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HomeMy WebLinkAboutPermit Electrical 2005-7-11 \O\\OVl"'~ . nPf'1""- 1ne and does '--...I<--' zoning. r"\fQ\la.\. Wy . g Zof\\o .- , 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 "u,,2 '>;, :'" ELECTR,.f12AL PERJViIT APPLiCATION. ,j " , City Job Nul.:MemUJOS - CO R'/<o Dale'l -ll--d-,(JDS 3. Pj5__Q~~T~&gS9.l-(F.hl!L.itjJ!:tOW..\J ':,);<1.,;:.':: ,;;,1 A, kNl~\~~~sid~ngi~\l~rJ~~V~~"ip~r!.!w~iii,!g.~nit:"i! I ATTI=N' UN. ule U 'I'ty follo~efJf~~Ig~t€d by the Oregon tt I JOB DESCRIPTION Notifi~~r'i'Cl!flUl~slhose rules are set forth $106.00 n \ 1\./ t" in OA ~94i\iP.wfS<tf'lgofigR OAR 9:J<!-UU '" ~ ~ '-- 0 on-~786tain copies of the rules bl! $ 19.00 per~~on-~:rable and e~Pir~fwork is 0090~'lffi OUt~f(~6r the telephone not started wit bin 180 days of issuance or jfwork is nC~ OTIiffl!'\!i1l8~ilirt Notification $50.00 Suspended for 180 days, ee enter is 1-800-332-2344). ....'.-........'< ':'.-... '..,- ._,..,.c..,...,....."_ LC'-~_':''>-' -I rl"-"':' ',,' t""''''"",. ,..,., _' ,',I,...t ,,~' .\....,_,~..;.,._'.'. . 2. t:~g~gg~;-o/~T~rq'O!",Q.l:l,+Y,; , B. LMieryic~.-.,.r.;F,~e~~i;s:fJ,n~t~!!!~O:~,!1J!~~ti~~~.~'r.,Re!o~~tio,\!'):;, Electrical Contractor ~t..l~ \ Q\M.o.II"Zle(,..~(, 200 Amps or\ess $ 63.00 201 Ampsto 400 Amps $ 75.00 Address ,31-\ Z-. 1.3.tI fNe.. 401 Ampsto 600 Amps $125.00 <; '(]QII-J::\d AldO ~OJ !Ampsfto 1000 Amps $163.00 City L.M.t\ ~~ Phone t.\.::f:\.-~Qgo m~R~~1!9QO)AmpsNolts $375.00 J }1():lll-<I~U\J\"..rH v' it.econnectOnly $50.00 1 r~1 S111W'tl3d SIH~ 'tl30Nn 03 IOU' ,~,. 'I n'W,,\,-'"\uIG3ll\lHS lICIN~T' ~ '0>' . ,_.c;.n,. ..,'.,,'. ;"""1"" ", 'Ii' ".;"'.:,;' '1 Supemsor License Number':' ~f,,~H'~"'":\ l.!J LJ..:) . .~el!\P~r~ry Ser:vlces.or Eeeilersll:" '.. ,'" >'~ /,' ',.;,;. ~ ',d..... .'"t" ~!:. .~~,....-.~ ID/\ /'LODI C\ D "11.. '.::J \, [.coqqj01Y,6F:iN,~1.'~I.A:TiQN.,;,'-(. 'j (;) alJS U~C\I(' ~, LEGAL DESCRIPTION U -. . i \,0~ 2S '1-2..... col5'CTO Expiration Date Constr. Contr. Number Expiration Date !j\ ~ \ LoDLn "~'~":r~ owners~~~~.LLC Addr~\o,\ COt ~f~~G ::r- City~tfc.l. Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature; Inspection Request: 726-3769 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. []-..-r..r.", .....,yo ""j't'.,...."....,.., -,....,. -".'.~"-'-"""''lli(''"'l''''''''''. D. BralIch\Gircuiti> ,'; "~."}..~ , 'j'i,:l l'~:';,~-.l. ro\~(.I', ;:~", "":' , , _' ._, ~ ,'. _'" '., _ " " -, J.," New Alteration or Extension Per Panel One Circuit. , Each Additional Circuit or with Service or Feeder Permit $ 50.00 $ 69.00 $100.00 . "'''1 '~, ' ....,. l $ 43.00 43,QU ::<, . ()\:l \ $ 3.00 E. kM;;~~~~I.a9~ii~<'(~to/~~!_~~er~ho~fiI~I~~~)~ffi~h~\v~~j~h" Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Dc ,..v"'.'7,..,~,_.." """'",. ;:"..'-.:.,..:~,;t?'..~(' 1/ C)U 4, ~~::~~:~::~f!~';:,;,'"l':~~\':':~:{~q~. :~A- 10% Administrative Fee 4 . l.n C) TOTAL ~ ,53.' f() Shared Drive(T:)lBuilding FonnsIElectrical Permit Application I.03.doc . "~Q ;)y---- a~ Wic. ' .Y of Springfield Official Receipt ' Development Services Department Public Works Departmcnt . _2~5 Fifth Strcct Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00876 COM2005-00876 COM2005-00876 COM2005-00876 Paymcnts: Type of Payment CreditCard : RECEIPT #: 2200500000000000908 Datc: 07/11/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By DOUG PALMER Item Total: Check Number Authorization Received By Batch Number Nnmher How Received nJm 062639 In Person Payment Total: 2:51:19PM Amount Due 43.00 3.00 3.22 4.60 $53.82 Amount Paid $53.82 $53.82