HomeMy WebLinkAboutPermit Electrical 2006-9-25
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5PRIN~
I~' Installation, Alteration or Relocation
\/IT/f'C.
! HrQO ~~ps or less $ 50.00
., 20 PAmp,~,t? 1Bii\'\'PS $ 69.00
C"UTib'ORriJ.P~lY'tJR %l.rEXPIRE IF" $10000
UMMr:"~ _ IV Et:I 7'e"S ..,!,{7.t;,1A/fln
ANyOller(60Q:.~"IP~orSI OOlJ1l. Ilgefftiirrr ll'fc$WlI( .
D. 1 f1J?ar.iwq.iE'WiB~BANDDNE{J FO~ NOT
N't;W Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Owners N~ f2.~ ~ld^ykddJJ$. Service or Feeder Permit $ 3.00
Address r o. &x K<:J, 0 E. l\'liscclhll1cous (Sen'ice/fecdcl' nol included) -Elich Inslnllnlion
Permits are non.transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
CONTRACTOR INSTALI..A'l10N ONLY
2.
Electrical Contractor G 4 E E \ eC. T r- \ c IVl[
Address ?.n, ~o y.. I (P [?) b
51.(1
City n.. \ bcH\ \1 Phone q If) I- C;VO 2.7
q,S;1./
~J1ROS
Supervisor License Number
Expiration Date 1D - }- OlD
( Constr. Contr. Number
;)L( 2--15 e.
)Q-I-O(o
Expiration Date
Signature of Supervising Electrician
ex 52Q)rn 5)~
C~J..Rg .hllynL) Phone (o.,i~ _ 7n/
OWNER INSTf1rfr~
The installation is being made on property I own which
IS not intended for sale, lease or rent.
tQ,~~;:<( / I
JnsPe+\~~\~6-3769
~,
&,~I
$106.00 lab
Each ~~d~t~onal 500 sq. ft. or I ~ / j ( I .~
portlonltfiert9f/ON' 0 LO $ 19.00 __"2-
EacJ'l!ig,'tr.\!I(ll;~m:.:~~~'aw reqlJ/res you to
M~..'ct'{,j~r[)WelllnlitS~nijce. y the Oregon UtiJ~
F~Pct~)AR 952-001_00'lt~se rulp~ 'Ire sot'fo~
oe:;o" You mall nh: rough OAR 952-001
B. s~~t~fI!ffh~cb~cwtaIIM',ollill(!Jl:;)t\\'WVUfJ~ &r'Rrlocation:
nUmber f r nter. (Note: the te/ephn y
200 Amps 'f; PesJh~ Oregon Uti/it~/ ~!otifi . S;'I}3300
201 Amps to ~0Ile,{~H00-332 ?'l44). '1 mo
40 I Amps to 600 Amps $125.00
601 Amps to 1000 Amps $163.00
Over 1000 AmpsIYolls $375.00
Reconnect Only $ 50.00
l
c. Temporary Services or Fcc(lcrs
$ 43.00
Pump or irrigation $ 50.00
Sign/Outiine Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SWl1'(JJ:A'L OFABOVE 1/ / I rsu
~ta/t~rg~ .
10% Administrative Fee
dd. () ---
/7.~~
2L_
bi~
TOTAL
Shared Drive(T)lBuilding Forms/Electrical Permit Application ]-06,doc I
~~d-10 _GO :f:JSq.{eO
225 Fifth Street
Springfield, Or,egon 97477
541-726:3759 Phone
. ~ao~
Job/Journal Number
COM2006-00656
COM2006-00656
COM2006-00656
COM2006-00656
COM2006-00656
Payments:
Type of Payment
Check
Check
Job/Journal Number
COM2006-00656
COM2006-00656
COM2006-00656
COM2006-00656
COM2006-00656
Payments:
Type of Payment
Check
Check
cRcccinl1
RECEIPT #:
2200600000000001331
Description
Residence W iring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
C.' f Springfield Official Receipt
D opment Services Department
Public Works Department
Date: 09/22/2006
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Paid By
G & E ELECTRIC
G & E ELECTRIC
NJM
NJM
Description
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
12054
12071
<"':heck Number
Batch Number
Paid By
G & E ELECTRIC
G & E ELECTRIC
Received By
NJM
NJM
Page I of I
12054
12071
By Mail
By Mail
Payment Total:
Item Total:
Authorization
Number How Received
By Mail
By Mail
Payment Total:
8:53:40AM
Amount Due
106.00
114.00
11.00
17.60
22.00
$270.60
Amount Paid
$259.60
$11.00
$270.60
Amount Due
106.00
114.00
11.00
17.60
22.00
$270.60
Amount Paid
$259.60
$11.00
$270.60
9/22/2006