HomeMy WebLinkAboutPermit Electrical 2010-3-23
225 Fifth Streett Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689
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..DEPARTMENTUSE.ONL Y
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(0""",, zo09-01778
Pennit no.:
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
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Y;-. '."<1{0CAL:iGOVERNMENT:MF'R.bVAU.'f::!ii,:,:;:'!JX)~~:
Zoning approval verified" DYes D No
;;:fA',:,.,/:;;'CATEGORY;::OF,}CONSTRUCTION':ciY' on,,:. '.',
~sidential I 0 Government 1 0 Commercial
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Job site address: 31)<.(1 E ST
City: 5r~"~, f;elD I State: CK I ZIP: '7l'f.f9
Reference: J 70 Z- 3. II ~ I Taxlot.: / I 2.0 C
, 'DESCRIRTION; 0F :,vvORK<:~i':f;'_;;i?;;;\;.~:{~.~:~.. ':)".
LI ~ r Services or feeders: installation, alteration, relocation
Uectr;<fi.-- Si>lWlee
.r-. 200 amps or less (2) $ 81.00 $
h'.~;Sh W<Jrt-I<....
cPROPERTY OWNER " 201 to 400 amps (2) $ 95.00 $
Name: \(:.LlN\ r;",A-pj TAL' III L 401 to 600 amps (2) $158.00 $
Address: 971 Z- --st:J ~15~A Sr- 601 to 1,000 amps (2) $205.00 $
City:,v...At...A-,tll{ 1 State:ot. I ZIP: 970bl Over 1,000 amps or volts (2) $469.00 $
Phone: _ _ I Fax: _ _ Reconnect 0.n~~(2) $ 63.00 $
E-mail: TePH\f)~~r feeders: installation, alteration, relocation
This installallOn IS bemg made on residenttal or farm prope~\a'lll 0/ ~~Q!jll\R.&~ $ 63.00 $
owned b~ me or a member of my immedtate famtly. ~~~lell ~\ iol~,S~~~.X~~)';(lol\ $ 87.00 $
property IS not mtended for sale, exchange, leas""\G~A'b~aI6 6 .1l}I,~ : ,N.Q~'
479.540(1) and 479.560(1) "~~"~09\66 (Il-\6S 1'J~' 0 _"\I\atll iW"ps (2) $126.00 $
... S~ 'l.'l\OS6 ~~<:l 'l>'il~-.y;
Signature: '(\J.\~^,\e~' ,\a.~ O_\o.s ~'i'" ft0 OVWVl 600 amps or 1,000 volts, see services or feeders sectIOn above
CONTRACTOR INST ALL~ ^\ ,<<,6 )'::''O61'~ '!J" :Sranch circuits: new, alleratlOn, eXlenSlOn per panel
Business name: 5101E J!;tUCI(. cO?:~~Ol\6 ~~\l\l:'P' . a. Fee for branch circuits with purchase of a service or feeder fee:
Address: fa, i3v, 1-13& I 'C6l\\6\' Each branch circuit $ 6.00 $
City: Pu~ I State: Ort- I ZIP: 9"1'10' b. Fee for branch circuits without purchase of a service or feeder fee:
Phone: -h.- 22,-2"'45 I Fax: -S~I- 7<;1-/OBS First branch circuit(2) $ 55.00 $
E-mail: Each additional branch circuit $ 6.00 $
CCB license no.: Nl'tA
I BCD license no,: 2a-'11'zc..
Signing supervisor's license no.:
Print name of signing supervisor: .s:1Ellf !-IfhJC1(.
Signature of signing supervisor: JIiA dI'~
(/
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE
WORK AUTHORIZED UNDER THIS
PERMIT IS NOT COMMENCED OR IS
ABANDONED FOR ANY 180 DAY PERIOD.
440-2584-J (9/08/COM)
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
$ 63.00 $
$ 63,00 $
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
~~t~~~~~12?~7~ttit:l~1lARR_i2IC~Ntf:~us_-~~~,&ei~t~J;i@11t::'9~~i, _o~;:
$ 63,00
$
(A) Enter subtotal of above fees
(Minimum Permit Fee $58,00)
(8) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of[A])
TOTAL fees and surcharges (A through C):
$
$
$
$