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Home My WebLink AboutPermit Electrical 2002-12-16 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . ""'~towWIe r # ~!.3-{)W'l-();y- ELECTRl_ERMIT APPLICATION City Job Number () f) - 0 () 4 C, 7 -() \ . 3, COMPLETE FEE SCHEDULE BELOW 1. LOCATI,pN OF INSTALLATION I-c::, ./JPI.M .J LEGAL DESCRIPTION. f) ~ c ~ If.1~ 'fJ1.v. (I (] in , J: a j1~OL A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum ~ Supervisor License Number 3.;1 7 } L fA ~ Expiration Date /0/1>/ /0_'" JOB TlES~t!TION /J ~ 1000 s,~~ less ...hu.J, ,-I) (/ fAhP'K ./ a~~\~~onaI500 ~i\\Od \\ ,....lff8r portion ,,\>,.. ?ec~~ Permits are non-transferable and expire . eC\ as S ""ite S thereof if work is not started within 180 days \0",i~9 ?t~~ ~o\ te Ea ufd me or of issuance or if work is suspendillf~, a~d dO . . odul elling 180 d 'to(\\ a\ -,..-0 ays, ntO"' 'o\) __III ce or r a?" 1-00\ .z.- 2, CONTRACTOR INSTALLATION ON "ll' Ices or Feeders . oa\e Si\)oa\ Installation, Alterations or Electrical Contractor-.ADT s~~t Relocation: Address Z'll S SW 153 t! Or. 200 amps orless 20 I amps to 400 amps 40 I amps to 600 amps 601 amps to 1000 amps Over 1000 ampslvolts Reconnect Only $106,00 $ 19,00 $ 50,00 City. Bl!/lllt.dol/\ PhoneSD3- ""- 7100 $ 63,00 $ 75,00 $125.00 $163,00 $375.00 $ 50,00 Constr Contr, Number 5"4'1 C, Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date 5- 7- 05 200 amps or less 20 I amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts see "B" above $50.00 $69,00 $100,00 Owners Signature: d. \ "-'uull:-.~ l AI I t:!..1 tUI\.:.)le\lu, , ;he~OreQon UtilI' fe""'" rilles adopted by ,__ .::.~ ""pI fn' . . Notification c:nt~~1~t~:~~~h-OAR 952-00 in OAR 952t1-Ct:\1- h.' coPiesoltherulesb. 'I , ..., ~diOl~ am .... 0090. ~\].. ~<.~\Q (Note: the te\epho~<; ~ \1d:;\cl!)'~ ~m "I~P.' 'o;~gon Utility Notificatlo~' ~f,"'l' '0" . 1 e<or\ ~.~/.'),<46\ ~~~ente'" -r,"'" Signature of Supervising Electrician >~t~. Owners Name ~: 0(1M 1~A) ~~wB~~::a~~~r:ru~~tensionperpanel Address oL{"1;).. Jl(~ ~l One Circuit . NOTICE: .- City ~!ft' Pb"ffl~RMIT ~HALL EXPIRE~'tA2dWemlfircuit or with Service OWNER INSTALLATlONAUTHORIZED UNDER THIS p~MnefsN1ff - $ 3.00 - The installation is being madJ;QMMENCED OR IS ABANDQN6QiiQ,i!aneous (Service/feeder not included) property I own which is not inYll.l!e~80 DAY PERIOD. -Each installation for sale, lease or rent. Pump or irrigation Sign/Outline Lighting Limited EnergylRes Limited Energy/Comm $43,00 $50,00 $50,00 $25.00 -!- $45,00 KOO Minimum Electric Permit Inspection Fee is $45.00 + Surcharges TOTAL ~s.oo ~.Is... ~ ...&0... 