd JWI1a.f. C,/Z.CULI-s
:P~its are non.transferable and ~xpire if work is
not started within 180 days of issnance or if work is
Snspended for 180 days. '
0~m:,...,'ljk'ms~JmtrAqfeN1irt~a
2. iA1IT0=" "".: "F ' .., k 'Y'i. ""ff ;~""'.~,. " Vi';- +"''),'J_*-'\mrMi''ttmj,'''iPi,,~.i.0.( . :X~
:!:"-
City ""-
Supervisor Lice~
/
, Expiration Date
Constr. con~~ber
/
:ztion Date
/;gnature of Supervising Electrician
OwnerS S
Inspeetion Request: 72~3769
Date
3. 1t(f1ffif~~~~]f~E~iiJl!!.~WJL~
A. <N~~iR=af.it~q'sirg:l~~~Uit~F=il"fr~p' eM3~iiliI~g: t~riifJili
.' . "',' ..""".""""""""""",,;. ').;;0",,,, """' ("r~A-t,i", ,^' "'" ,,,,,.L ... ....' ,.,' __ ". ,
Service Included
1000 sq. ft. or less
, 'Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$121.00
$ 22.00
$57.00
B.
" 200 Amps or less
, 201 Amps to 400Amps
40 I Amps to 600' Amps
60 I Amps to 1000 Amps
Over 1000 Amps!\, oils
Reconnect Onlv.."., - .:.'\
rPI \! ,J,. ,r' ..' '.J
!\TTEh:1 J",.I."-::>~';(' ':',1 ',n.' "
d~- ..IL.%Hhf~&&0Sj~S'~01t;1~.~ ~!tY';;;T'lliJm\.J!M;V
memrmra.",a. ,,~~ces:otl'~;eedcrsJIDjS;g'd'!:d4~llih,
N .' .~"."r,;::-:..",,\;;;;'J;_ ."' . "'~I;i~""~' """""""""",,1ill!!lFlli "1"1 ,,"'"
, R" 9~:2.~OO'\.\)U ,,": '" . ',r";S ,..II 'i:n..;') 1....1!"".' "'
"\~OA ~ "r\htalrl Gvt-"~ _ .~liJrjhone
;.lhjponl\X1terabon-pr.. Re1ncation., 'Ion
v. h center. \, O' ,.t No\l\lca.
'2~jl~orlt'l\~ oregon Utili i3iA) $ 57.00
"2C\lIl@.~~g&mAnjpSlOO-332- ,..' $ 79.00
, 401 Amps to 600 Amps $114.00
$ 73.00
$ 86.00
$143.00
$186.00
$426.00
$ 57.00
Over 600 Amps or 1000 Volts see "B" above.
.D.
Ne';' Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 50.00
4D, oJ
t'
$ 5,00
'-.~
/~
,/
~
oV
TOTAL 4 Cl
Shared Drive(T:)/Building FunnslElectrical Pemtit Application 7-QS.doc
, 225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
6'....p.',iiiiN."'.'.'.'.....llU> ..,.)- ..'...'.',.'..'.'.
Ill.
, .. c-
. .
, .
.".." i
--., " 1
_ /: ",,_,,4
..~,.-..'......._... .... .. ....j- '" -
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1200800000000001036'
Date: 10/03/2008
12:53:27PM
Job/Journal Number
COM2008-00062
Description
Add, Alter, Extend Circ Ea Add
Paid By
JUAN DOMINGUEZ
; Item Total:
Check Number Authorization
Received By Batch Number . Number How Received
njm In Person
Payment Total:
Amount Due
40,00
$40.00
Payments:
Type of Payment
Cash
Amount Paid
$40.00
$40.00
'.
cReceintl
Page I of I
10/3/2008