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HomeMy WebLinkAboutPermit Electrical 2010-8-12 This permit is issued under OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started within 180 days ofissuauce or if work is suspended for 180 days.- . <'.;' .;. i'lllml':~1~IlfQCP';~GQYERNMENII':r~el?~QY~~!&iiti"~\;~jLr~ . Zoning approval verified? 0 Yes 0 No.. !61N~~1{C~"11EG-c:5R1Ti'fOt:]tc:ONs;fRl:ICjtl:ON:!.~~~ o Residential 0 Government To Commercial :~;..\l1l.1!JoEifiSI;J'ErINF.QRMAi)"I()Ni7Y.. '-IQN~1i1;'Jii;l' Job sile add~s; ~.() (p Lt "J.. y;rn 01. City;-:' O,I-ri I State,nff ZlpvT fLf7/ ~C~~~~~W.Q~~~~~~~. -+ ..f ml) I' ~ ~~. :t~- I/r.~~~ Address: ~O ~ C:Sv b 5 ~ citylJAth......vr!{c I State: ~ ZIP:97#(~ ( Phone: - - Fax: - - E-mail: ATTENT'If'lhJ. Temporary services or feeders: installation. alteration, relocation.- This installation is being made on residentil:l. ,',.. t!Il,P!\!PStit,';H911 ~P"~3s .or less (2) 7 $ 63_00 $ ( n r, ./ owned by me or a member of my Immedla!eCfawIyt.Jiffll" ,t, pea b) iilH tOl409 ao'\?su(~: $ 8700 $ property is not intended for sale, exchangel,lldilS\f,/<[tf2!\j['nM(. TI 0, ;'.' 1" '~:" . 479.540(1) and 479.560(1). 0090. Yo~ - D'(:OOlO t f( ~;0r~~qO!amRsf~t:h $126.00 $ Signature' calling thema~ _~btain ;0 ).ov~;;606'ari.'i2 JKl1GOO volts, see services or feeders section above . ~ cento.l' -VUlltD...' ~:~~::rCw0NT~i[J.jR!INS5r~~lfA~~@!~r~~T -. '-' _ Jor !:!~~it,~hl~~~~~&rClM~, alteratIOn, extensIOn per panel Business nllme: IAI I Y r '-Ii I J r )"(U~r IS 1-80, _3t0':J.;~I!~'.bransl1,~ircuits with purchase ofaservice or feeder fee: Address: (.) () ); 'I.. in V)...... Each'branch circuit I $ 6.00 $ City: WIA l/<f 'Iv; If State f) r{l ZIPf-f 'ill ')5(, Phone: /}. l.j '7 ~,/Y:7- l Fax: ~"7. '-I L/ /I)t} / . First branch circuit(2) $ 55.00 $ E-mail: ...hirYif)VI.DS/~..vl}...)/AI1Y7hnf./~)..1Y7 Each additional branch circuit $ 6.00 $ CCB license no.: J ~ Iii ( III (r,\ BCD license'~ 0,: . . Miscellaneous fees: service or feeder not included Signing sup~rvis~r'S'li~en~e'no: :-q=- :11 <./i.. Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor ~ vIr) r )v r r110il Each sign or outline lighting (2) $ 63.00 $ ''''_o,'_''"CO',\: ,~"~ ~.^~~ ~~:~:~,..~~~ I\t., '" . ..-- - (A) Enter subtotal of above fees V~l\t>.~' ~\J NOTICE: !"