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HomeMy WebLinkAboutPermit Electrical 2006-3-9 . _''''U'>uo''''''e,"'--'-~V'' .:.,j ':.;I.P'."'~l!k1[~"'.-.' '~""''''''? ,-. ~.' '<)f'),"'~ ~., 't'~.;~:r~.\~~. '. . @Z':~. .,.~~~d does not ~rl.ISI :C).()5'~ use IJ~~D~~~JJJ)~:e.~ ,...~~j9JJ.!!>~~!F"tt!'~'f.}~Wonif"~~GF'~"r "I=~'- 225 FIFTH STREET. SPRlNGFIELD,OR 97477 . PH:(541)726-3753 . FAX: (541)'726!3689 :~i;~::'~~:; ". . ~"" ' \..... ELEcrRlCAL PERMIT APPLICATION ' ",,_"V ~'gMMti< H ' City Job Number C-OlMzco6- Or:::)f~8 Date 3- '1-0G. , 1. LOCATION OF rNSTALIATION 4 $""3 AO....E'E"- '?lLvJ"i ~J LEGAL DESCRIPTION i 7C 3'1 $"" z '3. 07 too JOB DESCRIPTION Acid R c.(rc..~~+\ 3. COMPLETE FEE SCHEDULE BELOW' A. New Resid~ntial.- Single or Mulll-Family per dwelling unit. Service Included 1000 sq. ft. orloss Each additional 500 sq. ft. or portion thereof $106,00 $19.00 Permits are non-transferable and expire If work Is Each Manufact'd Home or not started within ISO days of Issuance or If work Is ~~ular Dwell~~ ~t'i'(.if9CJf~: Oreqon law re$50rOO; you to Suspended for ISO days. e er. .f?lIoW rules adopted by tile Oregon Utility 2. CONTRAC'J1~TALLATION ONLY, B. Services 0~:Feid.n0In~lIailiIDJAllerallons"oi\IRel6Caliiln';J (' t. . 'in OAR 952-001-00io through OAR 952-001- Electrical Contractor tlr.QOn:u\-l() I'J 200 Amps or li:SslO, You may obtain cOOlt$'63!OOle rules bv t:)f\n ~.. ~ . \'L 201 Ampsto4OOJ\~' the center, INote:$i75.00leohone Address n""M'1ltl \ ~ ~ 401 Ampsto600~rfortile Oreqon Ut$I~5~ootlfication n (. '" 601 Amps to looo~enter is 1-800-33&163:06). City r::. I c,- 0 IA. I Phone ~l\\)lt~.Qq05 Over 1000 AmpsIVollS $375,00 '\ Reconnect Only $ 50.00 \ ':) lA.6 s Supervisor License Number Expiration Date ~o,., Constr. Conlr. Number .!to.!;l..5 'Oc.... Expiration Date '1 \ \ \ ~014 Signature of Supervising Electrician 10];).~~ Owners Name L,,^ l~ L.e- ~ ..... k........... Address 1>~ ~." IOOZ-b City t.-v...G-t:Ne Phone OWNER INSTALLATION The installation is being "",de on property f own which is n9t intended for sale, lease or rent. Owners Signature: 3 C. Temporary Services or Feeders Installadoll, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401~to600Amps $100.00 Over ~O...tl&~~ 1000 Volts see "B" above. D. Bra~dMwr?T 3HALL EXPIRE IF THE WORK New ~t5l\,'~?l'r{I~~t'O'Aa~fi.Ji'~~~ERM/T IS NOT One CifFJf. L. IS ABANDVNEIl ~IDW Each AdlhtiJ~a9 J1~~ifJi~. 7 Service or Feeder Pennit $ 3,00 lf3 21 E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation Sign/Outline Lightins Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25,00 $ 45,00 Minimum Electric Permit Inspecllon Fee Is $45.00 + Surcharges 4. SUBTOTllL OF ABOVE blf '5'L t.l(O 7-'~ 8% State Surcharge 10% Administrative Fee TOTAL Shared Orive(T:)lBuilding Forms/Electrical Permit Application 1.o6.doc . .r;~;~ Wit .-;ty of Springfield Official Receipt .evelopment Services Department Public Works Department 225 F;ifth Street i'; Springfield, Oregon 97477 541-726-3759 Phone Job/Joornal Number COM2006-00 158 CIJM2006-00 158 COM2006-00 158 COM2006-00 158 Payments: Type of Payment CreditCard l.r :, :\ - " , 1.( \ . " 3/9/2006 RECEIPT #: Date: 03109/2006 1200600000000000276 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add' + 8% Slate Surcharge + 10% Administrative Fee Paid By PHIL ROSE Item Total: LhecK Number Authorization Received By Batcb N umber Number How Received njm 954131 In Person Payment Total: I of I 11 :08:48AM Amoont Due 43.00 . 21.00 5.12 6.40 $75.52 Amount Paid $75.52 $75.52 .