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HomeMy WebLinkAboutPermit Electrical 2003-3-31 (2) 225 J.Ulrt STREET. SPRINGFIELD. OR 97477 . PH:(541)726-3753 ELE~.I..tUCAL PERMIT APPLICATION city Job Number {'/J'U-? ~3 - ()~ 2../SDate y "}H":.T:l~~ irp~. ,..jl4\"'tJ!j".,,,,, '" ",;'I;l~\iJil.!~'a\I't~,(tH~':":~:;~' l~lI~lt!l;W;'IOI.ii\l.Ifll;.\,:;~,,:I,~\~;~iF*ii.ifr,fi'I~'~;: 1 .,.,,~. , '_~'~.".. I' \. ilf:~'~' ."'''''''-''''1'''''' I.,'. I , '..' " :. T'" 11 ~ -' .. .. ,I. .I.; . j,ltl:li"~,r;\tn'I"'"'''' .,. . .' \ . '\ '.: ~ . " ;"., ......".jl,'.... .;, \....:. I...,'....,.. .;-I~.J~,"'/l':l~"';.,~\:,...,..., \.:' ,'..: ~_ '. ~,I ":,::,~'~o'-I:I::~ ~~~~,~,~,.~; "1," \,~\I~\o'~:~.:~.' ~1~,'1~t.;'~':':'~:n\.I#""~1 "'.::',..""" .,I.:.,..............'..........T.. ..1.' I 1'.' I ...___,__ .....,W.,,' r,~....M....M"V.J ......,-..-,.-...... .3-.60 -P~/.SV.=K4S-~w.MLA LEGAL DESC~ON ./dG.-K ~..ft---,y.... 2.f-~ JOB DESCRIPTION t/drr A~~.# It! / ~ J//C Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, Electrical,Contr:actor.\l"1 II C" in', L,u, .'(-,dlll{~;;: Vi',l ''':, M' .L.,I".''-''I -- v I in.)'; '. A1~Wi~C;~{:~I~~~~~:~~t.e;~~~~:;h,~,2~J:~~~~i~~~:: in OAH 9!i~-OUi -OO~ (} i::;OI'r;fl ifA'0. 95~-Ob'~ Ci~O~~. \.'-::'.:. ~:'.~' ,:,,:,:,,,;r~r~J;~ f'I'~ ~l1".. "'I d(.\"j t calling the center. (N~: ':10 telephone mhYlber for th8 bOre;Jun ! Jt;lity Noti{-ication SupervISor License Num., et,;,., '" '" ,..,., '" I"\n ~ A \ ~..f'rtc:" 1. .1-" " ,- '.... .', -,', ,. . " , / " Expiration Date // Constr. Contr. NUinber / t!Ql!r~ ~~ ~ '^L' c"olfl~ n:: THE WORK THIS P \Mll VI t. -,,, .- T A' t(l@~rEilctM~~ERMIT IS NO COMMENCED OR IS ABANDONED FOR , !\N" 1 Rn nA.Y PERIOD. Owners Name Po..:r t3re'c' -A+-tJi t/ Address '5 ro en 0 L:>a ;5 u Sf 1(fr 4~ ...J Phone 5r11- '1'1V -~;;'5J' City ~J. OWNER INSTALLATION The installation is being made on property T own which is not intended for sale, lease or rent. Owners Signamre: A~ ~.u Inspection Request: 726-3769 , .. . . " , ',.. .. . " " ' . . ct as sUb:miil~tl:~aS'I~:;~: :.: ::::; . F~5111~nol rdli:'~:',~"",,,,,,, " .,., 1I~"l'.w!ng approval ":'i,~'~~.~l'eClfIC;'~(ld use: I, .. "'IM. "",' '" " ~,' ' 3. Zoning .r.l''''I-.-----~- . ,.. .QI..1.l.....,.,4 ., ....'........rlt,.""n'l':r;.........,........._-~.......,."...lP'ft.lf\'tmUi'/I. '1"'-'" ~.!.I~:.ll;.,ii....:.;~l)'.;i 'ljl\~\':1l.:.n~'- '." ..jj,~....!~~~r~i;;iF,;ill1.:\.:-M:x\ ~ ..I1I:<'.:~.:...,...: '\lP~I-::~...."w":tl!l:lfli.:"II~m'.:'I.ti(:., ...~I:I:\"\.;..:.~:1,.l ~ .(;!i,~lr,.',~j. A. "'~.. .... .. .' ....... ~f '$J~""'''''''''''' . ~~,.,..,~.._, "..ji;....IIIl.....,. . ,......,.,..,',:;:.:/:;':',."",,.' ~~.'., .~~:- e.;u..!, U'~~I!i.' ' , !l l!jOU: ' -J 11'U....l~.~:').)I~;.' ::~I..\ tl.t..~:,.~I.:~'" I , 1~,U..;:..,:.;:..,~.,I,:.::;}ii.l:..:. ....,.'.....~:~~/':.I".\,....~.~\:..::.,I\\\~Ilt1:.l11.._.?:\ ; i,' ,.,I,~~~:.lH,,~.." ,1\,~.