HomeMy WebLinkAboutPermit Electrical 2007-3-22 (3)
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT A7'LICA110N ::--/. -J /..,
City Job Number ~ -. '7 -5 Date .}/ ~ 7 () 7
J. ~ LOqAiio/iPF INSTAiiA'TiOJl! .-- 3. ; COMl'li~i"E fliE SGHEDU~ BEWW
. ~:, {; / Jili7( jJ/(~
LEGAL DESCR.IP;'ION' {
J(ru J -T/t/rPC - ><-/~
JOB DESCRIPTION 1000 sq. n. or less
/ 'A.. ^ Each additional 500 sq. n. or
75at.iL/(".c 5 / 8JA1C (~/ltllk7I-71lfVjportionthereof
Permits are non-transferable and expire if work is Each Manufact'd I-JOllie or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days, Feeder
2. I (:pl'VJ'~CfYJll,-!:;;r~r:'L,!:4,]]ON 9.NLY. B. i Services or Feeders - Installation, Alterations or R~I.oen!lon:
Electrical Contractor &Ji Iclers G t-'C.-t r-iC j()( 200 Amps or less ...---- $ 63.00 0.~ 6-()
201 Amps to 400 Amps $ 75.00
40 I Amps 10 600 Amps $125.00
601 Amps to 1000 Amps $163.00
Over 1000 AmpslVolts $375.00
Reconnect Only $ 50.00
Address IgS MClcl.s\Jl\
City ~VCjel/e
Phone 4 gS - 09'2.'(,
':J .,00 - <",
Supervisor License Number :...Jo(. I --..J
Expiration Date I 0 ,- / - 0')
Constr. eoolr. Number 4 ~ (p
Expiration Date 12 - I 0 .. 07
Si~ of Supervising Electrician
fU,w.),{ LJ L
Owners Name /~r 1/crtI,1tf
Address
City
Phone
OWNER INSTALLATION
T~-inf\3Ul1liIl'l~~.lJ<.i!!l\..l]:!ad~ on p,r'lP.erty lawn \vhieh
IS )llriiiJ~de/r'ti!t ~r<f.!ll!:\Q"rWM\l~U1res you 10
ollow rules adopted by the Oregon Utility
t!>WJ\~~S\ilnlltc;re;nter. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You mav obtain cooies of the tulfll; by
calling the center. (Note: the telephone
number for the Ore.,gon Utility Notification
Inspeeti:n~R~~f\'s ,~nB3~32.2344).
.~, ,~. ~.iI' !"l" , "
. .
'.
-'-.
- ;<:>'<
, ~y,
A. New Residentlal- Single or Multi-Family per dwelling unit,
Service Included
$106.00
$ 19.00
$50.00
C. Temporary Services or Feeders
InstnllationtJAiitl(ii'bn or Relocation
200 Amps on~ PERMIT SHAll ~l(Plfl~ IjIl.VIllE "'OR
201 Amps tiW(1(I{{JlilliED UNDER THIS ~~ IS'N ~
401 Ampst\)@\1J1rL,'\[#CEOOR IS ^B^ND _ G,
.~ ~IV .. " FGn
Ove! 600 I\mps olIlBofi),\'(l(IiSE<RIOlJ.above.
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Pemlit I $ 3.00
~ov
.. - - - ~ .' --...-. .
E. . MiseeUaneous (S~rvlc~ifeeder not included) -Each InsiaUatlon
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is 545.00 + Surcharges
4. SUBWTAL OFABOVE
66/U
<) ,2. '6
/,.., ." u
~o State Surcharge
10% Administrative Fcc
TOTAb5"?~ T~,t=tY . ~ .~O
Shared Drivc{T:)/Building ForlllS/Elc2f?'~1 ^JlPli;~ ."IoJ~t'Ce
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
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Gaof Springfield Official Receipt
JJI!It!'elopment Services Department
Public Works Department
Job/Journal Number
COM2007-00425
COM2007-00425
COM2007-00425
COM2007-00425
COM2007-00425
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
1200700000000000312
Date: 03/22/2007
Description
Perm ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
KELLY OBRIEN
Item Total:
l;heck Number Authorization
Received By Batch Number Number How Received
dIm 076048 In Person
Payment Total:
Page 1 of 1
to:57:47AM
Amount Due
63.00
3.00
3.30
5.28
6.60
$81.18
Amount Paid
$81.18
$81.18
3/22/2007