HomeMy WebLinkAboutPermit Electrical 2006-11-27
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- CITY OF SPRtl~JFIELD, OREGON
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CDW! z.c,Cb ~ D/S' '3 2.-
I. I LOCATIONOFINSTALLA1'ION: I 3. I COMPLE1'EFEESCHEDULEBELOW
l'tzB$k/U.o l..-n :.2:P/Z-/tI {.f~{)fU5, .
LEGAL DESCRIPTION: } /<) 3 Z. ':), :1 DI)15't> A. I New Residential- Single or Multi-Family per dwelling unit.
(Jrz.IUC f5-T },(/ I~ Service Included
JOB DESCRIPTION:
I /LLc.Jf/h ~u
r
2-1 y
/ Q
11- "1
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each M:lIIufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
Permits "are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
$50.00
2. I CONTRACTOR INSTALLATION ONLY I B.I Serviccs or Fccdcrs - Installation, Altcrations or Relocation:
Electrical Contractor lJ1er:en SCC,d C/J tJl:! tJflE'200 Amps or less $ 63.00
/J . 201 Amps to 400 Amps $ 75.00
Address It;:;''Z.o r- S"tJ 74"tJl /T7It5 401 Amps to 600 Amps $125.00
FL .601 Amps to 1000 Amps $ t 63 .00
Cit;-[i '-. I'H't.M L//tPhone 003 c,?-o .1J:,z.. oD . Over 1000 AmpsNolts $375.00
- lVullllt'ReconnectOnly ~,,$50.00
THIS PERMIT SHALL EXPIRE IF THE WOII"
Supervisor License Number )'6 {:> s::r: 6i AUTHORq8lTemi>'Orar);rse'l[\.iw.\ft\MiJelj~~U I
COMMENCED OR IS ABANDONED t-UK
Expiralion Dale 10 - 01 - () 8 '''v 180 .Jnstallation,-Alteration or Relocation
"r. UJ-H icnlUU.
200 Amps or less
20 I Amps to 400 Amps
40 t Amps to 600 Amps
Constr. Contr. Number C,4tJ /4-
Expiration Date ' / - '3 0 ,... f) 7
$ 50.00
$ 69.00
$tOO,OO
Over 600 Amps or 1000 Volts see "B" above.
~ature isin D. ..B~'al~~.hCircuits .'all..'
ATTE '\I i Uj~.VilClt'""j, '-" ,-.,- '. ..
I ~ el.",A1terati.n.o'!'...xtcnSiOJilp.erIPiiliel'
f IIOWrU~f::lSi:1UUf!"'''~ :t.. - ::>
. /l 0/ o. . . ne,Circuit Those rules are set lort' $ 43.00
PH-< <.... V --= ~ JI/ 0 u:5.s ~\Iuljhcatl~.1_~I1~A~1!i~~Hri(51:!1lIlr&A~1952-001
l--"'" "7 ..11" .1 ,1J1,Q~R 9.~N,~~ or Feeaer I':polil. of the rt:-':-: h. $ 3.00
Owners Name It<-\ -v.lr-l""'~'" . -,)(j9bl\.I:OU~t~;Aoll~la_l~ ~o ~~;i,~....leptlG;: a . '. .'.
Address ID 0 S<r CiLy('~1 flt-IC-(::I"' Ca I1Ig Nf,sce ~neous .' .,~~/J~~II~,'tfllUe~!uded) -Each InstallatIon 1
. _ _ .J/~ [j. LV&' ,number tttJ:0r ,~u
City G:ra..-vA-tl,\ 'hone 7S7- 2/TO ellJIlltlJfliTigam;',0-332-2344l. $50,00
-- Sign/Outline Lighting / $ 50.00 ~ 0
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. I SUBTOTAL OF ABOVE -SO
8% State Surcharge ,,/
10% Administrative Fee .,
5% Technology Fee 't l U
$b/~
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)lBuilding Forms/Electrical Permit Application 8-06.doc
225 Fifth Street
Springi'ieid;'o'regon 97477
541-726-3759 Phone
~F11lU>
. )'.....":;_.~ .... .......
~_..}
~'h
Ca..of Springfield Official Receipt
~opment Services Department
Public Works Department
Job/Journal Number
COM2006-0 1532
COM2006-0 1532
COM2006-0 1532
COM2006-0 1532
COM2006-0 1532
Payments:
Type of Payment
Check
cRcceintl
RECEIPT #:
Description
Sign - Outline Lighting Each
Sign 0-35 Square Feet
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MEYER SIGN CO
1200600000000001766
Date: 12/18/2006
Item Totat:
l.:heck Number Authorization
Received By Batch Number Number How Received
djb
16614
In Person
Payment Total:
Page I of I
11:27:09AM
Amount Due
50,00
80.00
6.50
4,00
13,00
$153.50
Amount Paid
$153,50
$153.50
1211 8/2006