HomeMy WebLinkAboutPermit Electrical 2006-2-6 (2)
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SPRiNCFIEL.D ~ri.'t.Nil:q:'
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225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number Con< J{oo" - 000"14 Date;J. - .r,. - 0 Co
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I. '."LOeAT10NOEINSTALI.ATION"""'"i!!c"~'-:'Ji
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LEGAL DESCRIPTION
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JOB DESCRJPTION
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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.
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;~COIVTR.ACT6RINSTALIiATIONONLY~'"
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Electrical Contractor ~r j\<i..J fl f(l ill
Address fJo Box 91Z ~
1 II (hi 'L 953-67~
City(re:~L)(, 't l~fl~one/i4Jr7ttl-~
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Expiration Date
tftvO)
/()-OI-07
Supervisor License Number
Constr. Contr. Number /?;.: 7 ~
Expiration Date 1!- tK-07
S;~ir;]JJ;ts
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Owners Name
Address
City Phone
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oWNd1T~~6~PIRE IF THE WORK
i'ZEO IDER lHIS PERMIT IS N01
The in.s q\\Op~ . i8'f1~l./Vf..t:twfIOO'D which
1S not m l~r I e or rent. .
80 DAY P ,
Owners Signature:
Inspection Request: 726-3769
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~ ~]~Ji]~J!~~Jj;~:~~€;~~~;if~~B~E~~~l}Xi~~~~IT~~~Th
Servioe Induded
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereol"
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
I
$50.00 t:;/).-
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B. f:Senices iiYFeedeioS"-.::ilnslallalioii;-Alterritions 'oi\Relo'ca tion:"'"'
j.l>t:';';~;~:%~;:;::;ii;;,;,!~t;;'';;;~~':::'':':::~~;'i:$-;';;:4;1;'-1\f:.:&''''~.s.:.:.-.i~::...~;;"ro:i.~;:.:/N~-t't.:;.;:!)..~:;,~..{tii:,'~:~
200 Amps or I...
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIV OIls
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c. $11~gi~&i~[€:i~~~~!~~~~~~~~~I~~$*~fl~~~~~~~1
Installation, Alteration or Relocation
200 Amps or less $ 50.00
20i Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
~ 6.'!l Aml'~"~~}oo!?''y~lls s,::~" ":.~ve. ,_._ __"_' .
D. [i~~E#~st!iftl~:~;~J1~~~;~~fJ~~~~j;i~i(~;;~I~~t~~~}x1lG~i\~m:\
New Alteration or Extension Per Panel
One Circuit $ 43.00
ATlFach.-tdditional Circuit or with
fo"o~~~;:F~P1:ifilil requires ,,~.. ._ $ 3.00
. . .. '. u,~., c1uuprea by tile . ;.:-
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. E. ;"MiSCeiian'eO~(SlirnCeJfeidef,iiot>incli1ded '''Eac!iJiislallatio;I':;
In O. .;:L~'-"""'~71_1'J_.o'I.;t("::.t~~~'M""-'-':O":-:" 'rir~'; :-.::J',....'.:':-'I.V.-'..__.-.~:,~~_-. . ,.'~,,;,-._ ,......' ,.~....~...;.:.
.- ~~..."",. V I. "uu:..J'ff iXn -'~ ,,~"_."~,,_..- .._"-- .0- -" .~
0090. You ma" "hI-" _ 952-001_
calli Pump or irrigatib'i\ Copies of the p ,100 h'J $ 50.00
r I~ (, II=! ("'onrcr, ft.l....... I .,
IlUm,Si~Oulline I:ightinge: t le telephnno $ 50.00
1Jt:' I.or the On?"'nr. I 1t;I~h ' ,
Lun.tcd Eii!;IWlResl<lenl1ii1 Not/fiCa/inn $ 25.00
v,,", Ilt;"s 1-81l0~3~~ M
Limited Energy/Comrilercial~4). $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. ~~fI~~{Mg~[tl~~f~l~~
50.
.if.
5.
5er. -
8'10 Slate Surcharge
10% Administrativc Fee
TOTAL
Shared Drive(T:)lBuHding fonnsIEJec:tri<:;d Permi1 Applic::alion 1-U3.doc
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· 225'I<'lfth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
~
~
~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
2200600000000000174
Date: 02/06/2006
2:38:37PM
Job/Journal Number
COM2006-00094
COM2006-00094
COM2006-00094
Description
Manufactured Home Service
+ 8% State Surcharge
+ 10% Administrative Fee
Received By
Ikw
Item Total:
Check Number Authorization
Batch Nnmber Number How Received
4 035922 In Pcrson
Payment Total:
Amount Due
50.00
4.00
5.00
$59.00
Payments:
Type of Payment
CreditCard
Paid By
BEAR MTN ELEC
,
Amount Paid' '
"
$59.00
$59.00
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2/6/2006
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