HomeMy WebLinkAboutPermit Electrical 2006-10-4
CTTY OF SPRINGFIELD, OREGON
BPR'.LD ZON tV
~~ INITIALS ~VI'\
.... I DATE II') - LJ -; Crol,o
1OiV'......... SOURCE
225 FIFTH STREET. SPRJIo:GFIEI.D. OR 97477 . PII:154J)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICA TlON
City Job Numbe&:rn 7.crri.(1 .- lX.'Jr1 ;(
I. LOCATION OF INSTALLATION: 3.
2.32.5 0\'1,",,0' L S\ SP"'l. E.
200 Amps 'tII'f);T1CE: $ 50.00
201 Amps t'tW~1Jt~MIT SHAll !='x'P\Rt6!f:ooHt WUKI\
401 Amps tOAUT~lrnlZED UNC.:::11 n~ls l'lmWIIT IS NOT
Over 600 A~~~~9(lC~lJ' t<f1. 'l~"I\'1PANDONED FOR
D. Onn<h <t~yt180 DAY PERIOD.
New Alteration or E~tension Per Panel
One Circuit
.. Each Additional Circuit or with
~I/-D -xL" __...- Service or Feeder Permit
Owners N u.rrn LQ. '-..JTl~..../
Address l1J ~)( t;:)C:, / d5 fP.~p "E. Miscellaneous (Sen'ice/rt'eder 1101 included) -Each InSI:lllation
Cit}~'JjLf .I Phon~- 7.:.1t :.-
Cf7YOJ-... /75/
OWNER NS)-ALLATJON
LEGAL DESCRIPTION:
S2CU{\+-I AL....iM :tf..lS'Tott.L
JOB DESCRIPTION:
i7()? ~ 5 "7/ 011 ()b
,
Permits are non-transferable and expire irwork is
not started within 180 da)'s of issuance or if work is
Suspended for 180 days.
2.
CONTRAClOR INSTALLATION ONLY
Electrical Contractor SEC<l"\\~ ~Loit>R"" Co~.
Address ~ \"1 l\I\..It,..J iT S ~
City
ALB.lrr..H Phone
q-rs,;;2/
'128"-4 S'1'f
Supervisor License Number qOc(.Lc?>..
IO{OQ
Expiration Date
Cansir. Contr. Number
4oS"l I
Oc;{o,
Expiration Date
SQ:~er\'ising Electrician
The installation is being made on property I own which
is not intended for sale, lease or rent.
Date IcJ Iy! ~ au(..
COMPLETE FEE SCHEDULE BELOW
A. New Resid('nti~l- Single or Mulli-Famity (If'r dwelling unit.
Sen'ice Included
1000 sq. ft. or 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'ices or FeedC'rs -Ins'allation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpslYoits
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
C. Tt"mponu)' Sen'irrs or Feeders
Installation, Alteration or Relocation
$ 43.00
$ 3.00
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial I $ 45.00 '1<:; -
Minimum Electric Permit Inspection Fee is S45.00 + Surrhnrges
Owners Signature: \ ~. SUBTOTAL OPABOVE /.../ S -.
~ \"771 7.00-'7 8% State Surcharge '\ "0
-1"""-"'"" O. A)-tENl tUr,,:Ult::YVII ICtv~ 11,;..........11...... JUu \....' 10% Administrative fee ..., Ji,U
~ C IS ()l""\" fOllOW ru1ltS adopted by the Oregon Utility 5% Technology Fee J. . 1
NntifiR,\i!ip,n (tenw,r. Those rules are set for 1 S'
'nspe<t!dn-Re~tg:ltfol~'(j'010throu hOAR 952-001 TOTAL ...... .. . .))'
In OA 5 .. 9 f th I b Shar...d Dnn..'( I :)/BUlldmg l'orms/Uectncal Pcrmlt ^ppllcatlon N.(/(l,doc
0090. You may obtain caples 0 e ru es .
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
225 Fifth Strect
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-00778
COM2006-00778
COM2006-00778
COM2006-00778
Payments:
Type of Payment
Check
cRcccintl
RECEIPT #:
.
~
WiL
ca of Springfield Official Rcccipt
_elopment Scrviccs Departmcnt
Public Works Dcpartment
2200600000000001389
Date: 10/04/2006
Description
Low Voltage - Commercial Indus
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MARTlNVEST INC.
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
By Mail
Payment Total:
45699
Page I of I
11:33:45AM
Amount Due
45.00
2.25
3.60
4.50
$55.35
Amounl Pltid
$55.35
$55.35
10/4/2006