HomeMy WebLinkAboutPermit Electrical 2007-7-20
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22SI'J.I'lI1STREET. SPRINGFIELD,OR97477. PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PE~ AfnlfJt!TION
City Job Number \/ \ - \ V"\V
3, . COMPLETE FEE SCHEDULE BELOW
1. 'LOCATION OF INSTALLATION:
~Q?D\0 ~
LE\~1_ ~\ t tl(00 A. 50:' :~::"'- Singl,., "'ulti-Oumily p" dw<lUng n.it.
JOrnSCtfTIO~' '\ - 1000 sq. ft. or less $106.00
vt ~(e \ M fY1 (1 ) Eac~ additional 500 sq. ft. or
1. V \ ../ '~._~.~ l ~ l.::./ portion thereof $ 19.00
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is . Modular Dwelling Service or
Suspended for 180 days. Feeder
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
OWNER STALLATION AI, c..JTION: Oregcm~_6fjal $ 25.00
The installation is being made on prope~"~~~ adoptelitmrtUlfE~dJtl_al $ 45.00
is not intended for sale, lease or rent. "Notification ce~;,:rb.~ ~t.I'.U.I4fi....ft.MJ fodll.tion Fee is $45.00 + Surcharges
In OAR 952.Q01 ~tJ(ffO'ffirou~911()Alt'W~..wf:~ , 00
Owners Signature: 0090. You may ofJtafR~W~ " lR'
Calling the center. ~<<cMi~trlft~one .rso..
nurneer for the Ore91cm W.~n J- .QU
Center I. l~)vee -c:.-m
TOTAL Shared Drive(T:)lBuilding FonnsIElectrical PermitAP~~? ~~oc
A. (\ \~0
~\)-/ \\~\j ~~cP'\'"
2. ; CONTRACTOR INSTALLATION ONLY
Electrical Contractor &W\ D Z-.l~, ~
Address Q,57 '()or-\-tr.;tdqe.-:> ~
City ~d
Phone '/;)'kr~ho/
Supervisor License Number <-Jf? 7 'f..5
Expiration Date /0/7
'/
Constr. Contr. Number d 0 ;-:S~ 7 G
cc. ett I ~I t:t I
Expiration Date / ?!JJ/d~
Signature of Supervising Electrician
~!1
/ ~'-.J
City
Phone
Inspection Request: 726-3769
~t~
~~@o
$50.00
B. Services or Feedcrs -Installation, Alterations or Relocation:
\ $1Q flD,6)
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/Volts
Nrfrfe!: Only
; J~g=~~mPrnriF'THE WORK
COMM~'(JRe/S'Ai~_" IS NOT
ANY1bB~Wfm ABANDONED FOR $ 50.00
201 Amps to ~/IM1f'S $ 69.00
401 Amps to 600 Amps $100.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
aver 600 Anlps or 1000 Volts see "B" above.
D. . .8ranch Circuits
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Permit $ 3.00
E. Miscellaneous (Service/f~eder not _inclIJded) -Each Installation
#
Receipt No: 2200700000000001135 l'
Line Items:
Job/Journal Numb Tran Cod
COM2007-01048
COM2007-01048
COM2007-01048
COM2007-01048
Payments:
Method
Check
'"
<
1004
2099
1099
1098
Paid By
MICHAEL LANNING
Transaction Log
For Date: 07/16/2007
np~CI.wtion
Perm Serv/Fdr 200 amps or less
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Received
'Rv
Check
Nil
dib
3503
Page 10 of 16
''\,
7/20/2007
9:05:50AM
City of Springfield
Development Services Department
Public Works Department
Revenue Account No
Amount Paid
$70.00
$3.50
$5.60
$7.00
$86.10
224-00000-426102
100-00000-425605
821-00000-215004
224-00000-426605
Line Item Total:
Annroval #
How
~rwl
In Person
$86.10
$86.10
Amount Paid
Payment Total:
,
cTransactionLog,rpt