HomeMy WebLinkAboutPermit Electrical 2009-8-18
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225 FIFTH STREET. SPRINGFIELD,OR 974i7 . PH:(54I)726-3753
ELECTRICAL PERIVIlT APPLICATION
City Job Number C '1-4 lj if '
LEGAL DESCRIPTION
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JOB DESCRlPTION
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1. . LOCATIOiY OF INSr4:LLA,TI{J1V. .....
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
S~spended for 180 days,
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-,'COivTRA.CTORiNS'f.AiLATi01V'ONLY'!
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Electrical Contractor //0. /,,"",,/, ~.flc_f-//c..
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City
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6~5 ~IL..
Phone ,3 V.3 -7 1-'77
Supervisor Lic'ense Number
.2-5.u> - ...s
Expiration Date
fa I, /.2.rJ In
Canstf. Cantr, Number J 7 2S 2.
Expiration Date .2.. I ~ In '7
Signature of Supervising Electrician
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Address' ~ ~'l.", \ \~ '
City ~ l:f~ Phone ",\,.<\- ~1
O'WNER lNSTALLATION
The insTallation is being made on property I own\vbich
is n01 intended' for 'sale. lease or rent.
Owl1ers Signatufe:
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726-3769 \<{,,~'
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. FA..X: (541)726-3689"
Date 3"//4700/
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3, C01VJPLETE FEE';crilObDll'BELQW
A. New Residentiaf -:-Sj.ii~Ie',;Jt~~I:'ulti7'Famjly.'per 'd~'~~l:li'~g:~nit.
, - .c. ',..e _.'-'-'. ,..... ." .',..' _. _<~...:_,. ; ': "".. ,..',
Service Included
1000 sq, It, ar less ,
Each additional 500 sq, ft, or
portion,thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106,00
$ 19,00
$50,00
8, Sen.i~~sorF~ede~~~:J~~i~@Ho~~tiier;;ti;~.?~'~~I~~h~~ri~_
200 Amps orless
20 J Amps to 400 Amps
401 Amps to 600Amps
60 I Amps to I 000 Amps
Over 1000 ArnpsIVolts
Reconnect Only
$ 63.00
$ 75,00
$125,00
$163,00
$375,00
$ 50.00
C. Te~por:lrY:S.efvices;'~,~/~.~e~~n~" ::,-'-" ,
".-,.,'
Installation, Alteration or Reloc3tion
,200 Amos or less /
'201 Amps to 400 Amps
40 I Ainps to 600 Amps
Over 600 Ampsor 1000 Volts see "B" above,
0, Branch Circuits.
S 50.00
S 69,00
$JOO,OO
so~
New Alteration or Extension Per Panel
One Circuit
Each Addi tional Circuit or with
Service or Feeder Permit
$43,00
$ 3,00
E. :VJis(;eJl.aneous:(Se~,~rice/feedcr not :jncludcd) "':'Ench' Installation
Pump or irrigation
SigniOutline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50,00
S 50,00
S 25,00
$ 45,00
Min.imum Electric Permit Insp~ction Fee is 545.00 + Surcharges
-I, .S,IBTOT.lL OF.4BOVE
11.-
Jtr;Stare'SurcharE:e
15'oA~eFe6 '
TO\R..CZlo ~
5O.a)
lo.DO
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6 ~}'?9
Shared DrivelT:VBuiiding ro~.s/Elecmcd P:=rrriit -"'-.!Jpiic::.rion i-06.noc
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Developme'nt Services Department
Public Works Department
Job/Journal Number
COM2007 -00464
COM2007-00464
COM2007 -00464
COM2007-00464
Payments:
Type of Payment
CreditCard
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cReceintl
RECEIPT #:
2200900000000000927
Date: 08/18/2009
Description
Temp Power 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
***+ 10% Administrative Fee~**
Paid By
JEREMY REYNOLDS
Item Total:
Check Number Authorization
Received By Batch Number Number How'Received
CIC 052160 In Person
Payment Total:
"
"
Page 1 of 1
1:16:I7PM
Amount Due
50,00
2,50
6,00
5,00
$63,50
Amount Paid
$63,50
$63.50
8/18/2009