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HomeMy WebLinkAboutPermit Electrical 2004-3-4 I' ,., . I I' I' . Ing ubmllled has the following , d d no require specific land use . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 'iPfl1'~4$.41)726-3689 . ' ELECTRICAL PERMIT APPLICATION Zoning e<!...- . . CityJobNumber Cd#~-tJtJ/~ Date -j/~~~::. _' . --.;- ~-():kJ 1. r~tiiC4tlq~(jJi,'i.ifs-t4J;r:AtJ9Fi .~.'i~t;;'j 3. eGQM~EE'fg*,E~~Fm{>:V~'~}',!;;'Vl~~(~:'f, ij.:.;:, 22-~o MAJ;2.COLA #~ LEGAL DESCRIPTION r7C3ZS'/3 tJ/tJ,/1tJ Ql;:;bN~ it>~, Permits are non-transferable and expire two not started within 180 days of issuance or if work is Suspended for 180 days. Expiration Date I () ~I/ / V c/ , Constr, Contr. Number ... c::; / 0 cP J> Expiration Date t, - d 7 -j) 5 ozupe~' gE trici / /"' New Alteration or Extension Per Panel '/; . ~..;,~/ One Circuit L- $ 43.00 4- ~ - ~"-N=' ~~ J7w/t/~ ;:~=::::.,~,~ <,~: _~::_ ~~ _ ;j Address ~ 7 ~ ,.. E.1Y1~ella!lj~l!s:~~r~\',~f~,,~ert~~t:~'!s}(i'!~,d);;:-'ENai!>'!i!st!U~~!jfil City -:J~-"v.#?I?;fj Phone 2. WqQW~tT9m~~T;,fM~fi:t9~PJY!N'1 Ele~;li~~;~;~~~~E,e~ ' ~~J:g~:g:~n Utilityc... Ad~$~caYcJ/9(0I.ft?~, -= no~tp...&;6'det for' n OA!:'l952.001-00 0 through OAR 952-00 CitY'H?',. '( ,. ~iljreainph'Ob'~e~Y.7$J?~W.:%S calling ,1e cemer. (Note: (IlEi lelepllone number for the Oregon Utility Notification Supervisor Li2eitS; NJmtiefn~~~;Pdt'.S OWNER INSTALLATION The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 '';'.i1M ..':Ji:j A. ~'~~~t:Ri~i~.iHii~t~~!f~f~gl~,Qr ;.*i!),~~[~,~~i1y'~~~~C~,~~!tif:ll ~!'f:::;~ Service Included 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof $!06::M $19.~ $50.00 Each Manufact'd Home or Modular Dwelling Service or Feeder B. ~er..~t~~'s-.'6~~E~~d~~~;';li~i~ll~trHln)\Ait~iiti~ ~~1i~(ic1~tiiln:~t,:~!! S..._,~}..'!~. -".." .,..~.,,'::<;". "..~ "-~,\..)-.";~'.' ,': -,~.:'_.'.'.:..",..'.'> ::-.;;;'-1">:. ,,;.;':';( ., ,. .l<-:"":"_.....r.- I $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to I 000 Amps Over 1000 AmpsN olts Reconnect Only NOTI~f' C ~"..... '.;.::..'...'\.~ ~''-'~-';'^':tt.<;':l~' ft"-i.t<..-~":(;?;;;:.<:;y< )~;:-;....!t"::~ .:;.:"'~Vi:;;, ':";"'ij . \nOOK!' m.~'~ ;Jje !jf'.'r ..,'-", . "'j" '.r '-" ,.- . .=."...C<. . . .. 1''1'1'1' ... .' ..'. "', , ," , AUTHORIZED UNDFR T ~VUH,I\ ~tallationftJ~atiqnl.Hk~lgJiffi~1IT IS NU f MJ~~~:{9~If'JSE~:gD tJANDONEO fOA $ 50.00 201 Amps to 400 Amps' $ 69.00 40 I Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. rif'~.r,<,'e~.,.,q,. ill -'>f".:'4-. 1.-"'i\."':".""V1FiXt..,..,t'~f"',... ~"t~".."",,:+~. ",,.,~.<) '..rifj' D~ tSBr8.ncli~Gii~u'its';-b;\)i,j ~:W"t'f...~' ,,"'."r.mlt<~ 1i~',:/,',!?),,,,::~r:}:";%,~,:~~tr1~ ,J '~~ 'f; .'''.'".'''''.'c~ ,- ~..>,.. ........,._. .t,_4"'""., . ];:-.<,_t.~ ,..__."< :" ",.,.;'( .<.,' ":"f. ". ....' .,,,,.oP '-.f< .::,,,,IN ," '''''i.: Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50,00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~'L'~.'';'l.~'-''.' :-k. ..",".,..,",1"- . ,',"". ,.,," 4. stJIj-'-Of&'OEfABO@;:;'''::;' ''''''i..J, ...ft~,~, 'rli~,A. l{~';. .../~i:2::1":;~~,;;'r, .' ~;>~r~ a.1 , I>-(? f" ''f$t~ ~1 /. / 6!? q',o (' -/Dr;.. .., L 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnslElectrical Permit Application 1..o3.doc 2:':5 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00130 COM2004-00130 COM2004-00130 COM2004-00130 Payments: Type of Payment CreditCard .' ~.[j.. -.= "rII.~"~.....i...... Wi.'..............,..! , " ",' , 'c...._",...... .: " ~ ~ ..~, 'C' "L~'" '"". \' Receipt #: 1200400000000000267 Description Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add + 7% State Surcharge + 10% Administrative Fee Received By njrn Check Number Batch Number Authorization Number Paid By NEW WAY ELECTRIC 000312 031332 City of Springfield Official Receipt Development Services Department~ Public Works Department . l' Date: 03/03/2004 9:30:35AM Amount Paid Item Total: 43,00 48.00 6.37 9.10 $106.47 Hnw Received In Person Payment Total: Amount Paid $106.47 $1 U6.47 . . . .