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HomeMy WebLinkAboutPermit Electrical 2006-5-17 (2) t.-bYl- c:Kw A!. DATE 5-''1-0'' YAI! SOURCE ~,-_ ,_ ~!:; ~6 3. ~~6X1piEl?E!FERS:CHEIYu{8:BiO'";T~f:;~;:"::;,\~\;i~;;,-;/,E~/s<~ w". ",,'{'::-."~ ':'>0 .~<..-,.., ,_ ......,. ',Il"' l-:";,,,,~, ,I"" '~""'_ ~.~ ',.''-,' .:\' f .~,.. " ~. ......h. . ," ~" ~. . ~ ~z..;"_......<: '. '\ \ ~ ~_f \ Ul.. . ,....,t l)J', / .~. !.. t.~:A,......"~"..;:";:,,,,, "!db~":..~~\.,~:-.l<o'_...;,"~~,,,',,,:,,,,~,'-:'_,,, ".b~...~:.~,;. _....lo~ ,;.;.~........ 'l~.l ,..~.....:;..y...........~_'..);~.~~~ 4~~':"';''-'-li,.:l.l~ .' f;"-.- ZON INITIALS 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-37S3 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO HA ZCS"Ob - CC> S 7 .,. 200 Amps or less ~,... $ 63.00 , "0\.1 .. 201 Amps to 400 AmRS,\.Ii{es J , I~'II\\\' $ 75.00 ~ 13,\!'.Fi:.i-, all Vl. . 40L.t\,mRSjto-::'600 AmpS)fe9 o'i.'lI(\'\I $125.00 1\ON'. V' :..,c;\ n\1 \1 It: , {e s" , p...\\\:.N 60Ic,P::rop~)to'1000-6q1pS\S '3. n 9~'?'-C\()\ $163.00 {' I\e. ,\\0::.... OJ};p '.\1 \0\\0\N Oved:..o.00)~mp"1f'8ltSj\' \-'" \\..'.~':', \ $375.00 .' a,'oll v ~~... r I \\"w 0\ \:\ 'v ~O\i\IC Res:~~ept-0nly cooies \__ ...;,~C' ' $ 50.00 . OP>-B 9';)~ v 0'0\'3.\11 "e:. \\,8 \. > . " .' \ II 'Jt;\t:H~;;,\,.':l;l'" "'..... ,~,,,..t~I).I''''':~'-'''~'''''':\'ll'\J<~ hV";'~~''''''~'''~ ':.,~' ..,...~."....,.._""=,,,,,,,,,,,,,,.,,,,~ nr.: \N(:'" x" "., ~.....tt:^B:\",'~.~;::::r;,~)':'h,~j' '<:~A t.:"'~t,~ i1'"""~""''''" <"'t"~.",'J,,"l~l"'r.~.t'-s:,,,h-(:' 1 '-;':"_'#.'.....l.~~.. OO'=J'C. ",'Temnorarv;-Se~lces ,or'Feeders ~';,,~ ":.,.~.~,-:;~\i-:~~;Y.'i:t:,i";~'~";'~(\.'I'~'11t.~' \~ -J:~; :7:" ~~i"i< \~, 'Me'!";'_' ~"',~,>....t5$,~.!.,':t (,",.' ,'.M~ ~-" ".....,:",'.~." '~",,>> .,.,-- ,','" " ' ...." ,. '*",.,..1"( ~" ...",-,. .t a. i ca\\\(\~ ..,......"\'Y;e ,j\ v-'0""..~".~?}t.c~':.1'i"'" '"..~,.'~_..,"~'w.^.: ''-'"'"''''''''-''~''''''''' ..,,^ ,.....",,,.. , ne{ \Of '" '\ _'OUO- lIu(fInst~~~'~)Ji,\A1teration or Relocation / , ~i,(fCATloi\rOE:"'; s'TAiEATloNc!l~/,ni(;~jl~~ 1. ~'~'-">:""~'~l',"t;~-.,.,., l.-:'"... "5.!~,.:" ,~~,:"_>~""<,,,"~'.;,, ,!...\,~i~'i:,~,<!',~'~:i~~;~;D52 ~..... . ~, .~.......:",.:J.:..u_~,. t:..~-<t.~~~....~SAl.:,,)~......! '~i.., \,.'W~~.:.;.....1~;.""~- ~"",,,*,.,,.,~t,,,l.,,,l....,,...., \~'''":>_''''...~ L/~8L{ Dt+l~1 S, LEGAL DESCRIPTION )70 L -.s 'Z. l{"3 o 9'(nC> JOB DESCRIPTION - 'cvvt~ P~W'cYL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~.~~~:;'~:-,~>-'f,?1*1~~:,}' !"t,::-~; ~F~!.'1~M;'}-::-":~"'?t,~.-~ ~~'8,'J~~J:fr~~:j io/ }~'.{\t~.;~::?;~\1:Q. (CONT1MCTOR'.JNSTALEATIONONLY~, 2. ~,,~:;:~0.~;:lr.H7;~$i.;,:\:,,~:~.~~:::'~('i:;;:;r~'\I~.~li1~~~~"s'b:~-,.t:~~$',.'l~::'~1;~'::~.~~~:..~2~;:;~ Electrical Contractor Address City Phone / Expiration Date Supervisor License Number Constr. Contr. Nu , Signature of upervising Electrician Owners Name )lilt ~- 'it "~ sLt,:o Address gOb:S itt "" ~ J..v-- \id ~~F~ Phone 7'16. Of ~t( City OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Own'" Signr;e: \,~ . Inspection Request: 726-3769 Date C-':;;7;(~'>" '-i;1V"f""''!'A'{~'";t,';~:~~~''''~''''''f4J~"\'f';!'