HomeMy WebLinkAboutPermit Electrical 2009-9-28
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.. City uf Springfi~ld
Electrical Authurizatiun To. Begin Wurk
E-mailedTo:dana@jbelcctriCinc.com
. Check on status of permit
,~.~.~ Ph~ne: 541-726-3753 or Email: permitcenter@cLspringfield.or.us
,0 New Co~stwc~,o~ . '.r.'
o ,Addition/alteration/replacement
o l.or 2 family dwellin~
o Multi-fatnily @Commercial
o Accessory
Job Address: 2187S F.ST,.
City/State/ZIP: SPRlNGF~E~D, OR 97477
Suitelbldg.lapt.no.:
- -.-
P~oject Name: Add a refrigerator
Cross Street/directions to job site:
I Tax map/parcel no.:
--I
Hookup a refrigeralor
I Name: DelTickD
Phone: 54]-5]7-7277
Fax:
Email:
Elee lie. no.: 37-587C
Business Name: JB ELECTRIC lNC
CCB Iic. no.: 104929
I Confact: 1l"'TIO"'-
I Address: 4685 ISABE[~E ~r .....
I C;')'IS'","ZIP: EUGt~~~~~ir~q;o~!~~L L\~~r;~~~ .~:~~ ~/?~f\
I Phone: 541.687-577~~: ~~9~~i.~L._~ U~~~}i~~i~.~~ _L...i'.l~V~II_~J_I"vT
I Email:JOHN@JBEL~ctRr'tI'Ne.roM=U un ]0 MDMI'\IUUI\lCU run
;'NY ~<){l E;;Y r::r";;;,F;, 0""
I Metrolic.DO.: t:,;IlY'1ic
L Supervising Ele.ctrician'S lie. no.:
r Supervising Electrician's Name:
Number ofinspeetioll5 included in paid servicn:
Residential Service: 4
Reconnect Only: I
All Other Services: 2
Upon review and approval by your local Jurisdiction, your permit will be
e.malled or faxed within one business day, with instructions on how to
schedule your inspection.
NOTE: This Authorization To Begin Work expires within 180 days if a permit is
not obtained.
The local building department may determine ~hat an A.uthorization To Begin
Work is null and void if it does not meet applicable land USE; laws and local
ordinances
69600- BEL-09-00 151
9/28/2009 11 :25 am
Approval Code: 006685
IBalancecifpenriil fees I
l~jec_!rical.i_~~~!{~:e~~1it:~'I*~~~::~:J~nt,
ISublotal
/State sllfcharse ()2% of penn;IIDtIlJ)
ITt:chnologyfee(5%ofpemlittota])
I TOTAL PERMIT FEE
Pleasecl1eckalllhalapply:
o A service or feeder beginning at 400
Amps where the available fault
curreIltexceeds JO,OOOAmpsal
ISO-Yolts or]essto ground exceeds
l4,DOOAmp5fQTaJJml1er
installalions
o Fire pumps
o Emerllencysystems
o Addition of aneW motor load of
100 HPormore
o Six oi more residentiaJ units in one
sm.Jcture
o HeaJlhcare facililies
I Description
circuits without service or
I
I
I
I
I
I
I
I
I
CCl-3ln
DllazardouSJuealiolls
DA service or feedel rated at 600
ampsurmore
DBuildingsmorethanthreestories
OMari1l8S and boiltyards
DF'081ingbuildings
OCommcrcial-useagriCultural
buildings
OlnslallationofalSOKYAOrlarger
5epeJ"atelydenvedsys
D"A","E",or"I.2"ur"I.3"
DRecreationa'VehideParks
DSupp]yvol,ageformorethan600
supply volt.s nominal
$3.00
Kk.
$58.001
$6.961
$2.901
$67.861
C1\~\cA
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those ruies are,set forth
in OAR 952-001-0010 through OAR 952.001-
0090. You may obtain copies of the rutes by
calling the center. ,(Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
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This Authorization To Begin Work must be posted at the job site until replaced by a Permit
225 Fifth Street .
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00347
COM2009-00347
COM2009-00347
Payments:
Type of Payment
ONLINE CHGS
cRcceintl
RECEIPT #:
Description
Add, Alter, Extend Circ
+ 5% Technulugy Fee
+ 12% State Surcharge
Paid By
,ONLINE PERMIT CHGS
8P.il'!P}~..,~..'...:.".-. .."......
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City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001101
Date: 09/28/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KR ONLINE JB Online
ELECTRIC
Payment Tutal:
Page I uf]
11 :27 :37 AM
Amount Due
58.00
2,90
6,96
$67.86
Amount Paid
$67,86
$67.86
9/28/2009