HomeMy WebLinkAboutPermit Electrical 2004-8-20
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CITY OF S"PRINGFIELD, OREGON ,./
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (5~M7! -36~1}1i, '. "6~' .
ELECTRICAL PERMIT APPLICATION ol},;.~ 'l)~';'''''If::
City Job Number ~f-d)r$Jate lif~'*~ (f.\}Ul}ql". ~<?fip:"~~/~;~~I,~1i
1. If('j~!~i?&i<ili.';F~1l!@N-'I!III.II 3. 'fg.iiJii~~)FEEISifHEJjUImiii'O '" - . .~~
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LEGAL DESCRIPTION (
/ 7/):S :J -I- 22- /9/J/b ~tft,
JOB DESCRIPTION
!,r;a; I/ot7M~
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
OWNER INST ALLA nON Limited EnergylResidential J...... $ 25.00
The installation is being made on property I own which Limited Energy/Commercial $ 45.00
XfTgA~r6~t5r~~olf~'W'f~~res you to Minimum Electric Permit Inspection Fee i.s~ $~~.O~ Surcharges
fo\lr;,\!Hlll~ruw.Pted by the Oregon Utility 4 .,..,....'.:tQTAl.O. ,. . _ ,< \\1 . '. '
Notification Center. Those rules are set forth. 2- 5
In OAR 952-001-0010 through'OAR 952.001- "'\rWil ~t. ~I:~t.\\ "'\B^~DO~t.D 1'0\\ /.1 r
0090. You may obtain copies 01 U1\llul"" l.i "'\b-W~' -ij'a~ ~ II- " /_so
calling the center. (Note: the telepho~e cot1l~t~II-'i 1lt.\\\GD.
WdffifM~'f~'l9nl?fiJi\7~lityNotiflcation . ~fN^80 2./. 2-r
, 1r\7\ ~Ate-\01-800-332-2~ ~
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work Is
Suspended for 180 days.
~;A~;W""",~,,"......._.'L" .l.lI""I~_,JlI;illlll _""10111' '.
CONFRA&@R~JNSTjfijHArqJ!JiJONL~
2. Ill.-<o/:IUI.,LII!.., II I....~lli,..... ,I Lo....1
Electrical Contractor G~OU^,Ll ~ ;: ~~
Address 5'0;5(9 .."5'. 'A I ;:;;:r
City",."')()i)/~7r;;Kf.J_ Phone '7';?c,,-t,R'.S:i'
Supervisor License Number ~ 7. ~ t: . <:;
Expiration Date /0)0/ I i2 0{)4
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Constr.'Contr. Number
/S'RR(')ij
Expiration Date
..:J/ ;;} ~ /.< 0 Q ~
s~]Jng;:cian ;.~~
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Owners Name .J~ J'TbJ/A
Address U-'. '/ALV~~~
City --i~/J. . Phone Zfl'y, ././h?
--
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
~1:<J._U~;III!J~,AA~.Il!."~I"I~ltlJ.i.' lJM"",I~Wi~""~";~II, ~111U~lllli,III'_III(I! U
B. ,,,~~~.I,~~~~~;feeile!:s~!!lsJ!.~atlon~7Al~~~~~~ons ~orJ~el~,~atl~~_
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50,00
C ';r"~uw;l" ,,'I.I..I~\.IIS" ftl.t"....III.'I! I. IF' .tL..a"1I I
. empol.'8rY4 e-:Vlces~,~~e~
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "'B"' above.
D. Branch,Gircuits
$ 50.00
$ 69,00
$100.00
, - .' ~ i l '.. -. -,
" " _' ~" ". of'., ,
New Alteratioo or Extensioo Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
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Shared Drive(T:)lBuildi~g FormslElectrical Permit Application 1-03.doc
\:01
"225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00387
COM2004-00387
COM2004-00387
.
RECEIPT #:
Description
Low Voltage - Residential
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment Paid By
CreditCard HOLLY MAHAFFY
8120/2004
~l
",ty of Springfield Official Receipt
",evelopment Services Department
. Public Works Department
1200400000000001249
Date: 08/20/2004
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dIm T37561 In Person
Payment Total:
Page I ofl
3:32:50PM
Amount Due
25.00
1.75
2.50
$29.25
Amount Paid
$29.25
$29.25