\w\-:'--''''~'~M'.~~-..~'r*,'''''"1'~ ~.... ..m......:.; w:r:(,'..-:''''''~' .K ;' ..~",;j".:\t:~~...-t'l"'.-.,,;"~':Jt-,'t""t'<"'" " .f,,'.;. 'k-:::-.~i';.';\~' -r '!.\...::.,~' ',' ft. ,') :_:'(.";'~.~:..'l;'"-.~,.~: ''''~~'':'!.$.. .~ _ " "':-. .t-~'\h""/)>. ,,;,'i.'i":'{'~'h' ,1,...\ .'<r.~l' 'l'" .~ fr....".. _ ~'c .1 A. ~;\~,e)",,~es,!q~lJtt~ti':~ !.~g!.~,o~r,~~;u',ti.T~a,111 ily,~p.~r(~ ~\;~,l' !hg:,~ #it?;~.1:5i.,~ .",0.;.. \.i,).'.!\!~.M:^~.-.:.^,1' l~",,,~,..~.... L'l i)-",~.",..,+::oi."::"" _,-~__.~!tP,...'i'_"""'''~'''~''~''''h~ ....a....'.~..l"~..,,n..... 4;;,-*..~,....'~,,,,.,.,,...,~.'~lJ.....,,,,...wtlt\ Service 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 }QK;.~,.:~':5J~Ys:;';.~q~~~~l~~~0~:1~:;~:~~~~~':~;:;:~flf~~~}1~~)~:~:~tt:~\:?,:~~~;:~~}{~:!ft~~:;~~~1 ;;~\~~~~~~{~~~:C~-~{~!J B. j;Sen'~ces o.r.,"'eei:let~,,:,:;;lnstaJ!!,!bon; i\ltera,tJons 'or,RelocatlOn::: ,:( ~~;~~~;"':'r.'j.A:~~:';,..,,;.,~(;...'it~~'~~...;tii~,,-~~y.-~~~,~~'.j.i'~_\:.;.'.t ~~~'M':".~.'::~'':'_J",,~,~.\.l~:.~~.i:.:.:,. :.;';t~.t....W....f":'~..4"':G 200 Amps or less 20 I Amps to 400 Amps . 40 1 Amps to 600 Amps $ 50.00 $ 69.00 $100,00 s-u Over 600 Amps or 1000 Volts see "B" above. D. ~lI~~"~~Ri9if:~~ril~~~, i,J'~~"J~'~Ml~~l~~i{~~~;,~~~F~1~?;~i:,'~~!~;:~.&;r;f~~T~~[;:;~ . ,~.........."~._.....,_~"~",,,,....,., ..",""_i(C,,.1lOi.~........!>...;...l..~.... "" dbtt...........,"'~.f;~>,l:.l.,...'>l;A~.....l......t..;;J,'\i.:..~;. hq.'oY....._~~,..;~.,.,,_.......:.u:.t.~~ New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with 'f.- Service or Feeder Permit {r\t0~~0~ ;\"n:'W~'1:i:""tft~\;~~i:'"*,\,, itT,,;Xhf!s;\"'J'~?'~~1.~ ~~\:1\';\~r~91" ~ "~',';F~?':';" E. ~~:Jl~$~jra'ii~o,.u~'jf$:eilyJg~f~ed~i~~\iP'~dea},,~Fj~~4.iiI~t~ll!~,ti~'~::': '--''''''''''''\r\~\:Il-t:i~J''~l''\\J~e~~.;L'~~mO~c\)l:r ,..._,f_,....M.....u.:_..__' . .' \"\\.~()~\lt.u 00 \S ~~~\~u Pump or 1ift:i.gafiOn~~ct.O f\ D $ 50.00 Sign/Outli~GJi~'i1\mg O~'l ?t.~\G . $ 50.00 Limited EnJ'F~m.\~~ential $ 25.00 Limited Energy/Commercial $ 45,00 " . Minimum Electric Permit Inspection Fee is $45.00 + Surcharges' ~;~.?~~~~t::?::~~7T;~1t~V~~~j'7>::~;0:~,li"'$!f~;~1:'~;~?Z;'~:P~;~:::..~:_: '.~~~~~~r.'~~;;~:~:1;. 4 ~BUBTOTAL'OFABOVEr'::"" ' """.<~.",~._..,. . tt~~:~Yi~,~:{[:t~i.;~t.~~3,~~JtiLi~i JA'1~,~.~~&~J~i~t~.:.~r~:~ ~~:~~}~;.?!:.~~.~:~E,~'r~ . )0 L/ r S~~, 8% ~tate Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-06,doc . 225 Fifth Street Springfip,Id, Oregon 97477 , .... 541-726-~759 Phone Job/Journal Number COM2006-00579 COM2006-00579 COM2006-00579 COM2006-00579 LDP2006-00074 Payments: Type of Payment Check cReceint I av of Springfield Official Receipt Wvelopment Services Department Public Works Department Date: 05/17/2006 8:39:00AM RECEIPT #: 1200600000000000662 Description Plan Review Residential + 8% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less LDAP Short Form Paid By MIKE BLANKENSHIP CORP Item Total: Check Number Authorization Received By Batch Number Number How Received djb 10143 In Person Payment Total: Amount Due 428.94 4.00 5.00 50.00 300.00 $787.94 Amount Paid $787.94 $787.94 Page 1 of 1 5/17/2006