~..,...:,"",d!:lll.,."..,: ,/':'.1,11"1, ,... M _........ .,. .:1.:;,__,.,10:1""''1' _,..:.a.\,oo,_, "'... .".,.,_,__,...1'11,1 'I ...._.-.........................,........"",',/lJI Serviee Jncluded 1000 sq. ft. or less Each additional 500 sq. ft. Or portion th... ;,wf Each Manufact'd Home or Modular Dwetting Service or Feeder $106.00 $ 19.00 $50.00 ".:(.;..,~:.:WJJ"\;.Il'.l'M...'.~T....._.---'.""""'""'~1'i:\""U.., "'l~m~"." "...... '''-~.,flI_~'otfl.T.\M.llll1.11......'''' 'fiJ'''.''''--'.......MI\,&\'\'\I\. ...;4.~ltllIW:~~''''. .,.',iim~,'mr: 1,~m'~I~~.,"...ir"~:~!!i;;;;i;.;;mnstalil~w:,.,. ..Oo'~";:.~7.,;!,~;1'~.'~;,'~;.:i~,;.~.. ;;.~"',.\'I):I.'.:i~';;il;liilSlI )ij,,'i;'ij!,~~W~!:-':~J"" \~.'~~.I,.~ti.jl.I"'.~!.,tl':li.~;ihi\I B ,,., ,.......:... .........1" .._.. ...,.'''.......... .. ,'..-,."'" . 1:"",;1' "....... . .,,.,,, I.........~.....'#;.,..... . ?r:' :1f,~~.a.....esiO~ I '" ~.. ,.,1......"'...~."~1 'I:'d.'f u . ia-e. ' . llil.~IH,':';' J\~I~~.' 1:'\.n",,,,,.r'ltl1"ln'A~ .' l'\I""'~:""',:",o';'n' '.II"\"\'.\l\\u:~"::',;,'J~. .::.o"""',j"'I.I''':''''J~!:'I~'''''\O::~~'::'~~;'~' ~~:::""I"'~.'.I(I.~ ...I,,'~'o1U1.I&\\:.l~'.LI:l.ll '~""rM"" ,.1.;,.~l"\flWlIl'Ilto.:.I,4I"VJ 1~,..c.:.::'>:;.l.:..o':,I~ '. t".. "'~",,. I'''l."",IIWllOlII.:",,~uQ'.:u:~:~~.:J.' ~ II,.::'.:",' M :. ':o'{, ""1 ',.1\1........ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNotts RecoIlI1ect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 . , .. --~P"'-=-[;'("-miZ--r.I':':":!I'-mil'lf'" ''''T'IT~,...~t.mI'!tii1--:7''''I''''-'''ml'llfl~ 1.\1,1"''''''(1-''.' C. 11~ijJ!'~I\!""~~iH:~: \~ "1/QltlJ\~F . ~.,~~':'.II~H...FJ!~g:r~fj:!j'~'" 1iil.i'~.'.!::'I!i!;ih~ ...,,,~il!\i:~~, ~~!i\t'l\' 1,,:;\~l\t~mP:!~:~\~,:If,:~~:.I.';"'i~'i,"'~:/,lII;'\'~!l:I;~b,~~:)l, "Q . , ~..I f ~ e.!t:~n 'jl '.. . ~{~gmm~!::!!t'!p;:"ljm~~i!~!~;I~'tl;;;;,d.;~l;!:~i;)~f!r!I~;t~:;:!m~;~t,'i:Wl,ir. 0./& ,.,.......I.r...'~" ,Utll ~'.l',,,---, . ..,..,,;: ~,~M,,, I ,~\ ,...,,_._.,.....,.,....\mo'~.:.o':"~.).Y~w.,....,,: :'~o'. Ult\llU\l"."..""J"lo.l'~II.I',~I:)jL. .m.....,." _.............. ...."._____~, ..1J'l ,.....__. __M.. I.u..__l.:1oO.11,,"1..I~" ..._1,'...;;. -..0'".........,.. _.. __,.,__, 1""'.''''~'''~ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 V oits see "B" above. ~1"''''!'.''''''.''''''''._~!1l':'l~~T' t1T.'lIt=.-.;.l,TI\;T,'tI.I1fJi\IL-....'rp"Jjil'i"--~I1I~!r.-\mf.r..l~U'~"..I'rrlltl!..' .,."tc,,'...'-"-'.'''''JI}Ull1l'.'''' D fv:iii~-:~~l:i:t.r.::"'\U~~~.J l;t mrJ:\~~:'l !;~~I;"lr,b'li;~;,~.l~.u~miT~ii.1Smf"Iv.r1'rmi'l~r;~'l'.:"'r~:~J!ilf:~\r~::.il:l~t~1~t::!:2r:llt1J"t.;ti . 'tlilD ~~..IX~ ll:,ll!t:!':':~:\l "':t:j!:!-!;~fl~~I{""j,h.\fl"4;' f,":ji"~+,~~~i~'~l':l:~~:':n tl~c~m~:~:~.';'II~;~;.r,~."tll11l''''''~~lilr;r'I' :,,~,:1 &i."I.IIIn:':'''n;;,' .~ "":~l.! ....' "'Z'~'I'l"'I~:N\~Ii:iniii~i'):~)"!of)( ",:~I""":"'."'