HomeMy WebLinkAboutPermit Electrical 2009-1-7
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" CITY OF, SRRThJGFIELD, OREGON ,
225 FIFfH STREET' SPRlNGFIELD, OR 97477 . PH:(541)726.3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPliCATION
City Job Number -Cfr-\~ fi) ,
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LEGAL DESCRIPTION:
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Permits are non-transferable a~d expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
SignatUre of Supervising EI\"trician
, -/1'0;; ~~ ,
~ers Name-.Art\1 ~ ~ i1(1~i:\ E. ~iM~flr~'"t$~~r.~"~!1t1l';j'll~'~~;~h'~ifiiillt~,
Address ~n ~. u...h.S~~ ~~~.J;"m".p,.1t'1~I'?iIT_*,~",,,,,;,,",",,m+'!"~""''''''''''f'<'''=~'''''illk''l&w"{_~'~',':n~i0M',""'<#_"";h.",~",",,,,,:,,"'".t.'TI;. ""', .
City ,_: OrPp!a\O.J......MQLo
, , Illes aaopted b~O;~gon Utility
OWNER 1:N~' f lt~tlP[I..Gmt.er. Those rules are set forth
m.t:J ~2-tJt}f''tJ01 0 through OAR 952-001.
:ne ~a8B~'1fnringJnyt@lJ(l!;Ijlil'''''''f"fJSlcll'ffile''f~ by Limited Energy/Commercial , $ 52.00
IS not mtendEl!tI1'IIiIl!Nll!ilIlIClllllltOf~l{Jte: the telephone Minimum Electric Permit Inspection Fee is $52.00 + Surcharges
number for the Oregon Utility NotificatiOn""~~-'.'~';''''''''f'l~!'''",,'~''''r'''''''"'''~I'' i-. '. ;ilii"". 11m co'
Own S' lure Cent . 1 800332 :i. tl,(}!FD,(}E;!lm(}1Jffi1 "'~I!:*. '
e-rs 19na: er IS < - - -2344). Nu '",~i' Mi, ''ie''''''' ";:iI''''~,*"fi1l''- :JJjili~,,,,;d",,I~i it .
THIS f~R~exr..tRE IF THE WORK -1f) .00
AUTH~~ ;tM~ PERMIT IS NOT -1l2.00
COMMENCE'D OR S ABANDONED FOR ~ DOJ
ANY 1~()'N.ti PERIOD. 11). 'J.CJ "
Shared Drivc(T:)/Building FllIIDS!Electrical PcrmilApplicalion 7~8,doc
1','."',,,"iO''''''i''''.'.':'''w.:4,'.'.'01' ~i:r:'l\,";;,\t.~.fd"il;AiIi,:1!)t)~t'b.R0.:I'!l'ii!): .Iimi.,.."';:f'i -"".'lh4.~i'"otl"\';":;:~!$i"iM YWil.'.
.'C'fi)xi;l;J>a'l:i"T!eR~~rDIi!A:tl'Ll!JJ,V,:el111iJH
2. ~~~:t.1!i~~WiVliif~1r.lM!;;"'f&.<"jjib'K",i~"4:oIt,;w0;r>W,"!"~"ltMl~'IJRi:;~i.11 .
Electrical Contractor G'e ~ v-d rBJ eo)
Address eBCfS''! ff;-q~ 8y- f2d
City Sf fLl dD!2.Phone 7'1f~2$f6
Supervisor License Number ,~?6'51 S
ExpirationDate ID..../ -It)
Constr.Contr. Number 15' '7/45
Expiration Date II - I D - 2. ooq
"
Inspection Request: 726-,3769
,
3. rm~w_-m._.~ltlll~B_~fl~
A ~iaralttilri~si~~td~l_tilItFilin@~~mliiiF'~Jiilb~
~!i;~k"~"""'""II!\"""k"~_,*<0i1Z4,",,>[!!g..,..,,,t>'>N""'''',,w,,y"~'b''''';,";,'/"n;,):\';P",-"'1!.;,~";""_",,,,,,,.~,,,,,_,,,m'.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$]21.00
$ 22.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$57.00
'I
B :{s'-',wi~%Jt~~I'..-:aw~d'i!!~~irtml~'~'-ti' .!'51!Mm~~it:~0"'Jj@ti~1~~~ &zm:RJ\tri';I'.;.~~~'r#*:'tI~~~"'
~ }.. e .....1ces\:Qf!" ;~ 'e..~~lnst.aua . o~a.. era . ous.or' 'e ocation:-''1!!!il
i '" ,".." iilui, 1<lt..i,'!Wlii!H,~""Ii:'~!;r:'f'i""M"i'"-,,""""j""WTI!t-'fl_iirn1i):*,01j,,,~~j~. :.17".," c',.
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over ] 000 AmpsIV oIls
Reconnect Only ..
$ 73.00
$ 86,00
$143.00
$]86.00
$426.00
$ 57,00
;~~G;ili!)f$l0'TI!Jm~~"~-fuWl1\W!iaJm!jiih~i~~~~'_mlf"'~""
C. fWeml!l!""J:Y&~!'m~~2P.r1J<;o;t'lJ_!,!:,!g. ;1.1':
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps'
40] Amps to 600 Amps
$ 57,00
$ 79,00
$1l4.00
New Alteration or Extension Per Panel,
One Circuit 1
Each Additional Circuit or with I' '\
Service or Feed"1' Permit U
$ 50,00
5D,CO
!SO. rp
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
$ 57,00
$ 57.00
$ 29,00
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0 1200
COM2008-0 1200
COM2008-0 1200
COM2008-0 1200
COM2008-0 1200
Payments:
Type of Payment
Check
cReceiotl
RECEIPT #:
Description
Add, Alter, Extend Circ
Add, Alter, Extend Cire Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
MIKE BLANKENSHIP
City of Springfield Official Receipt
Development Services Department
Public Works Department,
220090000000000002]
Date: 01107/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Ilh 12238 In Person
Payment Total:
c
.."'..,.
Page I of 1
8:4]:06AM
Amount Due.
50,00'
50,00
5,00
12,00
10,00
$127.00
Amount Paid:
$127,00
$127.00
1/7/2009