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HomeMy WebLinkAboutPermit Electrical 2004-3-4 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPUCATION City Jab Number ~za> If ..c;C) 273 Date 1. LOCAij'OJ/oiINSTAiiATION "-~ ...... ., . -"~._. _\... 'c.... _- b~" 'NIA:v') ~\. CLub~!;:: LEGAL DESCRIPTION /7033531 10900 r<'<S\~\\ 1.\.'* 10")<. 10"'" -sif..-.c.\.Q. JOB DESCRIPTION -f"'-d!. ~\,\ "'5,"t.'('I i. 'n.oac::. u(' -{;:, ---\U....,~d '!"'-'.",.,- "t>I"rtJ.AtL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. The, following project as submitted has the following 2 L( ()' I zoning. and doas not raquira spacific land usa ~ . . '"\ approval. (\ 3. ecoMPiiTEFEESbH~~[kEBiioi1;~...'- ;"""'-" . ,_.. .,~... .- Date'" ~~. J,~, '*",. . i-<-f"{' _, A~.thqrjzed SignaWre _ _~uJ A.,Ne,vResidential': Single' or Multi-Fanlil)' p~r dwelling unit. ., ... _. _ _ ..,-- ~. -. .~- -... ,- - - .-.... "._-. . ~ ~.. ,. .., Service Included 1000 sq. ft. ,or less Each additional 500 sq. ft. ,or partian ,thereaf Each Manufact'd Hame ,or Madular Dwelling Service ,or Feeder $106.00 $ 19.00 $50.00 ~_'. -..-- d. ----.- .- --- -: -:--. --,"". ~ r- 2. CONTRi\W:OR!lNSYA1lbtJrIo~\ONl!Yirj3S YOlB~O),: Services or Feeders - Installation,Alterations,or Relocation: L, "~'-~"'lollowiliresao6plei:fbyThe-Ote90n UtiliW ~_..._- - - - . - ,~.~._. .--. . Electrical Cantm<;tqr;aI7t\Q;\Xh~~(.'S~~!',,;1'Awn'ti-~200 Amps ,or less $ 63.00 n OAR 952.001-0010 through OAR 952-02'01 Amps ta400 Amps $ 75.00 Address ~t'b9G"5y.o~~i8!'I 6Td.in 'ffi/)I,~ of the ru les40 I Amps ta 600 Amps $125.00 calling the center. (Note: the telephonE'601 Amps ta 1000 Amps $163.00 City ~i'I"I~'l3!'&t-for.~~~~pr61'4r~l!I~'b~I12!ificatio8ver 1000 AmpsNalts $375.00 l_"~ll I-.,,\,"/' t::.1't'f,. Reconnect Only $ 50.00 Supervisar License Number .fi5Ft 5' / q Expiratian Date It) - / - tJ S Canstr. Cantr. Number \.;:l~ S'l>lP 4. l?' alp Expiratian Date Owners Name f ,K. ~. \(. I - -. LLC- Address 7:.'\1. 'l~ <S~"':""'3 "',\uti, City 'i..u.'lfV\ll.o~. Phane lD~lp.a~b q'l'IO~ {~~. ... OWNER INSTALLATION The installatian is being made an property [ awn which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 C. '~i~O~;;y~S;r~.ic~~;;.!.!!:~e!.~~.: ~.' -', ----.. --"-I I ,') Installation, Alteration or Relocation 200 Amps ,or less $ 50.00 ~~glfm~ ta 400 Amps $ 69.00 TtP,~~I1~r!\1~D8I{}w.~ EXPIRE IF-lI:lEJA!O~WO.OO P0Ver:(;6():~~.~i[]ooo Wl& !eERB'li,[b!5YQ\iOT D::O~ilfn,r<fil:1:l;ltfls ABANDONED FOR -- p~e'tv1f\1m~ir.ro~RJQPe~~ion-P~~ pa'n::I' - ~.~ -' ~ One Circuit Each Additianal Circuit ,or with Service ,or Feeder Permit $ 43.00 $ 3.00 '-'~ -..-------.--- - . """.- . - y. -, E. ' Misc~lianeous (Service/feeder nol induded) .,-Each Installation ,------. --'- --~ - -- - - _.--'- -. -- Pump ,or irrigatian Sign/Outline Lighting Limited EnergylResidential Limited Energy/Cammercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 50,00 \ Minimum Electric Permit Inspection Fee is $4:5.00 + Surcharges 4.. :SUBTOTALOF ABOVE 50.00 '3,<)0 5'. oc) S<t.SD 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectricnl Permit Application 1-03.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number . COM2004-00273 COM2004-00273 COM2004-00273 COM2004-00273 COM2004-00273 COM2004-00234 COM2004-00231 COM2004-00234 COM2004-00234 Payments: Type of Payment Check . -.~. ..,,'!!I.'.~ '..". ~. , . . !,.. i _.,~, ,."............ .'. " Receipt #: 2200400000000000237 Description Sign - Outline Lighting Each Sign Plan Review Sign 36-60 Square Feet + 7% State Surcharge + 10% Administrative Fee Sign - Outline Lighting Fao!! Sign 61-100 Square Feet + 7% State Surcharge + 10% Administrative Fee Paid By METRO-WESTERN Received By Check Number Batch Number Authorization Number 8494 LKW City of Springfit:id Official Receipt Development Services Department Public Works Department Date: 03/11/2004 2:51:27PM Amount Paid 50.00 40.00 11 0.00 3.50 Item Total: 16.00 50.00 140.00 3.50 19.00 $432.00 How Received In Person Payment Total: Amount Paid $432.00 $432.00