~:I!~'O)r~\I""IH.I:JI:",,\..ir.,i1;:i!;t\lii..:it:\fI'~'11UI.:_.:.::t~".tllll111 _._-.lrl ~1Uo1li1M~_ .:.:..\W":.IIt:t.l_.......,.r"r::'\,I:Jtll<llt\IoIWJ~/,\..,..,:.I...Iiol.UW~ill1.I,Q~lill,.,,.,.....-,..,.......I'I.I.NlJIW'IIIIIIlU..,...o.I.... New Alteration or Extension Per Panel One Circuit ;.,-- Each Additional Circuit or with service or Feeder PeImit $ 43.00 43 p~ $ 3.00 ""~~:'ii;:iio'l;::~-:"'l'" _ ... ~1""'"_"~.\':"".'IlIl_"__~, ''''''''.''~::::':::':':''::lmI'' """.._...,....1 ,..........,."....... _.' " ""...,...:;':\~.'":'I':'....,...., "ill !\. ......i',;.~1:,:..-~"'1.1\1,41. 'l!.'"'. I.',..,"!.~I"llT~~I~3'r.I~t\IM\f\"'~i::,1~~~...;.&I. ~~{m~"~'~:.:~..:..:TJfl/l,',.' '. '.'lI~!t',! ~',~)~ .i_'l."'jll.:l\ 1..~\~'i:~.,~I~JTJ::r~l!.~~ltm;-nflo1,.',...,',. E ",' ;;..,..' ...-., ..., S''.d!Ii'1 .,." ., i.O:o:'''('''~:i!'n'' ,..- ,,,. .,..."..,. ';!j... "il'--'" . :~~,' . 'gee " . .. 'US: Al~X:' UIli~;UQ4'::l 0 :0 e :l.llol . .. 'EtIlG - a,I' . :f:':: :it:QolI\r~..:.'.t:~.I~.I,,1IP;_~,'1"~~~\~.,:l~~T~;.ItIl~t~,~..~1,.,'.TI....,'~:I~Itl~~~~~,~ji.,...l~"IoIM.:'UI..:.~~fl.J~f,'.!~~n',''',.....II.'~'.l'''''~.,J, . __,____...._......,.....'...,..............__..,~,,':"'~.j... ,," l'Q' ..... or.:.oIo.o......._...""'......._._,... to' I,.,..."..,JI "'UI.\l:.l,..;;.~!zHf~. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Comntercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges l,~Cm~1~(~~~~~~ii~I"~~ )tT~~Jlmm';!~!;:#.;m;lifiiO,:It-rJ~~;:ill~~~lt~~l!':*::::ml~~~H!~~ 4 ""S:!I . "" .". "'\'.'.'/I'fol"".\lI'':~:'\'''''''''~ll\-'r.'I''f..,,.,,:,.~I-I' ~'I' ,.. I'.'~ .. ,. I.T'....."."oI.l't\ll.~I\~! ...1'1 ) I"I'.'''''.~J . 1,:,:)' .1 )' I ( 'I' 1 1,.1' <;. '" ~. ".~.. '''',:.,jii1:::=i:i:~~~:''J:..'~:::~!:!\:~'~;\''t'~~h.;~:i~:7.~j", ~.;~.'.;r.L,t'j;,,;;,...i, \. f~"'~Ii'.,"l:i:J'~\i.;~;~a\ll"I:..r.:\'~l~~.Io)~\~"':;i\),~iU".,,'~~,;~:~lm~;~!'i'~~Y~j~!\t~!",:(.u~!~\lnr,i.l;~r.':ll'li.',',.:.'.Ir ... .,_""~_".....,...,_,_ II,I~ tII n"",,,,U'~~......,.,ilil, -..........,--..-..--...,"...-.., ".".. ~ 45fNJ , Ir g', 4. J -0 f ~2_ (pj- 7% State Surcharge 1 0010 Atlmini~trative Fee TOTAL Shan:d Dri"e(T:)IBuilding FormsIElcctr\ca1 Permit ApplicatiOlll.03.doc FROM 5417263689 OF Property Services 3/18/2003 9:30 AM Page 1 '" f;..b:t:J~&:"'!A~'j, 3/27/2003 12:10:22PM -, :; 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt ; Receipt #: 1200200000000000901 Date: 03/27/2003 . Line Items: Job/Journal Number Description Amount Paid C0M2003-00215 C0M2003-00215 C0M2003-00215 C0M2003-00215 Add, Alter, Extend Circ 43.00 2.00 3.15 4.50 Minimum! Adjustment Electrical + 7% State Surcharge + 10% Administrative Fee Line Item Total: $52.65 Payments: Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid dIm 1346 In Person 52.65 .~ Payment Total: $52.65 I Check PAT I BRECHTBILL Page I of I cReceiptrpt