Loading...
HomeMy WebLinkAboutPermit Electrical 2011-3-14 225 Fifth Street. Springfield, OR 97477.PH(541)726-3753.FAX(541)726-3689 iW'." -;f'....':.':'-.;,)<'=...~,."...'>.;>:-'~!.'._.:i,~~~.~;i.".";;;.!iI~~. .:u;.~.:'<I.~..'(~~:.. }~i1d2;~r~R;;tJI~~!J1!,~~!'tt~ Date: .\4.. \ This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ~~r:~~~lt:bG~L!G-O'v:EBNMENJl;~P.RBQv:.A:~~~ Zoning approval verified? DYes D No ~~~B1~!MiE;G~ORy!i1Q~&!;;.QN$)l1B!!!.G.:l1lp:N_~~ o Residential I 0 Goverrunent I 0 Commercial ~~QB\!l$I$E~IN!iQBiiiI~mi()NrANDllI!!Q(;;;\I1I.C:!Nr~iti lob site address: II '-\1 ~n C'\ ~t". '/1)1 City:....~\ ~ r\ I State:N ___ ZIP~1A1' Subdivisi~:\ 11fi) <0.. ~() Lotno[) ~i r ~~~~ll[jE;_$RIBll1!~N{O~VvQB.J:<~~~ \l.1I .\- .V~ _~on)\t"o J , ~~~~~eB.O~ER.'ii;y;[O,\/VNE~1-~!1t~*&~ Name: 1___\ <::;.( €..J \)n,'Jr..,. / Address: "\"1.C\"\. \('2..- ~_'^" ~-' n \ City:'\("'\\.. ~~ I State: f"\~ :J I ZIP:Q'14.1<iS Phone: '- \.: ~rt, f'ln . ^ .A-I.......' E-mail: .IV\.. This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: ~~C.(;jNjJj~G;t(ijB!!!INS!tP\l!~~l1IQN_~~;~\1W Business name: r-:;'!.L <; -t- l.cili"i: rJ':. d.4;C .-,...., .... Address: 'Kf'iZJ97 ~"z5?t- L l'?V;Ll . City~,.(;:"_ T' .J I State:o..c I ZIP: 9"7,/)Jf Phonx;3Y!<:rr,t;- '7P<.'3 '71 F~9'f ).y,~ -02.96/ E-mail:.sq'~'4.A~ ~"",.:/YG /H-S~' ~'V; CCB licen~e no.: /77'-Y/hl BCD license no.: C.~ ':?L I Signiog supervisor's liceose no.: 717'70--S:' Print name of signing supervisor: 4,/A<iVP'e h1 ....s-~: ' . Signature of signing supervisor: ~~- ~, '--z'/' ~H~[';:~MIT SHALL EXP~ T~~ '~ef{f ce:= AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED f~ . ANY 180 DAY PERIOD. }~ ~, 440-2584-J (9/08/COM) ~""~"'~F.....EE. %S"''''E..D';''i'E' ~"""'-'i;-"..,,,,,,,,,,;;,,,,",> ~~~~i~ff~ ,};., ___~ C;J;!, _ :_lJ._C: j.i~1'EE.:!;""?.1LJl:,!f.-P$~~ :l"'~II;y"&~'-',""1!\'i!Wt~.~,""'""!lj i'";\,~"'riG..tl..I[{:~ ',", .Numb.)"ipfiinspeCtio~~\P_elllliemW)~ .QrY' i t.~~." ,~Qt.at~ ~}~~~~l:I~~},:.~~>i: ,.~R:; i!J.~ - co,s ~ 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 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) \ $ 81.00 $??\ .a:J 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect oniy (2) $ 63.00 $ Temporary services or feeders: installation. alteration, relocation 200 amps or iess (2) 20 I to 400 amps (2) 401 to 600 amps (2) $ 63.00 $ $ 87.00 $ $126.00 $ Over 600 amps or ] ,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit I $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch ~'~;~N: Oreg n raw rlea?,Il\l,. $ Each additiotblo!ifill'<lt~ff . 'oy hl$ Clr.BID '{iijtj1;~, Miscellanenu~~tl.g'itIfi'lql'll.,... ~e set forth Each pump o~OOtal co~ iet 91'IW..t~S=-UU1. Eacl>sign or oull~ifu!l(JbJe Or~' ",U:E J~l@Jteie ~ne-' Signal circuit or a limite!r-~ ~ 0-3 2ils~'~~1/ c~tlon alteratlOn, or extensIOn (2) ......". Each additional inspection: (I) $58.00 $ ~~gRP..lll:C:j'gRjI~i)'fs~~~'" (A) Enter subtotai of above fees (Minimum Permit Fee $58.00) (8) Enter 12% surcharge (.12 x [A)) (C) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through C): $f)\SXO $ {; ."1'1 $ l. . r-~ $(1 ^ - 1 \\" . SI~RIN.GF.IE~.... Iii L~. OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541~726-3753 www.ci.springfield.or.us 811-SPR2011-00411 7797 1/2 MCKENZIE HWY permitcenter@ci.springfield.or.us RECEIPT NO: 2011000479 [OESCRIP..1JON1;ki'; "'1:~7~ .~;. Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of pennit total) "'cc RECORO NO: 811-SPR2011-G0411 OATE: 03/1512011 "ggg" '~ug;ACJ;hUNJ~QOOE";"L"t';" ,.t;" AMOUN)"J;lUE, 224-00000-426102 81,00 821-00000-215004 9,72 100-00000-425605 4,05 TOTAL DUE: 94,77 COMMENTS', ;;,:LTC- "i~IT":; '':;JAM(jUNrPAII')~R 94.77 j <h>~.. ...-:-_< [PAYMENT TYPE" ';;:;':;PAYO~' cAsHlefl:L1'OPPER - '-~ Credit Card FIRST LIGHT ELECTRIC INC T1412Z "'''~'::.:;& 'I TOTAL PAID: 94.77