Loading...
HomeMy WebLinkAboutPermit Electrical 2010-11-17 " ";; k . DE~,,~RTMENT:LJSEONLY . ?ett~o I 0- 0-0 7 '3 3 Date: ((-/ 7-/0 Eied'iicaI Permit Application ~PRINOFU!LO ~"~ r'~~,~::::t,~,-!\:M:,:,J " ~.' ~~" 'WJI ^ ',<~, :'f4;~~\ "'t.:Jl" ':J>." -~,{:..;.,,! "'i. 1<4i",J'_~ ~_4~b'U'" ,"" L~~]~P~'S8:~~~l?m~D,:f)l!~@J!I~~} i " 225 Fifth Street.Springtield, OR 97477. PH(541)726-3753. FAX(54 1)726-3689 This permit is issued uuder OAR 918-309-0000. Permits are uontransferable. Permits expire if work is not started withiu 180 days ofissuauce or if work is suspeuded for 180 days. , ", ,-,., ,. FEESCI:lEDULE . : . '". Nu~J)0~T~~Hn.spectionsper'ite~'~)J. "Q~y. Residential, per unit, service included: . ; Cost Total'" ea. ~,cost ~ $134.00 $ $ 25.00 $ $ 32.00 $ $ 63.00 $ . :. .. '; LOCAL GOVE~NMENT 'APPROVAL'"'' '.': '. Zoning approval verified? 0 Yes 0 No '>CATEGORY OF CONSTRUCTION" -';, '. ~sidential I 0 Government I 0 Commercial . JOB'SITE'INFORMATION' AND LOCATION ' Job site address: i 00 l Kou...;A('\. .~\J City: C" ,;, r, _\ 11 I State 0l- I ZIP: COu:f)' Reference:'\? d::r -:S;tl'2.. 3. I Taxlot: 61( t.'I c.... ,,'.',' .i.i,;, '.: ;DESCRIPTION .OF WORK;'... ' ~e r '" r- i.rr. "" c n \ ,'k ::J. 'o"""<'c.. '" r,~r .;,..."" / u..~ ,~ e \e..~ :'i;; ',~. , ,. -';+:PROPERTY;,OWNER ,"':~9';';.,.,:,..,.: . Name <rO~ l$(fr(..Ol.1 Address bO I ~OL.//1;'-I' A-V City: S pf 0 I State:OI'L I ZIP <; "7l(77 Phone: - . .1 Fax: - - t,OOO sq. n. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) Services or feeders: ins/aUation, alteration, relocation $ql.~ $ $ $ $ $ 200 amps or less (2) 20 I to 400 amps (2) 40 I to 600 amps (2) 601 to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) $ 81.00 $ 95.00 $158.00 $205.00 $469.00 $ 63.00 Temporary services or feeders: installation. alreration re/ocalion -.," E-mail: This installation is being made on residential or fann prope.1y 200 amps or less (2) $ 63.00 $ owned by me or a member of my immediate family. This 201 to 400 amps (2) $ '87.00 property is not intended for sale, exchange, lease. or rent. OAR $ 479.540(1) and 479.560(1). . 401 to 600 amps (2) $126.00 $ Signature: Over 600 amps or 1,000 volts, see services or feeders section above '.4',: '.".' . CONTRAC;ro~:tINSTAI:LiA'TI()N" -:'_ ~,?''t''" Branch circuits: new, alteration, extension per ponel Business name: ~ ,rv:::.r=> ~ J:=\r-c}-" \..z.....r l ,....J'"l/' a. Fce for branch circuits with purchase of a service Or feeder fee: Address: -z,"C1j( 0 c:,ec..~\( 1-0 Q..J Each branch circuit ;] I $ 6.00 $\),01: City: .c; ~ (.&1<"""'" ) State: t5K-' J ZIP: q')Uc)r b. Fec for branch circuits without purchase of a service or feeder fee: Phone:)''il-..... I Fax:St9,- 76. '3&-"'-1 First branch circuit (2) $ 55.00 $ E-mail: q . \ I .\ ~ ~ d- _ -.l-- Each additional branch circuit $ 6.00 $ eCB license no.: '1<:9.~<~ I Ben I:"".-me ~ . <IrQ.... Miscellaneous fees: service or feeder not included Signing supervisor's license ~ /"\/ Y Each pump or irrigation circle (2) $ 63.00 Print name of signing superv .' ~J i,nc...r, Each sign or outline lighting (2) $ 63.00 Signature of signing supervi<" : / /7'. > V'" ~ Signal cir.ctlit or a limited-energy panel, $ 63.00 $ ''7'' . . ~ ----- alteration, or extension (2) ~~~I~Et.~M\T SHALL EXP!r...-1l ,,;-;:WORK Each additional inspe~tion:(I).. . AUTHORIZED ,UNDER THIS PERMIT IS NOT. '^ ~~~:.;;~'J;~,~'?~'~'APPLlCANT USE · COMMENCED OR IS ABANDONED FOOTENT~ON. Oregon ba t 1~Ahr~~ffr1~\m~yofabOve fees ^ NY 180 DAY PERIOD follow rll,as adopteTdh Y (Miniin~meP"mil Fee $58.00) , . .. t' Center ose rI.J!->:-; i11t:: () l'V'" ~ Nottflca Ion. " n c.-O) "'" 0? 1"\ . OAR952.001.0010throI11B)IEnter.J.2v,.'su,CliargeCI2X[A]) ~V In bt' OI.I~~~"'TrH::::'Ult::;,"),...,y. \ex 0090. You may 0 am c .(<;:J.T~S,lj\'.'l1~g~.;f;>e(5% of[A]) . \ \ ..~ lI'ng the center (Not" ....... , \," ncuam1ber for the Or~gon \ ~T:~,T^",re~stind1surChargeS (A through e): tltl Center IS 1.800.3v2 2344). "~. $ $ $58.00 $ '.,' " ". '. , . .: $ '1:S~ '$ 1(<e. $ l{b'5" $ 1119'8 , - 440-2584-J (9IOB/COM) ~ "". -. S~::~~~EL~ ~~ ~OREGON www.cLspringfield.or.us TRANSACTION RECEIPT 811-SPR2010-00733 601 ROWAN AVE CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 . permitcenler@ci.springfield.or.us L j'AYIVIENT TYPE, fir. '. 'PAYOR;"CA$H'oRrOBOWlSBY" , ~c_QiYfJYIJ;~TS.."'"" ""':''','.'''''''"''{ DATE,11/17/2010 l_'l~Jl.MO_U.N:u~li~' : '~;~_C:F ~ F~ $81.00 $12.00 $1116 $4.65 $108.81 ," ,- AMoQ~tiTtFfAItr:;;,T~, ~~' J ';":4~il RECEIPT NO, 2010000855 RECORD NO, 811-SPR2010-00733 lbE$C~!PI!,Q,r:4~i:?'11"';j~ 'W'~:::::~:~~~'~i/<": ' ,'.," r ",;/-f;:,'~.J"~~~': ",. ';~AGGbUNT~CoDEJ'!'.,";,~~2, Services 200 amps or less . . -224:00000:426102 ~ Branch circuits with service or feeder each circuit 224-00000-426102 821-00000-215004 100-00000-425605 TOTAL DUE: State 01 Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Credit Card 022398 SUNSET ELECTRIC INC $108.81 $108.81