51.15 4, SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee '. :225. FIFTH !)TREET ;', ~'\ r' "~"I I: ',; I I . SPRINGFIELD, OREGON 97477 i'_--, '-, . I ,. '- ". " , \ '" , ~ , , '," I INSPECTION REQUEST: '726:3769--, I \,:,'\ f o~FicE726-3759, .,1'.:1:; l:: I' J1 t,;'" i. .:, i.,.,'i;""I"t'J"llt:..J. I ( .', ,',' ._ _..{ .,,' \ 1 :;:';"1'_-,~_. <' ",',; , I, \ ", ;1 f i 1. LOCATION OF INSTALl;ATlON A '-.- '~, 36. \~:-::'!{~ jiy;;KZ.3.(,(j L otJ JOB DESCRIPTION . 10001~\l;f.l or less t-ot-J VO C.1~ng prolect as submitted has Wi~i%onal 500 Z' nHl(.:j Hno a095 nUl requIre speCifIC ft rt' .' ,J . , sq. or po IOn Permits arc no~-tn1l1sferabl€\\\\'d'e~brc. +h . thereof, if work is not'startcd within 180 day~onmg 10 -r'K ...- 6 v I Each Manufd Homc or of issuance bi ~f work is suspendedj",.... .-.. J IVIUGUlar uwelling 180 da)'s. : t 'f'\1^/ t:."n,;,,'j;' gr Feeder hU:Il;jI"ILOU Signa lAre 2, CONTRAC::TOR INST ALLA TJON ONLY B. Se,'viccs or Fccdcrs / ~ , . ,', ;' . , ;":,' i~11 J <:::' r Installation, Alterations or " Electrical' Cbilliactor +,l~"U I 0 tv oJ c-tl.4cr€/Z' Relocation: i:' , .;t I..} Address i'i:i8.sT 6 R e. /.....- H /~',::: , 200 amps or res/.' , .... ~ ' : " \: '\ /' '(" ",\ 201 ampst0400amps"~(:)~ City Eo&-" I P!lOne 1i{/7....{,'7,t, "~401 ampst~600)~ ~~t:::J'\' . \ \ ' /- , . . GQ I amps t~i~illl'~\!.!R\ '\ ~ Supervisor Licensc:Number 2:4 3 ~ /..../3. p. .. "Over loel'~:1l!.~i:S) '(\S !' 'li ' " .. Rlld>ln~,,\~ R)~~ Explralton Date 10 - 0 1 - Cis--. " ~\~f(,.:..~~ ~~~<;)'(.."~' ~~~ ..' . 1'/ ',' ~ _ ~~ ~\'J'~'l!ild1'm~ '~es or Fceders , , -C::onstr:C:ontr. Number 7,11 9 j ,\~~~(:)~~~hfu,~ ,,,tion or Rclocation . ,{ , '--~--_.' '. ~~ ~~~~Y"', " " ''-ExpIration Date )~-I-l?:.=-O y "'<;)~ \'O~ 0 a!nps or'less .. . $50,00,. .. " ": ~_,~~OJ, '201 a!"ps to 400 amp~ -----c $G9,OO -;:-- Signaturc of,~upcrvising Electrician -~--O,V:'i[401 to 6.00 amps , . _ $100.00--2' ),' ".C'\ ',';"'--',.. Ovcr600amps.orl~DOvoltssee.: \ ..,."'. ?" ,M~!:,€~ "B"a~?\:, ~~e~~O~~~~\; !' '" . c- . J/; C"..'I J 1_ D, Brauch ClrR6~ 0~P~ ~~~~'\' l ' .. Owners Name "'>co~ ~"':. N&\'\~~I?>~~lfJv:,;,~~pa~el c , . . :' " (I /'. j) ',( ,O,0~ 6'O~\'! ~e~l'-~ ~.s.e'<>~. . ~, . Address 70'31(2. t-.1. r<-~ '\O~' "'o~Q[.:.s;~!>>Q;~ ,~>{<\e n~o~.o~ $43.00,_ , _\\ n.U ",.;~~o ~o. '0y ",-'I): ., " ','. ''f('- ~e~Q ~\0" t)",' '~0~ \0' '~\C" , " . Cit).pIJffl~vf-' .' Ph~,~C ?Z6 -6~~ ~,~ ~G0 ,slliil"A~~ij~&:~~~~~Vlth Servi~e, '. . \O\\~c~\~<:>~~l.b~~rl@f\n\!)'i.~\ ~ . ---.:.- $ 3 00 _ ; ~0\\~1'-~'?J \~~ 0~\0"0~0~ ,1>1>7: ,~ ' " . . \~O RP~l~P:~l$~~ @.eg.ice!f~eder not includcd) ..' t)f;;)'?J ~\~Q;~\ef;j'\1clI;'jn~al}atlOp " ',,' C ~~'O0. ePil'~ 0: irrigation' '. --":. $50,00 -=-- ~ Sign/OutlineLighting $50.00 LimitedEi!ergylRps, , _ $25.00 ~ 'Liinited Energy/Comhl, ---L- $45.00.'~ r' ,. - ,., , :.~ /. (, i" \. . ~"'.. ..' \ \ .' . I j'" ~. ~. -'.' { -" !i~}~ ' ! \ I I. r,' , , . I.'. . , 1 ~. , . '" I ",.--1, , i ' ,~" \-' ' I' i , \. ~ ~ . . "" , .. LEGAL DESCRIPTION /70"-:>ODO .111 ;:j (';~: \ EV.~:AL PER},!n:AP~L1cA:~~qN. '. ::i "' I.City Joh J':!umhcrDZ :-00q?7 (j f I' !; f'i I'... ",... "". ,I ~..: , .! ,. ~ 1 ~' .",.' "':.' ~.,'" ; + ' - j"C9rMPLEJEffiESCHE~ULE,B~L?:V ,:."; ',.... '" : l,.~ 'il . './ I, ' :~ ',~ ' ,'.:. -" " ~.;..4.-dA~. " Nc,'" Rcsidcntial::'Single or- -----~... ->~-- _\....~~^ ;', . Multi-Family pcr dwelling unit. . .. " Scn'icc Included: .. , 6a'l-DZ Items Cost Sum.; ,', $106,00 $ ]9.00 :}:~i~; .",,-..'1 ::'i<I:.!;" ~. I ( t. {-. ~ ; '\'" ',' .., $ 50.00 . ,"----' ,,'JJ . "-"";~ ,'" "- ',".~- ,C\. -.', '.>'.. , ' , r~'~~?;:)>\' : ": - ~.~ :', '$'63.00 V :: '. ';<0$'75,00 -;--;-: -:--:$i25,OO =' .. $16~.OO --.:..: ~ $375,00 . .$ ,~O..OO ~. ': . OWNER INSTALLATION , ," The installation is:beil)g made on property 1 0\\'Il wInch is not intended for sale, lease or rent, O'Yllcrs SignatUl'c: . , ",' '. "'. "c,-,.,. . .. I\'1inimli;n Elcctric P~r~it Inspection Fee is 545.00 + Sllrclilll~gcs , ", .-, ; -:.. ;-.. , r.' 4. SUBTOTAL OFABOVE 1 I.{j . 7% Sta,te Surch)lrgc V.i 8% Administrative Fcc '< 60 . . c.s:liF~ TOTAL .. . .._....t ""'_..~~ ::':_i--~.".' .'a cIf)-/ . " . r'225 FIFTH STREET i' .., r '~r17~~'!:'j i~ "\ El..;~_CALPERMI!APPLlCATION' : .-" ',' -SPRlNGFIEDD, OREGON 97471\ j i ... t'l' I ' ;. ' .' :.' . " ; , -;. i ! INS~EcTIO* REQUp;-r: 726:~76f-, I S j i :CitY~Ob Numl;er 6 2- GO i.f?, 7- G i , ~ \'" " OFFICE: 726.3759 ,I,!! ~ : j "J "1 . J i I :'i I' I }, . ':... .'\' " G)..J. 1('" : n ~ Ii :"\,'1\,,,/ ,i 'r ,.\ .,C,,:3,~C?MPLETEFEE'SCHEDULEBE~O~V "~" " ',,: x".>! ~iI.~~~;;T7,\?~~oll11,F'~1j~~}TION "i ~~!:_ i!,;./ .1::" ",,";'.' :.~..' ',: , ..-:::a. y' / fV'~W.r IG.-r"--.:- A. New Rcsldentlal-Smgle or.-:...-.-...._.... -~~--.~. "'l :- Multi-Family per dwelling unit. :..; " . LEGAL DESCRIPTION Sen'ice Included: ~ : .- (7(')?"SDoc> 00762- Items Cost Sum '. ',.-'" ., . ,~ ;" ...' JOB DESCRIPTION L -I- 109,~d\'lJh or less i~;: WI rus- Nt:sr../ (',..,,,,,,.KL S;;:_~rdilf!l\\ledh.st'/:RBl~ijdditionaI500 .'I~"~""".':"<"! .!} 1he 10\\Qw\ng pr~~e~'ot Srequire specll\C sq. ft or portion PermIts are !10n-transferabl'iil\lldlJ'~gedO t L there~f - ", ;', if work is "?tlstarted within<4llllC(l(~s . _ 1'" .~::ch.MaI)Y; d Home or ,/,l':,'/ .'......,. c.'' ,..' of issuance br if work is suspended foto"'"9 ~ ... 0 u ar Dwelling " ;, ' 180 days, ;',, . Dale Sp"'iee oJr"feeder i. ~ .......~ $ 50,00 :' .", I~ d s\gna\\Jfe ~ ,', . I) i)" 2, CONT~C!OR I,N~T AL~A'i"r()fl ONLY. B. Services or Feeders /' f~' ',:'\ :,,1'" Electrical,~6~t;~lct~t*at "'<A '" f"lecT ~~~~~:I:;:~:~,AIt~t~P:o,::? "i.";;f':~ t::;: Address !3?1 J.';~\ /It:h d/:~'-,,,, 200 amps or le~t"", . , : r.: ~$"~3,O~\ ~; i . 'j ,/ Ii ~,', I \ e /, .,,, 201 amps to 40,0 amps . .',' ~ $,75,00 --"- ~ I "'; C:l)'_#"!-rv,<;,4.1q...,'Phone Cj /.5 ",401 amps 1'J600 anlps' ~I:)~~ $125,00_1 ''-''., l f \ I}. ; , / 6QI amps 101000 an!ps ..~~ ~ ~I.63,OO_: ", Supervispr LicenspNumber 12 06 ~ 5 ,OverJogo ampS!vo~ ~ ~'\\~,~ $375 00 ~" , I ~ I "V '/ ,< / ' . __I' .. ' " Reconneel OnlY~~ q~~ '!) llol~ $ 50,00 --,-' \. I E"plr,ation D,,!e I 0 / / .;;2 0 0 7- ... . ~\..~~~.,~t:::J~YJ ...., " ~, ',' ,I :. t:. .' " ' , c.T.~pr~\~~'X*,oT~~rs. ' ' .' " <" ,.'..: Constrj;:ontr. Number IS/ '1/ I ~~"J,Ml.~~~~~''\l!P~orReloca'ion,. ' . j ., ",,- " ----~'.' . '\" ~~ ~.(\~t~ ~~'?- ~t:::J~.. " .'. " ',' \: ~.. :-E~lfallOu Date I ('")-Y'IJ_A ;;z..... '. ."; '\~~'\~~~~. ',. -;-;-, $,0,00 ~ i ' .: :,.: ,"''-, I I ~ ~ #~0400amp~: '" _ $69,00 _: ! 'c, ..: Signallll'e or.~uJ1el'\'ising Electrician "--"~q~OI,to ?OO a,mps, .: . .. -----.:. $10000--.! L.,,~': ' . './.1.1;.;.', ,.,;. '. ",.q".,,>~.. / ~'~;~~b~~,~ampsoI:.~~e, " ',' " . .~ r,::" , . .;tVza.' "0' ,>,~ /\ < "[ f ,',' . .~>' '. ,-' :.l_:-._ , <~'>........ D. BrarichCircuits \' . <, f"' Ow~c : Name c; Cd 77, ,6(+:+-:. J4 <; Ncw'Aiterdtion or Extensioh\l{~~p;nel ' , , 0' .. ./ /1 h. / j,~ \ 0b.~~0"'0~ \)\\ ~o\\\'\ j , , Address /03 "I:J' #/11 rd 01"~,'!=lre~\'30~~4o~ag ~0~0~,~ $43,00 _,'. ..,. ' ," "~0~() '1\X'\' ~0S 'li- f?,f:J'l<, ",'0'1, , Cii.v~. . . .,fj, 'Phone ",'C.E~g idaitEnal~Cilc~iil~~\'Itli;S~" 5:' .. . . '. ,', , ~\,' . .'\0 ~vc ~'Y>,. .\\,V "" :-" 7 :.. '.. ..' . . ..". ,\1(;.\' oJlFeed,s\.P,erl1!\$)., SO' e'Y'" $ ~,OO ------' '. OW:--ERINSTALLATION , " ~"o'll~~\~t0~,()I)\~~<?o'Y\~\'(\e\~o\\~\c; " . " ,~. The l1;Istallat,lOn IS bemg made on ' 'OE~\~J,rcel!lineo~,(Sern!;,<;/fee~~r~n~t 1~~ludcd) " pio.perty I O\vn which is not intended ~o\\ ...~ '()<J-Eai'l~inst'tllation.,~ $'Il n~'2-~o." \, : ' . . , Or ,r-o,} , rl1"" cO\) ....'3"'. , for sale, lease or rent, ',.. \(\ ",'Pump;or irng~i1ion,,,.,, . . $50.00 ' 9\.1' r\"'" \':'old t;l.\-,V -- Cl;j h\\\SigilLOlitlined.:ighting $50,00 C~' ~\.... 1)'\'- -- ~~l!i7Ilil)1Ilt:nergy/R~s '. _ $25.00_ ~ 'Liinited Energy/Comm ' $45.00 . " . t - . . ,~ . $106.00 - ';',;... h~n~-~>} $ 19,00 ~:. ,; ;.., ""',\ ." , , , , . O'\'ncr'~ Signat,ure': " . , .,' 190: I>J3IHS\-KJ' . : 38N~H8 . OL'SgT $ ~:a83~ lW~ GOO~ 91 d3S:31~a ~T90TOO~10:#SN~al , . '. . I\linimu'll1 Elcc~l~ic-~~~'mitJnsJlcction Fcc is S45.00 + Sl.ll"cha.l"gcs . , , , .' /3t", 966 If Ol{ /,Yg ~ 4, SUBTOTAL OF ABOVE 7% State Surcharge 8% Administratil'e Fcc TOTAL - -, ' .,-~ -,,,,-,.,,.--.