('j" p'. -! '(l~iiIii;num Permit Fee $58.00) $ -6'> 'v THIS PERMIT SH~~ ~Xp"IRE :IF:.!t6tt1~Vo surcharge (.12 x [AD $ 7 )b AUTHORIZED UNDER-THIS PERI no ogy Fee (5% of[A]) $ 31 J COMMENCED OR IS ABANDON ~ ANY 180 DAY PERIOD. L fees and surcharges (A through C): $ "/771 ~lectrical Permit Application 225 F;[Ib Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 440-2584-J (9/08/COM) ~INCPln.D 1~~".1'~ ;} ,.:'~~~F~6~1~~~; ~"As...~ )h.~ <"'I ~p..~gS;D:i'""1,r,..~. ,'.;.&,:;-,~.;.~' f..-!, '.'.11"',1, r" ':?d';;"'1,l{1::1 i,jit'~... EB~RTMENT.l;JSEO_NP('",,~\ ...<1-' .j.. ~ '''''''-'J,I) ,o"'":'!t, '.. __.., ..~~r ';. ."',.. ,"'-.C ."If,',-.'.-} ''''', (0",", ZoO ., . 00 8'of::, Permit no..: Date: 8-( Z. -/0 \lJ-f~1:"""$.f2m~~'i':;l't~1~F.EE "SCFtEl:lllll!E{':;.i-li;olii!Jl;"';-"'ci,f*~"~': """_-t","_~~P4--"t~ili""",~"__,,_,1!'..,,.__ .._J!. ... .'..__,~. ..__~*l', .f....-~~~~1..&3_~~~:-1'h>5it, ,!r."1N, ~~"~b.'w;f~}f;:W1~1~t:.(l~A~~~,~t-tZ:~>FF;~~ ;jj~~1 ;r.;lreost~~<! ~'~;cTotaHil'; " um erO ,IDS ec Ions, cr"rem;,"ffi. .. ~~,t""'"_ '$_~ V~.,__.,__ -~"; ~i(lt~;i~l~\1/!f~1-i;\;NitiiS~~1'dj;&X~1\!U~)j~rt~:~ B~~,1 ~:LttZ~,~~Jfi1tJ, :~fic9~t.~'t?!; 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 $ dweiling service ?r feeder (2) Services or feeders: installation, alteration. relocation 200 amps or less (2) $ 81.00 $ 95.00 $158.00 $205_00 $469.00 $ 63.00 $ $ $ $ $ $ 20 I to 400 amps (2) 401 to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) b, 'Fee-for branch circuits without purchase of a service or feeder fee: S7~:.IEL~ ~~. ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.c\.springfield.OT.US permitcenter@ci.springfield.or.us RECEIPT NO: 2010000042 RECORD NO: COM200'9-00806 .,; .J ~" DATE: 08/12/2010 '.", k.MO_UN:tD.UE,"",~-:-J $1.341.70 --,~,- $2.180.26 224-00000-426102 $63.00 100-00000-425605 $3.15 821-00000-215004 $7.56 TOTAL DUE: $3,595.67 ,- ~"- ,,;,.:,; - AMOUNT PAID. ., . . ,'. i "".- -"I_",,,-~_._.,,,,,~__.____,_,,,,-___........._.._.~J $73.71 lli~SCBIPTj6NY . :-:-:';'. J";-;-' . p' Plan Review Fire & Life SafetL_,,_ Plan Review Comm/lnd/Public Temp services 200 amps or less Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) ",/".,-,,:; ~:'-'--,';~; ~-;-~- ',,'I''AC,C.o.UNT2c,cibE:C..3' :' ..,i.~u, ~:J. ~: ,1'! ~. ,,\,;.,:',"\' !...:.:,:~:: ",if:! ~;j,pAYMErtUYPE:;;I':Pe,.Y..c5R;;;'}:~ASHIg-~'DB~~~_x.:..;t;:;,C~QMMENIS .',~ Credit Card BURRELL JOSHUA J temp power only 05565d ';;~i\'=. '.. , ' ~. . "'1_. (,'-,,, :-::""f..~;" '; V;'.i~ --' ,.~';:", ',~" ";.; ;".1. '; _~ 't!!: ' ~"1 '. '.. i, '!' ", ,~ .';'!:~~ I, .!".~! ',r:; " ;' .)\.: